bluuebunny/crossref_metadata_2025 huggingface dataset:
MIP4IBD: An Easy and Rapid Genotyping-by-Sequencing Assay for the Inflammatory Bowel Diseases Risk Loci
Authors: Verstockt Sare , Hannes Laurens , Jans Deborah Sarah , Deman Stephanie , Souche Erika , van der Werf Ilse , Vandermeulen Liv , Lobaton Triana , Laukens Debby , Verstockt Bram , Van Houdt Jeroen , Hoischen Alexander , Vermeire Séverine , Cleynen Isabelle
Published: December 2024

Background

Inflammatory bowel diseases (IBD) are polygenic, with many genetic variants contributing to disease risk. Knowing the genotype of specific variants or calculating a combined genetic risk score benefits translational and functional research. To address this, we developed MIP4IBD, a flexible and cost-effective genotyping-by-sequencing assay using molecular inversion probes (MIPs).

Methods

The assay targets 463 IBD risk variants, and 77 additional relevant variants. Molecular inversion probes capture and library preparation were optimized using 15 IBD DNA samples, comparing genotypes with immunochip. A custom GitHub pipeline was created for data processing, performance testing, and genotype calling. The final design was validated on a larger scale (149 IBD patients, 104 non-IBD controls, and 3 external cell lines), incorporating post hoc quality control criteria.

Results

The assay achieved a 3.5-day turnaround time at €15 per sample with optimal sample throughput, demonstrating a 92.6% success rate in variant capture and genotype concordance rates of 99.3% and 99.6% with Infinium Global Screening Array24 BeadChip and WGS, respectively. A downstream application involved the calculation of a weighted IBD polygenic risk score (PRS), which was significantly higher in IBD patients than controls (mean 0.42 vs −0.49, P = 1.95E−11). Individuals in the highest PRS quartile had a 15.7-fold (95% CI: 6.5-38.3) risk of developing IBD and an earlier age of onset (26 vs 37 years, P = 0.02), compared to the lowest quartile.

Conclusions

MIP4IBD is a validated, scalable genotyping assay targeting IBD risk loci, with an integrated bioinformatics pipeline from sequencing data to genotypes and PRS calculation. Its cost-effectiveness and flexibility for additional variants make it particularly appealing for translational and clinical applications.
Research on the mechanism of green industry investment to promote sustainable utilization of water resources
Authors: Jiang Juan
Published: December 2024

This study aims to deeply analyze how green industry investment can effectively promote the sustainable utilization of water resources. Firstly, we defined the concept, characteristics, and corresponding evaluation index system of green industry investment. Subsequently, through the comprehensive application of literature review, theoretical analysis, and empirical case analysis, we constructed a mechanism model to reveal the promoting effect of green industry investment on the sustainable use of water resources and verified it with relevant data. Meanwhile, this study emphasizes the critical roles of policies, technologies, and markets in the sustainable utilization of water resources. The empirical results indicate that investment in green industries has improved water resource utilization efficiency and strengthened water resource protection. Therefore, the policy recommendations proposed in this study have high practical significance for guiding the practice of green industry investment and sustainable water resource utilization in China.
COVID-19 Pandemic, Poverty and Health Outcomes in South Africa: Do Social Protection Programmes Protect?
Authors: Omotayo Abiodun Olusola , Ogunniyi Adebayo Isaiah
Published: December 2024

The COVID-19 pandemic resulted in significant income loss for many people and deepened poverty for individuals and vulnerable populations who were adversely affected through job losses. In South Africa, income loss made it harder to acquire health care and a healthy food, which had a negative impact on health outcomes. This study hypothesised that the COVID-19 shocks disproportionately affects the poor's health, hence the need to know the impact of social protection programmes and interventions through the South Africa Social Security Grant (SASSG). Herewith, we employed the nationally represented, robust and reliable National Income Dynamics Study (NIDS) data set which was conducted in 2017 (pre-COVID-19), with the first wave of the NIDS-Coronavirus Rapid Mobile Survey (NIDS-CRAM) conducted in 2021 (during COVID-19). The household's per capita total income was used to generate poverty lines, while concentration curves and indices were employed to explain the income-health inequalities. The difference-in-difference with fixed effects model was used to estimate the impact of SASSG on the COVID-19 poverty stressors and self-reported health status. Given the significance and magnitude of institutional variables in determining the socio-economic inequalities in poor health, addressing hunger, income inequality and unemployment slightly helped to mitigate income-health inequalities during the COVID-19 shocks. We found that the social protection intervention in South Africa (SASSG) cushioned the impact of the COVID-19 pandemic in the context of poverty stressors and self-reported health status. Therefore, we advocate for programmes in South Africa that focus on reducing poverty and health disparities connected to income, as well as more proactive social protection programmes.
Coping Strategies and Inequalities during the COVID-19 Pandemic Period: Evidence from Kenya
Authors: Giovanis Eleftherios , Ozdamar Oznur
Published: December 2024

