bluuebunny/crossref_metadata_2025 huggingface dataset:
(091) THE PREDICTIVE EFFECT OF ALEXITHYMIA IN RELATION TO IMPULSIVITY IN INDIVIDUALS WITH AND WITHOUT COMPULSIVE SEXUAL BEHAVIOR DISORDER
Authors: Do Espírito Santo Gonçalves P , De Tubino Scanavino M
Published: December 2024

Introduction

There is a consensus among researchers on the main characteristics of compulsive sexual behavior disorder (CSBD): impaired control of behavior; clinical suffering; continuity of sexual behavior despite significant impairment in important areas in the person’s life. Previous studies already show the connection between alexithymia and CSBD, as well as impulsivity and CSBD.

Objective

This study investigated the predictive effect of alexithymia in relation to impulsivity in individuals with and without CSBD.

Methods

Cross-sectional, observational and exploratory study, with a sample of 451 participants. Of these, 324 (71.8%) individuals with CSBD and 127 (28.1%) controls. They completed the Barratt Impulsivity Scale (BIS-11) and Toronto Alexithymia Scale (TAS - 26) questionnaires. Exclusion criteria were participants who met diagnostic criteria for paraphilic disorders (DSM-5685), gender dysphoria (DSM-5451), schizophrenia spectrum and other psychotic disorders (DSM-5 87), current hypomanic or manic episode of mood disorder (DSM-5123), neurocognitive disorders (DSM-5591) and other mental disorders (DSM-5707).

Results

In the univariate linear regression which dependent variable is impulsivity, and the independent variables are the four factors of the TAS - 26: TAS Factor 1 – Difficulty identifying and describing feelings and distinguishing feelings from bodily sensations; TAS Factor 2 – difficulty in daydreaming (fantasizing); TAS Factor 3 – Focus on external events rather than internal experiences; TAS Total score. The variables that presented a p value of up to 0.20 and were subsequently included in the multivariate regression model: presenting CSBD (β = 15.41; p-value = <0.001); TAS Factor 1 (β = 0.84; p-value = <0.001); TAS Factor 2 (β = -1.14; p-value = 0.0001); TAS Factor 3 (β = 1.87; p-value = <0.001); TAS Factor 4 (β = 0.67; p-value = 0.096) and TAS Total Score (β = 0.63; p-value = <0.001). The following variables with independent associative effects were observed, namely: TAS Factor 1 (β = 1.36; p-value = <0.001), TAS Factor 3 (β = 1.85; p-value = <0.001) and TAS Total score (β = −0.92; p-value = 0.008).

Conclusions

The study confirmed that alexithymia is associated with impulsivity, the more alexithymic the person is, the more impulsive behavior they will present.

Disclosure

No.
(106) SURGICAL OUTCOMES OF PLICATION TECHNIQUES IN SEVERE PEYRONIE’S DISEASE
Authors: Zandoná P , Pedrenho R , De Bessa J , Barbosa C , Goes P , Valente Coimbra I , Pato E , Nahas W , Hallak J , Nascimento B
Published: December 2024

Introduction

Surgical techniques for Peyronie’s Disease (PD) exhibit varying profiles of advantages and disadvantages concerning outcomes such as shortening, postoperative erectile dysfunction, risks, and satisfaction.

Objective

The objective of this project is to present the surgical outcomes of plication techniques in patients with severe PD.

Methods

This observational cohort study was conducted at a tertiary hospital involving Peyronie’s Disease patients. Following comprehensive discussion on technical alternatives, patients who underwent penile plication techniques were retrospectively analyzed pre-, intra-, and postoperatively. Penile length was measured from the pubic symphysis to the tip of the glans, with stretched flaccid penis (SFPL). Curvatures were assessed using a goniometer. Perception and discomfort regarding shortening and residual curvature, as well as penetration capability, were evaluated through interviews conducted by a team member other than the surgeon. Improvement in sexual life post-treatment and satisfaction rates were assessed by direct questions, including a 0-10 scale.

Results

A total of 48 plication procedures were performed between November, 2017 and December, 2022, with preoperative and intraoperative objective data available for all procedures. Complete follow-up data were available for 20 patients, with an average follow-up period of 20.4 months. Overall, the mean age was 61.9 years (SD 10.3). The mean intraoperative curvature was 54.15 degrees (SD 15.58), decreasing to 10.54 degrees (SD 5.87) following plication. During follow-up, 55% (11/20) of patients reported perceiving some residual curvature, causing discomfort only for 18% (2/11) of them. Penetration capability post-surgery was 95% (19/20), with the only exception being related to rigidity issues. Mean erectile function (0-10 scale) was 7.36 (SD 1.46) preoperatively and 7.26 (SD 2.25) postoperatively. Mean stretched flaccid penis lenght was 13.8 (SD 1.51) preoperatively and 13.71 (SD 1.3) after plications. 75% the patients reported noticing penile shortening, although only 26% of them referred being bothered with it. Average sexual frequency increased from 2.78 (SD 3.43) times per month preoperatively to 6.78 (SD 5.4) postoperatively. All patients (100%) reported improvement post-surgery and expressed willingness to undergo the procedure again. The mean satisfaction score (0-10) was 8.8 (SD 1.47).

Conclusions

In this sample of patients with severe PD, our results demonstrate that plication techniques, chosen after comprehensive technical discussions, yield satisfactory objective, functional, and subjective outcomes.