Governments worldwide have implemented stringent lockdown measures in response to the COVID-19 pandemic outbreak, which had an adverse impact on employment, affecting people's public life, health and well-being. People have witnessed job losses, cuts in wages and a decline in their living standards. This study aims to estimate the inequalities and well-being costs, demonstrating the living standards necessary to make up for people's wage reduction or job losses. In particular, we aim to explore the coping strategies used to enhance their well-being compared to those of households without a coping strategy. We use food insecurity as a measure of well-being outcome. The empirical analysis relies on detailed household surveys from the World Bank Microdata Library. We use seven waves of the Panel COVID-19 Rapid Response Phone Survey with Households in 2020–2022 in Kenya. Also, the results highlight the potential inequalities of the COVID-19 pandemic across gender and types of workers, such as those employed in the informal sector and on temporary contracts. The findings show that specific coping strategies, such as delayed payment obligations, credit purchases and reduced non-food consumption, are associated with larger inequalities. Regarding the gender of the head of the household, the results suggest that the disparities between female-headed households that had to cope with income and employment loss and female-headed households that did not require to follow any strategy are significantly higher compared to their male counterparts. We derive similar concluding remarks when we consider households with social security coverage and the type of employment contract.
Characterization of UGT8 as a monogalactosyl diacylglycerol synthase in mammals
Authors: Ohba Yohsuke , Motohashi Mizuki , Arita Makoto
Published: December 2024

Monogalactosyl diacylglycerol (MGDG) is a major membrane lipid component in plants and is crucial for proper thylakoid functioning. However, MGDG in mammals has not received much attention, partly because of its relative scarcity in mammalian tissues. In addition, the biosynthetic pathway of MGDG in mammals has not been thoroughly analysed, although some reports have suggested that UGT8, a ceramide galactosyltransferase, has the potential to catalyse MGDG biosynthesis. Here, we successfully captured the endogenous levels of MGDG in HeLa cells using liquid chromatography quadrupole time-of-flight mass spectrometry (LC–QTOF-MS)-based lipidomics. Cellular MGDG was completely depleted in CRISPR/Cas9-mediated UGT8 knockout (KO) HeLa cells. Transient overexpression of UGT8 enhanced MGDG production in HeLa cells, and the corresponding cell lysates displayed MGDG biosynthetic activity in vitro. Site-directed mutagenesis revealed that His358 within the UGT signature sequence was important for its activity. UGT8 was localized in the endoplasmic reticulum and activation of the unfolded protein response by membrane lipid saturation was impaired in UGT8 KO cells. These results demonstrate that UGT8 is an MGDG synthase in mammals and that UGT8 regulates membrane lipid saturation signals in cells.
Host control by Acmispon strigosus constrains fitness gains of ineffective Bradyrhizobium symbionts in mixed infections
Authors: Wendlandt Camille E , Avelar-Barragan Julio , Zomorrodian Avissa J , Al-Moussawi Khadija , Porter Stephanie S , Sachs Joel L
Published: December 2024

Plant hosts can gain significant growth benefits from symbiosis with microbes, but these benefits could be threatened by divergent fitness interests among partners. Here, we measured fitness outcomes in symbiosis, by varying the genotypes of both microbes and hosts, to examine scenarios that might favour uncooperative symbionts. We studied associations between Acmispon strigosus, an annual legume native to California, and its nitrogen-fixing symbionts in the genus Bradyrhizobium. Bradyrhizobium symbionts form root nodules on compatible hosts, with strains varying from effective, fixing substantial nitrogen for the host, to ineffective strains that do not fix nitrogen and provide no benefit to host growth. We co-inoculated four A. strigosus plant lines with nine combinations of effective and ineffective Bradyrhizobium strains and measured the relative fitness of ineffective strains within individual nodules, as hosts must select against uncooperative symbionts to maintain benefits. In mixed infections, ineffective strains always had lower relative fitness in nodules compared to beneficial strains, consistent with efficient punishment of non-fixing rhizobia. However, ineffective strains exhibited genotypic variation in their fitness in nodules within individual nodules co-infected with a beneficial strain, suggesting a role for symbiont competitiveness in shaping this joint phenotype. Variation in symbiont fitness during co-inoculations did not measurably affect plant performance, suggesting that predicted conflict over the joint phenotype of rhizobia fitness has negligible effect on the host.
Genome assembly of the winter ant, Prenolepis imparis
Authors: Cash Elizabeth I , Ward Philip S , Escalona Merly , Sahasrabudhe Ruta , Miller Courtney , Toffelmier Erin , Fairbairn Colin , Seligmann William , Shaffer H Bradley , Tsutsui Neil D
Published: December 2024