Disclosure

No.
(115) THE IMPACT OF VACUUM ERECTION DEVICES USE ON PENILE DOPPLER ULTRASOUND READINGS AND INTRACORPOREAL INJECTION DOSAGE INPATIENTS FOLLOWING PELVIC SURGERIES
Authors: Khalaf Alla K , Mahdi M , Majzoub A , Jacob J , Slovacek H , Wang R
Published: December 2024

Introduction

Vacuum erection devices (VEDs) are believed by many to play an integral role during penile rehabilitation following pelvic surgery through enhancing penile blood flow, length preservation and assisting in achieving penile erection.

Objective

Our aim is to investigate the influence of VEDs usage on penile doppler ultrasound (PDU) readings and the dose adjustments of ICI therapy in men following pelvic surgery.

Methods

We conducted a retrospective review of our institution’s database to identify patients experiencing erectile dysfunction as a result of pelvic surgery. The study involved individuals from a single institution who visited the Sexual Medicine clinic, underwent PDU, utilized Trimix ICI, and had a follow-up for a minimum of one year. Our investigation comprised data gathered from 127 patients meeting these outlined criteria between 2020 and 2022. Patients were categorized into two groups: Group 1 comprising individuals using VED with ICI for a duration of at least 1 year (minimum of at least 3 times per week) & Group 2 without VED. Student T-test was used to compare various numerical variables between both groups.

Results

In general, out of the 127 patients included, 20.3% were diabetic, 50.8% were hypertensive, 18% had radiation therapy & 14% had Androgen deprivation therapy. B blocker intake was reported in 18% of patients. With regards to surgery type, 46.1% underwent bilateral nerve sparing prostatectomy, 35.9% underwent partial nerve sparing while 4.7% had a non-nerve sparing technique. Cystoprostatectomy was observed in 5.5% while the remaining 7.8% had other pelvic surgeries. Results of the patient demographic and clinical parameters along with the PDU readings between both groups are reported in Table 1. Notably, no statistically significant differences were observed between both groups in terms of age, HbA1c, Testosterone levels, PDU readings, or in relation to the alterations in the ICI Trimix dosage.

Conclusions

Our initial analysis indicates that the use of VED in the rehabilitation of patients following pelvic surgery does not influence erectile function status measured by PDU readings or Trimix ICI requirements in the post-operative period. While counseling patients aboutVED usage in conjunction with Trimix injections lacks substantial supporting evidence, theoretically, it might play a role. Additional studies are necessary to definitively ascertain its significance, moving from its current indeterminate status.

Disclosure

No.
(120) TUNICA ALBUGINEA FLAP IN FEMINIZING SEX REASSIGNMENT: A NEW VARIATION OF THE PENILE SKIN INVERSION TECHNIQUE
Authors: Rocha RI , Silva THCD , Paiva OG , Cintra Junior W
Published: December 2024

Introduction

Feminizing sex reassignment has been shown to be an effective method for treating gender dysphoria, and inversion of the penile skin is the most common method for creating a neovagina.

Objective

The present study proposes a new variation of the original technique, using a tunica albuginea tissue flap that is fixed to the ischium, providing support and containment for the local tissues.

Methods

A cavity is created between the rectum and the bladder, where the inverted penile skin will be positioned to line the neovagina. After the penis is removed and the corpora cavernosa exposed, a rectangular band of the tunica albuginea tissue is attached to the pubis. This flap is fixed with slight traction bilaterally to the ischium, on the lateral walls of the cavity created in the space anterior to the rectum. The urethra and neoclitoris are exteriorized through the midline of the flap.

Results

The use of the tunica albuginea of the corpora cavernosa allows for better containment of the urethral bulb, provides support for the urethral meatus, and improves the aesthetic appearance of the vulva by deepening the groove between the labia majora.

Conclusions

The vulva created is aesthetically similar to that of a cisgender woman and the vaginal canal, after undergoing a postoperative dilatation regimen, will be able to accommodate penetration.

Disclosure

No.
(126) RELEASE OF 6-NITRODOPAMINE AND 6-CYANODOPAMINE FROM HUMAN CORPUS CAVERNOSUM, CORPUS SPONGIOSUM, TUNICA ALBUGINEA AND THE BULBOSPONGIOSUS MUSCLE
Authors: De Miranda Cará A , Lorenzon F , Caliano Mathias-netto F , Placco Araujo Glina F , Glina S , Paiva O , Fregonesi A , Cintra Júnior W , Itocazo Rocha R , De Nucci G
Published: December 2024

Introduction

The novel catecholamine, 6-nitrodopamine (6-ND), promotes relaxation of rabbit corpus cavernosum, acting as selective dopamine D2-receptor antagonist, indicating that the modulation of corpus cavernosum smooth muscle tone may primarily depend on the balance of dopamine and 6-ND release and synthesis. 6-Cyanodopamine (6-Cya) is a novel catecholamine that is released from rabbit isolated heart and found in the circulation of patients with chronic kidney disease.

Objective

To investigate the release of new endogenous catecholamines from penile human tissues.

Methods

Human penile tissues were obtained from 13 patients (mean age: 45 years old) who had undergone male-to-female gender reassignment surgery. All the patients had used androgen blockers and estrogen treatment for at least two years before the surgery. The release of 6-nitrodopamine and 6-cyanodopamine in Krebs–Henseleit’s solution was quantified by liquid chromatography coupled to tandem mass spectrometry (LC–MS/MS). The method was applied to investigate the basal release of these novel catecholamines from human corpus cavernosum (CC), corpus spongiosum (CS), tunica albuginea (TA) and the bulbospongiosus muscle (BSM). To assess the NO involvement in the synthesis and the neural source of this molecules, the tissues were incubated for 30 minutes with NO synthase inhibitor N(ω)-nitro-L-arginine methyl ester (L-NAME-100 μM) and the voltage-gated sodium channel blocker tetodrotoxin (TTX-1 μM), respectively.

Results

6-ND was detected in HCC using liquid chromatography–tandem mass spectrometry. Incubation with L-NAME significantly reduced 6-ND levels (0.6 ± 0.2 vs. 0.4 ± 0.4 ng/mL; n = 8), whereas incubation with TTX did not affect 6-ND release (n = 6). The 6-ND was also detected in the CS (2.1 ± 1 ng/mL; n = 8), TA (0.4 ± 0.2 ng/mL; n = 4), and BSM (0.6 ± 0.5 ng/mL; n = 4), and its release was not affected by pre-incubation with TTX, indicating that the source of this molecule is not neurogenic. 6-Cyanodopamine was detected in the CC (0.4 ± 0.2 ng/mL; n = 8), TA (0.4 ± 0.2 ng/mL; n = 4) and BSM (0.3 ± 0.3 ng/mL; n = 4). In the CS, 6-Cya was not detected. Similar to 6-ND, the release of 6-Cya was not affected by pre-incubation with TTX. Furthermore, tissues pre-incubated with L-NAME showed no difference in the levels of 6-Cya compared to basal levels.

Conclusions

The results indicate that 6-nitrodopamine and 6-cyanodopamine are the predominant catecholamines detected in the basal release from human corpus cavernosum, corpus spongiosum, tunica albuginea and bulbospongiosus muscle. Whether 6-cyanodopamine modulates HCC tonus remains to be investigated.

Disclosure

No.
(127) PREVENTIVE EFFECTS OF PTERORHACHIS ZENKERI HARM (MELIACEAE) IN TESTOSTERONE PROPIONATE-INDUCED BENIGN PROSTATIC HYPERTROPHY IN WISTAR RAT
Authors: Watcho P , Bonsou Fozin GR
Published: December 2024

Introduction

Benign prostatic hypertrophy (BPH) is an androgen-dependent and age-related disease which significantly affects the patient’s life. BPH can lead to a number of symptoms for patients commonly referred to as lower urinary tract symptoms including obstructive and irritative disorders as well as complications such as renal failure and sexual disorders. In addition, medical health care remains problematic due to therapeutic limits such as the cost, the accessibility and the side effects.

Objective

The aim of the present study was to assess the preventive effects of the aqueous (62 mg/kg) and methanolic (10 mg/kg) extracts from Pterorhachis zenkeri (P. zenkeri) on testosterone propionate-induced benign prostatic hypertrophy in rats.

Methods

Adult Wistar rats were randomly partitioned into groups of 5 rats each and treated with one of the following: distilled water (10 ml/kg)/soja oil (1 ml/kg), testosterone (10 mg/kg), aqueous extract (62 mg/kg), methanolic extract (10 mg/kg), testosterone plus bicalutamide (5 mg/kg) plus aqueous extract (62 mg/kg), testosterone plus bicalutamide plus methanol extract (10 mg/kg) during 2 or 4 weeks. At the end of the treatment periods, body and prostate related weights, biochemical, histological, histo-morphometrical and oxidative stress parameters were comparatively measured.

Results

Testosterone propionate induced a significant (p < 0.001) increase in the size and relative weight of ventral prostate, plasmatic level of prostate specific antigen (PSA), length of prostate epithelial cells and prostate structural damages. Additionally, the levels of prostatic dihydrotestosterone and, plasmatic nitrogen monoxide and malondialdehyde were increased whereas the activity of superoxide dismutase was decreased. Administration or co-administrations of P. zenkeri extracts with bicalutamide time-dependently prevented the above-mentioned damages through its anti-androgenic and anti-oxidant properties.

Conclusions

The bioactive compounds present in P. zenkeri extracts could justify the reported findings. Present results therefore suggest that P. zenkeri could be a good candidate in the management of BPH.

Disclosure

No.
(130) ASSOCIATION BETWEEN CARDIOVASCULAR DISEASE AND RISK OF FEMALE SEXUAL DYSFUNCTION: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Dilixiati D , Ruotong C , Yishen M , Yuting L , Dilimulati D , Azhati B , Rexiati M
Published: December 2024

Introduction

Female sexual dysfunction (FSD) is a considerably underestimated condition. It has been repeatedly reported that patients with cardiovascular diseases (CVD) may suffer from an increased risk of FSD. However, there is still a lack of comprehensive and systematic evaluation of various CVD and FSD.

Objective

We aimed to elucidate the association between CVD and FSD through a comprehensive literature review and meta-analysis.

Methods

The PubMed, Scopus, Embase, and Cochrane Library databases were systematically searched from inception to February 28, 2023. We identified all relevant studies reporting the risk of FSD in subjects with or without CVD. The associations between CVD and the risk of FSD were assessed by calculating pooled ORs (cross-sectional studies) and RRs (longitudinal studies) with 95% CIs. We employed random-effects models to account for potential heterogeneity, and the quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS). Fifty-four articles with 148 946 individuals were included in our meta-analysis.

Results

Compared with control subjects, subjects with CVD had a 1.51-fold increased risk of FSD (OR 1.51 95% CI, 1.34-1.69, P < .001, heterogeneity I2 = 91.4%, P < .001). Subgroup analyses indicated that the association between CVD and FSD remained significant in longitudinal studies (RR 1.50 95% CI, 1.21-1.86, P < .001, heterogeneity I2 = 86.7%, P < .001). Particularly, hypertension (OR 1.41 95% CI, 1.23-1.62, P < .001, heterogeneity I2 = 82.7%, P < .001), stroke (OR 1.81 95% CI, 1.54-2.12, P < .001, heterogeneity I2 = 0%, P < .423), and myocardial infarction (OR 2.07 95% CI, 1.60-2.67, P < .001 heterogeneity I2 = 82.4%, P < .001) were significantly associated with FSD. Meta-regression revealed that the primary sources of heterogeneity in FSD are attributable to adjustments for covariates, study design, and study population.

Conclusions

Our meta-analysis indicated that patients with CVD suffer from a greater risk of developing FSD. Meanwhile, we validated these findings in longitudinal queues. Notably, conditions such as hypertension, stroke, and myocardial infarction demonstrated a significant association with the incidence of FSD.

Disclosure

No.
(150) SATISFACTION AFTER PENILE PROSTHESIS IMPLANT IN PATIENT WITH PSYCHOGENIC ERECTILE DYSFUNCTION
Authors: De Rocco M , Silva Garreton A
Published: December 2024

Introduction

The penile prosthesis implant is a therapeutic tool widely used today for the treatment of erectile dysfunction refractory to treatment with oral, intraurethral, vacuum and/or intracavernous therapies. On some occasions we can find patients whose erectile dysfunction has a mainly psychogenic cause, making these patients a therapeutic challenge when deciding whether they are potential candidates for a penile prosthesis.

Objective

Describe our population of patients with erectile dysfunction of psychogenic cause to determine the satisfaction obtained with the implantation of a penile prosthesis, and compare them with patients who undergo penile implant for erectile dysfunction of organic cause.

Methods

The medical records were reviewed and did a follow up to complete an ad hoc questionnaire to describe the characteristics of the population with erectile dysfunction due to psychogenic causes, which included the questions GAQ-1 (Did your erections improve?), GAQ-2 (Are you more confident to initiate sexual relationship?), SEP-2 (Were you able to penetrate your partner?) and SEP-4 (Did you experience a satisfactory sexual relationship?) among others. Moreover, the QolSPP questionnaire (Quality of Life and Sexuality with Penile Prosthesis) was applied for the comparison between patients with erectile dysfunction of psychogenic cause and those patients with organic cause.

Results

The group of psychogenic patients answered affirmatively the GAQ-1 question in 96% of the cases, in 92% the GAQ-2 question, in 92% the SEP-2 question, and in 95% the SEP-4 question. In addition, 96% of them responded that they were satisfied with the penile prosthesis and the average satisfaction score was 8.71/10 points (5-10 points). The QolSPP questionnaire showed statistically significant differences between both groups in favor of the psychogenic group (N = 25) compared to the organic group (N = 36) in 8 of the 16 question domains, most of them related to the satisfaction and well-being with the prosthesis. Complications occurred in 16% of patients in the psychogenic group and in 2.8% in the organic group.

Conclusions

The results show a significant satisfaction with the use of a penile prosthesis in patients with erectile dysfunction due to psychogenic causes. However, we have observed a particular tendency to present greater complications in this group of patients.

Disclosure

No.
(153) CORRELATION BETWEEN SELF-AWARENESS OF PEYRONIE’S DISEASE AND CLINICAL DIAGNOSIS: A CROSS-SECTIONAL STUDY
Authors: Cavalcanti Filho M , Monteiro L , Lattanzi C , Fernandes G , Lemos C
Published: December 2024

Introduction

Peyronie’s Disease (PD) is a connective tissue disorder characterized by the growth of fibrous plaques within penile tissues. These plaques lead to various symptoms, including pain, acquired curvature, erectile dysfunction, indentation, narrowing, shortening, palpable plaques, and axial instability of the penis. These conditions can be together or isolated. PD becomes more prevalent with age and is estimated to affect 1–20% of men.

Objective

The objective of this study is to investigate the correlation between self-awareness of Peyronie’s Disease and clinical diagnosis during physical examination.

Methods

In our cross-sectional study, we examined men experiencing sexual dysfunction, focusing on their awareness of Peyronie’s disease. Participants were asked a direct question about their knowledge of the disease, with “yes” or “no”. A subsequent physical examination by a urologist confirmed the presence or absence of Peyronie’s disease. We divided according to the reason for the exam into erectile dysfunction, Peyronie’s disease and erectile dysfunction with Peyronie’s disease. All statistical and graphical analyses were performed using RStudio. This study provides insights into the correlation between patients’ awareness and the actual diagnosis of Peyronie’s disease.

Results

We evaluated 170 men from January to April 2024. Among them: A) 78 men had physical evidence of Peyronie’s Disease (PD) during the physical examination. B) 45 men self-reported awareness of having PD and presented with physical signs during the examination. C) 33 men had PD based on the physical examination but were unaware of this condition. The chi-squared test indicates that self-awareness of the presence or absence of PD is significantly related to the physical examination results (p < 0.001).

Conclusions

Our findings revealed association between patients’ awareness of their condition and the confirmed clinical diagnosis, and another part of patients has a significant unaware of Peyronie diagnosis, demonstrated the important of physical examination with specialist.

Disclosure

No.
(156) THE IMPACT OF RELIGIOSITY ON SEXUALITY IN PROSTATE CANCER PATIENTS
Authors: Silva I , Naccarato A , Souza L , Barbuio ME , Denardi F , Matheus W , Ferreira U
Published: December 2024

Introduction

The Prostate Cancer (PCa) and its treatments side effects have repercussions on self-image by encompassing cultural, symbolic, social, and economic aspects present in the male identity construction. Psychosocial interventions are associated with the reduction of emotional stressors by allow patients to talk about their experiences, sensations, sexuality and return to everyday life despite of the limitations that the treatment imposes. Sexuality is approached not only as a sexual function, but also its culture values that make it up. It is unclear, until the present moment, how religion can interfere in the sexuality and sexual approach.

Objective

Evaluate the impact of religiosity on the sexuality in PCa patients, who went through radical prostatectomy, radiotherapy, androgen deprivation therapy and/or active surveillance and take part in a psychoeducational therapy group.

Methods

Application of a six questions questionnaire addressed to the patients, from their own perceptions, that includes their sexual desire, partner’s and self-satisfaction, how the partner reacts to the patient’s sexual side effects after treatment, how patient’s and partner’s religion interferes with sexual intercourse, with or without penetration.

Results

The questionnaire was applied in a group with 7 patients, 6 of whom were Catholic and 1 Evangelical, 2 did not have steady partners. All the seven patients recognized that their religion did not interfere in sexual intercourse. However, the religion of the partner interferes in sexual intercourse with penetration for one patient, and for two patients without penetration.

Conclusions

Although religiosity is part of social and cultural values, it has not been shown to interfere with the sexuality and sexual intercourse of the patients evaluated. The religiosity of their partners, on the other hand, showed some influence in 3 of the 7 patients evaluated.

Disclosure

No.
(164) EXPLORING FEMALE SEXUAL PREFERENCES WORLDWIDE: GYNEPHILIA, NON-HETEROSEXUALITY AND FLUIDITY
Authors: Camperio Ciani AS , Colledani D
Published: December 2024

Introduction

Social influences and a lack of clear self-awareness might hinder women from openly disclosing their non-heterosexual orientation. Implicit methods may offer more dependable data in such cases.

Objective

This study explored non-heterosexuality and gynephilia in a large, worldwide sample of women, using both implicit and explicit methods. Implicit measures would exhibit consistency across different cultures, while explicit measures were anticipated to vary due to social influences.

Methods

A total of 491 women were recruited via an online platform to partake in this cross-sectional study. Each participant, expressed consent to partecipate, completed a brief biographical questionnaire, the Autobiographical-Implicit Association Test (A-IAT), the Sexual Preference-Implicit Association Test (SP-IAT), and an explicit measure of sexual orientation. These responses were analyzed to investigate explicit sexual orientation and implicit gynephilia across six major geographical regions (Middle East and Africa, South America, North America, Asia, Europe, and Oceania). In the subsequent phase, 263 participants completed a new implicit sexual orientation measure (Autobiographical Sexual Orientation-Implicit Association Test, ASO-IAT) and provided information on their sexual behaviors through two questions. Additionally, participants were asked about their subjective assessments of the stimuli presented in the SP-IAT.

Results

Implicit measures revealed a higher prevalence of gynephilia (67.8%) compared to explicit non-heterosexuality (19.6%), with consistent findings observed across continents. These results imply that women may experience attraction towards other women even if it doesn’t always translate into a desire for sexual encounters. Furthermore, the findings indicate a notable degree of sexual fluidity within the female population.

Conclusions

Compared with explicit assessments of non-heterosexuality, implicit measures appear to be less influenced by social factors. However, while androphilia is a prerequisite for non-heterosexuality in men, gynephilia is not necessarily a proxy of non-heterosexuality in women. Women also reveal a greater propensity for sexual fluidity than men.

Disclosure

No.
(166) SERUM TESTOSTERONE LEVEL AS A PREDICTOR OF BIOCHEMICAL RECURRENCE IN MEN WITH PROSTATE CANCER
Authors: Mulhall J , Elshafei A , Flores J
Published: December 2024

Introduction

The literature has engaged in a discussion regarding the potential connection between total testosterone (TT) levels and biochemical recurrence (BCR) in individuals diagnosed with prostate cancer (PC).

Objective

We herein explore the relationship between preoperative TT levels and the BCR rates in these men.

Methods

We retrospectively reviewed the records of 1599 men with PC treated by RP. We excluded men who had androgen deprivation therapy (ADT) prior to RP or within 3 months after RP from the study. Morning TT levels measured by LCMS within 3 months of RP with low TT defined as <300 ng/dl. BCR defined by two consecutive postoperative prostate specific antigen (PSA) levels of ≥0.1. Univariate analysis (UVA) was used to examine predictors of BCR. Variables included in the analysis were age, comorbid conditions pretreatment PSA, clinical T stage, biopsy GG, peri-operative TT, and adverse pathological features at RP (extracapsular extension (ECE), seminal vesical invasion (SVI), positive surgical margins (PSM), lymph node invasion (LNI)). Multivariable analysis (MVA) was conducted using those factors found to be significant on UVA.

Results

1599 men analyzed. Median age 63 (57, 68) years, median follow up of 62 (18115) months. Pre-RP PSA 6 (4,9) ng/ml, TT 447 (343, 575) ng/dl. Median GGG 2 (2, 3). 57% had ECE, 12% SVI, 22% PSM, 14% LNI. BCR occurred in 26% of men with a median time of 28 (5.7, 66.6) months. On MVA, higher biopsy GGG, clinical stage ≥T2b, higher pre-RP PSA, and adverse pathological features at RP were independent predictors of BCR, while peri-operative TT (≤300 ng/dl) was not associated with BCR. (Table) Additionally, we did not identify any association between extremely low TT levels (≤200 ng/dl) and BCR.

Conclusions

TT was not associated with biochemical recurrence in men after RP.

Disclosure

No.
(167) CONTEMPORARY HIGH-LEVEL RADIATION THERAPY PROSTATE CANCER TRIALS MAY UNDERESTIMATE THE RISK OF BIOCHEMICAL RECURRENCE
Authors: Mulhall J , West M , Flores J
Published: December 2024

Introduction

Prostate specific antigen (PSA) is an important tool for the diagnosis of prostate cancer and detection of biochemical recurrence (BCR) after treatment. Secretion of PSA is a testosterone (T) dependent process. When T levels are below saturation point, PSA levels may be artificially low. T recovery rates after ADT cessation are variable and often fail to normalize. Recent data suggest that PSA levels should be indexed to T levels. The Radiation Therapy Oncology Group (RTOG, now NRG) has performed numerous clinical trials of radiotherapy (RT) with androgen deprivation therapy (ADT) in this population. Herein, we explore whether the RTOG trials have indexed post-treatment PSA to T levels.

Objective

The clinicaltrials.gov (CTG) website was reviewed for RT/ADT clinical trials run by the RTOG/NRG over the past decade. For studies with results, manuscripts were reviewed; for the others the CTG protocol was reviewed. Demographic, oncologic, and treatment characteristics such as age, baseline PSA, Gleason grade, and length of treatment were collected if available. Data were reviewed assessing for mention of T measurement at time of post-treatment PSA checking, as well as assay suggested and time of day adherence for T measurement.

Methods

The clinicaltrials.gov (CTG) website was reviewed for RT/ADT clinical trials run by the RTOG/NRG over the past decade. For studies with results, manuscripts were reviewed; for the others the CTG protocol was reviewed. Demographic, oncologic, and treatment characteristics such as age, baseline PSA, Gleason grade, and length of treatment were collected if available. Data were reviewed assessing for mention of T measurement at time of post-treatment PSA checking, as well as assay suggested and time of day adherence for T measurement.

Results

15 clinical trials that met the study criteria were identified (Table). 14 029 patients have been enrolled. Median age was 64 (IQR [interquartile range] 2.5) years, median PSA was 0.5 (IQR 3.8), median Gleason grade group was 2 (IQR 1). 6/15 (40%) made no mention of T measurement whatsoever. None of the manuscripts published to date reported any T levels. One study had T recovery after ADT in the CTG results. Only 4/10 (40%) protocols stipulated that T should be measured concurrently with PSA, for an overall 27% T measurement performance rate. Only 1 protocol stipulated the type of assay and time of day (morning) measurement. 9/15 (60%) did not require regular follow up testosterone measurements for patients on ADT, while only 2/15 (13%) studies required a baseline T level to be measured.

Conclusions

Routinely indexing testosterone to PSA levels after high level RT/ADT trials is uncommon. This renders the BCR data unreliable, potentially underestimating BCR rates in these trials.

Disclosure

No.
(172) AN ANALYSIS OF THE EFFICACY OF MULTILAYERED REPAIR AND RECONSTRUCTION USING COMBINED TISSUE PEDICLE FLAPS FOR ABDOMINAL WALL DEFECTS IN ADULT BLADDER EXSTROPHY PATIENTS
Authors: Dilixiati D , Azhati B , Waili A , Li W , Reheman A
Published: December 2024

Introduction

Classic bladder exstrophy (CBE), an exceedingly rare congenital anomaly, is frequently accompanied by a profound and severe manifestation of genitourinary malformations. Classic bladder exstrophy has persistent deleterious effects on the urinary, reproductive, and sexual health of patients, which, if not managed judiciously, can culminate in renal impairment, infertility, and sexual dysfunction due to inadequate treatment.

Objective

In this study, we conducted a retrospective analysis of cases involving adult classic bladder exstrophy(CBE) accompanied by the absence of the abdominal wall. Specifically, we focused on the utilization of multilayer flaps for reconstructive purposes. Additionally, we aimed to share our clinical treatment experience pertaining to similar challenges, thereby providing valuable insights to complement the surgical management of this rare disease.

Methods

We conducted a retrospective analysis of 12 adult patients diagnosed with CBE who underwent initial treatment between June 2013 and January 2020. All patients underwent multi-layer reconstruction to address their abdominal wall defects. This involved utilizing shallow flaps derived from the superficial fascia of the abdomen and incorporating myofascial flaps composed of the anterior sheath of the rectus abdominis and aponeurosis of the external oblique muscle. The flaps size ranged from (9 cm × 11 cm) to (13 cm × 15 cm).

Results

Abdominal wall reconstruction in the 12 patients with CBE resulted in an absence of wound dehiscence recurrence, urinary obstruction, or urinary tract infection. All patients expressed satisfaction with the aesthetic outcome of their abdominal wall based on self-evaluation. They reported a successful resumption of normal life and work activities without experiencing any restrictions. The married patients expressed contentment with their sexual function.

Conclusions

The utilization of a multi-layered reconstruction technique involving multiple flaps in adults with congenital classic bladder exstrophy allows for successful restoration of urinary function, as well as the attainment of sufficient abdominal wall strength to support daily life and work activities, while preserving sexual function. However, it is important to approach the evaluation of surgical outcomes with caution due to the rarity of this condition and the lack of objective assessment measures.

Disclosure

No.
(175) SEXUAL HEALTH IN THE ERA OF ARTIFICIAL INTELLIGENCE: A REVIEW OF THE LITERATURE
Authors: Abou Chawareb E , Lu S , Chen H , Lee J , Hammad M , Miller J , Azad B , Yafi F
Published: December 2024

Introduction

Artificial Intelligence (AI) has witnessed significant growth in the field of medicine, leveraging machine learning (ML), artificial neuron networks (ANNs), and large language models (LLMs). These technologies have found applications across various medical specialties, proving effective in disease diagnosis, education, and prevention, while raising ethical concerns and potential challenges. However, their utility in sexual medicine remains relatively unexplored.

Objective

In this review, we aim to provide a comprehensive summary of the current status of AI in the field of sexual medicine.

Methods

A comprehensive electronic search was conducted using MeSH keywords, including “artificial intelligence (AI),” “sexual medicine,” “sexual health,” and “machine learning.” Two investigators screened articles for eligibility within the PubMed and MEDLINE databases, with conflicts resolved by a third reviewer. Articles in the English language that reported on AI in sexual medicine and health were included. A total of 49 full-text articles were systematically analyzed based on predefined inclusion criteria. Data extraction included information on article characteristics, study design, assessment methods, and outcomes.

Results

The initial search yielded 554 articles relevant to AI in sexual medicine and health. Upon assessing the full text of 56 articles for eligibility, seven studies unrelated to AI in sexual health were excluded, resulting in 49 articles for systematic review. The analysis revealed AI’s accuracy in preventing, diagnosing, and decision-making in sexually transmitted diseases (16 of 17 articles). AI also demonstrated the ability to diagnose and offer precise treatment plans for male and female sexual dysfunction and infertility (10 of 10 articles), accurately predict sex from bone and teeth imaging (5 of 5 articles), and correctly predict and diagnose sexual orientation and relationship issues (17 of 17 articles). AI emerged as a promising modality with significant implications for the future of sexual medicine.

Conclusions

Further research is essential to unlock the potential of AI in sexual medicine. AI presents advantages such as accessibility, user-friendliness, confidentiality, and a preferred source of sexual health information. However, it still lags behind human healthcare providers in terms of compassion and clinical expertise.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Sprout.
(176) ADVANCING SEXUAL HEALTH: PROSPECTION OF ARTIFICIAL INTELLIGENCE FOR DIAGNOSIS, TREATMENT, AND COMMUNICATION
Authors: Tunes De Paula A , Mazoni Costa R , Ferreira Arantes Da Costa T , Nunes De Brito D , Kretli Santos L , Luiza Mendonça De Amorim A , Eduardo Fernandes Tavora J
Published: December 2024

Introduction

Sexual dysfunctions, particularly erectile dysfunction (ED), significantly affect individuals’ quality of life. Advances in artificial intelligence (AI) provide promising tools for enhancing diagnosis and treatment in this sensitive field. By improving interactions between patients and providers, AI applications could transform approaches to sexual health, offering more precise and effective communication.

Objective

The aim of this study is to assess the feasibility, accuracy, and patient trust in AI tools for managing sexual dysfunctions. This involves analyzing various AI technologies such as machine learning, neural networks, and deep learning, examining their application across different types of sexual dysfunctions including erectile dysfunction and desire disorders, and evaluating their effectiveness and accuracy.

Methods

A systematic review was conducted, sourcing articles from the last five years using PubMed with keywords tailored to capture the intersection of AI with sexual health diagnostics and treatments. Terms used included “Artificial Intelligence,” “sexual dysfunction,” “erectile dysfunction,” “sexual health diagnosis,” “machine learning,” and “deep learning.” Articles from the last five years, in English, were included.

Results

Eleven studies met the inclusion criteria and were analyzed. AI tools displayed high diagnostic accuracy, with models providing in-depth analysis of ED-related queries. The accuracy of epidemiological information was consistent across evaluations. Treatment information, while generally reliable, showed variability in reproducibility and was often presented at a level too complex for the general population. Notably, AI models such as ChatGPT versions 3.5 and 4 demonstrated superior performance in clarity and depth of response compared to other tools like BARD, with statistical significance.

Conclusions

AI’s integration into the management of sexual dysfunctions offers significant potential to enhance both diagnostic processes and patient communications. AI-driven platforms, particularly newer models of ChatGPT, deliver accurate and repeatable results that are instrumental in addressing patient queries. Continuous improvement is essential to ensure the readability and accessibility of AI-generated content, thereby broadening its utility across diverse patient demographics. This study highlights the ongoing need for advancements in AI to align with evolving patient requirements in sexual health care.

Disclosure

No.
(186) IDENTIFYING PREDICTORS OF BONE DENSITY LOSS IN MEN WITH LOW TESTOSTERONE
Authors: Flores Martinez J , Ljubetic BM , Liso N , Mulhall JP
Published: December 2024

Introduction

Bone density loss (BDL), is associated with low testosterone (T).

Objective

We aimed to identify predictors of BDL in this cohort of patients.

Methods

The sample included (i) men ≥50 years old (ii) with low total T levels (<300 ng/dL using LCMS on 2 early morning blood draws) (iii) who had dual-energy X-ray absorptiometry (DEXA) within 6 months of T measurement. Men with prior T therapy were excluded. On DEXA, osteopenia was defined as a T score − 1.1 to −2.5, osteoporosis T score lower than −2.5. Additionally, demographics and comorbidity data, diabetes, sleep apnea, coronary artery disease (CAD), hypertension, dyslipidemia and smoking status were collected. We report rates and attempt to define predictors of any BDL using multivariable analysis (MVA), including age, comorbidities ≥3 (yes), and total T levels ≤100 ng/dL (yes).

Results

512 men were analyzed, mean age of 65 ± 5 years. Median total T was 223 (175, 262) ng/dL, free T 4.5 (2.8, 7.9) ng/dL, and estradiol 17 (13, 23) pg/mL. 6% had a total T ≤ 100 ng/dL. Median number of comorbidities was 2 (1, 3). 57% hypertension, 57% dyslipidemia, 40% reported OSA, 24% had diabetes, and 8% reported CAD. 34% of the men had ≥3 comorbidities. 44% were former or current smokers. BDL was present in 36% of the patients. 91% had osteopenia, and 9% had osteoporosis. On MVA, significant predictors of BDL were older age, presence of ≥3 comorbidities and the presence of total T ≤ 100 ng/dL (Table 1).

Conclusions

In our cohort of men with low T, one third had BDL, and we have identified key predictors of this occurrence, older age, higher number of comorbidities and profoundly low T.

Disclosure

No.
(192) RISK FACTORS FOR ERECTILE DYSFUNCTION IN DIABETES MELLITUS: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Dilixiati D , Waili A , Tuerxunmaimaiti A , Li W , Zebibula A , Rexiati M
Published: December 2024

Introduction

Previous studies have established that diabetes mellitus (DM) markedly raises the risk of developing erectile dysfunction (ED). Despite extensive investigations, the risk factors associated with ED in diabetic men have yet to be unequivocally determined, owing to incongruent and inconclusive results reported in various studies.

Objective

The objective of this systematic review and meta-analysis was to assess the risk factors for ED in men with DM.

Methods

A comprehensive systematic review was conducted, encompassing studies published in the PubMed, Scopus and Embase databases up to August 24th, 2023. All studies examining the risk factors of ED in patients with DM were included in the analysis. To identify significant variations among the risk factors, odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were employed. The risk of bias was evaluated using the Newcastle-Ottawa Scale for longitudinal studies and the Agency for Healthcare Research and Quality Scale for cross-sectional studies.

Results

A total of 58 studies, encompassing a substantial participant pool of 66 925 individuals diagnosed with DM, both with or without ED, were included in the meta-analysis. Mean age (OR: 1.31, 95% CI = 1.24-1.37), smoking status (OR: 1.32, 95% CI = 1.18-1.47), HbA1C (OR: 1.44, 95% CI = 1.28-1.62), Duration of DM (OR: 1.39, 95% CI = 1.29-1.50), diabetic neuropathy (OR: 3.47, 95% CI = 2.16-5.56), diabetic retinopathy (OR: 3.01, 95% CI = 2.02-4.48), diabetic foot (OR: 3.96, 95% CI = 2.87-5.47), cardiovascular disease (OR: 1.92, 95% CI = 1.71-2.16), hypertension (OR: 1.74, 95% CI = 1.52-2.00), microvascular disease (OR: 2.14, 95% CI = 1.61-2.85), vascular disease (OR: 2.75, 95% CI = 2.35-3.21), nephropathy (OR: 2.67, 95% CI = 2.06-3.46), depression (OR: 1.82, 95% CI = 1.04-3.20), metabolic syndrome (OR: 2.22, 95% CI = 1.98-2.49), and diuretic treatment (OR: 2.42, 95% CI = 1.38-4.22) were associated with an increased risk of ED in men with DM.

Conclusions

Our study indicates that in men with DM, several risk factors for ED have been identified, including mean age, HbA1C, duration of DM, diabetic neuropathy, diabetic retinopathy, diabetic foot, cardiovascular disease, hypertension, microvascular disease, vascular disease, nephropathy, depression, metabolic syndrome, and diuretic treatment. By clarifying the connection between these risk factors and ED, clinicians and scientific experts can intervene and address these risk factors, ultimately reducing the occurrence of ED and improving patient management. Keywords: Diabetes Mellitus, Erectile Dysfunction, Risk factors, Meta-analysis.

Disclosure

No.
(199) DO PEYRONIE’S DISEASE PATIENTS WITH CONCOMITANT DUPUYTREN’S CONTRACTURES RESPOND BETTER TO INTRALESIONAL INJECTION OF COLLAGENASE CLOSTRIDIUM HISTOLYTICUM?
Authors: Lumbiganon S , Nakamura H , Hammad M , Chawareb EA , Azad B , Lee J , Yafi F
Published: December 2024

Introduction

Dupuytren’s contractures (DC) are prevalent in men with Peyronie’s disease (PD). There is, however, limited data regarding the impact of DC on the efficacy of intralesional injection of Collagenase Clostridium Histolyticum (CCH) for the management of PD.

Objective

This study aimed to examine the demographics of patients undergoing CCH therapy for PD and compare the outcomes between DC and non-DC patients.

Methods

We conducted a retrospective chart review of PD patients attending a tertiary care men’s health center between October 1, 2017 and September 30, 2023. Demographic information, treatment modalities, and outcomes were systematically collected. A comparative analysis was performed between PD patients with and without DC.

Results

Among the 573 patients in this cohort, 43 with history of DC. Two hundred and ninety-two opted for CCH as first line therapy. One hundred eighty-seven patients had at least 4 cycles of treatment. Of those, 17 patients (9.1%) had a history of DC, and 170 (90.9%) did not. Mean ages were 66.7 ± 5.0 (DC) and 57.1 ± 11.3 years (non-DC), P < 0.001 (table 1). The pre-treatment composite degrees of curvature were 47.5 ± 14.4 (DC) and 43.2 ± 13.4 degrees (non-DC), P = 0.210. Number of injection cycles administered were 4.6 ± 0.9 (DC) and 4.6 ± 1.2 (non-DC), P = 0.904. Post-treatment, the composite degree of improvement was significantly higher in the DC group 29.3 + 12.8 degrees, 63.5 + 27.9 % improvement vs 20.8 + 13.9 degrees, 48.1 + 27.9 % improvement in the non-DC group, with a mean difference of 8.6 + 3.7 degrees (95% CI 1.4, 15.8; P = 0.020), and 15.5 + 7.3% improvement (95% CI 1.1, 29.9; P = 0.036).

Conclusions

Our study suggests that the concomitant presence of DC is a predictor of better response to intralesional injection of CCH in men with PD. Despite the limited sample size and the retrospective design, these findings merit further exploration.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Endo.