The winter ant, Prenolepis imparis, is one of the most common, widespread, and conspicuous ant species in North America. P. imparis is well adapted to cold climates, and consequently, is often noted as the only active ant species during colder months. This specialized life history makes P. imparis a useful model organism for exploring thermal physiology and understanding the potential impacts of a warming climate on insects. Phylogeographic studies have revealed deeply divergent lineages across North America, as well as a single collection of an apparent social parasite in California. In light of its distinctive cold adaptation and recently discovered geographic diversity, a better understanding of the underlying genetic patterns of the winter ant is valuable to future conservation efforts for this species. Here, we present a high-quality genome assembly of P. imparis from Santa Clara County, California. This genome assembly consists of 787 scaffolds spanning 327.3 Mb, with contig N50 of 901.9 kb, scaffold N50 of 18.7 Mb, and BUSCO completeness of 96.5%. This genome assembly provides an essential foundation for future studies of the winter ant and will be particularly useful for understanding the genetic basis of thermal adaptation, cold resistance, chemical ecology, and the resilience of organisms in response to a changing climate.
Natural history of HPV-16 E6 serology among cancer-free men in a multicenter longitudinal cohort study
Authors: Shing Jaimie Z , Giuliano Anna R , Brenner Nicole , Michels Birgitta , Hildesheim Allan , Srivastava Sudhir , Sirak Bradley A , Schussler John , Liu Danping , Wang Wendy , Waterboer Tim , Kreimer Aimée R
Published: December 2024

Background

Human papillomavirus (HPV) type 16 E6 protein seropositivity accurately predicts oropharyngeal squamous cell carcinoma risk decades before diagnosis; but the biomarker’s translational potential is unknown. To inform considerations for oropharyngeal squamous cell carcinoma screening, we described HPV-16 E6 seroprevalence, predictors, and kinetics among cancer-free men.

Methods

In a cohort study in Brazil, Mexico, and the United States, we calculated HPV-16 E6 seropositivity (median fluorescence intensity > 1000), measured by multiplex serology, in cancer-free men. We assessed HPV-16 E6 seropositivity predictors using logistic regression, adjusting for country, age, sexual orientation, and lifetime number of sexual partners. Among HPV-16 E6 seropositive men, we retrieved all available retrospective serum samples and described temporal HPV-16 E6 antibody patterns.

Results

Of 3997 men, 14 had HPV-16 E6 antibodies detected (seroprevalence = 0.35%, 95% CI = 0.19% to 0.59%; median fluorescence intensity = 2407 [IQR = 1325-5986]). Older age was associated with increased odds of HPV-16 E6 seropositivity (50-84 years vs 18-29 years odds ratio = 16.61, 95% CI = 2.20 to 417.03). Serum from 11 of the 14 seropositive men retested positive; 6 men had median fluorescence intensity above 5000, of whom 2 had median fluorescence intensity greater than 10 000. Seven men had 3 or more years of follow-up; all were persistently seropositive for 3 years. One man was seropositive for 9 years but seroreverted at his exit visit. Oral HPV-16 DNA (prevalence = 1.13%) was associated with HPV-16 E6 seropositivity (odds ratio = 16.87, 95% CI = 3.35 to 69.55), but oral HPV-16 DNA positivity was not persistent over follow-up, even when HPV-16 E6 antibodies were persistently detected.

Conclusion

Although HPV-16 E6 seropositivity is rare, it is generally stable once detected; thus, HPV-16 E6 antibodies may be an informative biomarker of HPV-driven oropharyngeal squamous cell carcinoma. Few men seroreverted following HPV-16 E6 seropositivity but remained close to the seropositivity cutoff; thus, cancer risk among these men is less clear.
Presenting data the Significance way – part 4
Authors: Krause Andreas , Rennie Nicola
Published: December 2024

The final instalment of our data visualisation guide, created by Andreas Krause and Nicola Rennie for Significance and our sister platform Real World Data Science, offers authors a complete guide to creating the best data visualisation for the needs of both their article and Significance magazine
Defining Donaghadee
Authors: Gustar Andrew
Published: December 2024

Andrew Gustar describes how he built a profile of a town in Northern Ireland, as part of a Royal Statistical Society voluntary scheme
(154) MEN’S HEALTH AND THE LITIGIOUS PATIENT: A REVIEW OF MALPRACTICE CASES
Authors: Voleti S , Warren C , Ghaith S , Punjani N
Published: December 2024

Introduction

Recent literature suggests growing rates of malpractice claims against Urologists, with the incidence of being sued seeming to be unrelated to one’s professional reputation. These cases provide insight into errors that may lead to litigation. Given national trends of rising malpractice cases, estimates that a Urologist can expect to be sued at least twice in their careers are likely underestimates. Malpractice cases can give insight into the common medical errors rising to the level of litigation. Given the elective nature of procedures within sexual medicine, understanding litigation related to these cases is crucial.

Objective

We aim to analyze malpractice suits related to men’s health and highlight clinical presentations and legal outcomes.

Methods

Per STROBE guidelines, we searched the publicly available Thomson Reuters Westlaw legal database for “jury verdicts and settlements” from January 1970 to August 2023 to identify medical malpractice cases in Urology. Patient demographics, clinical presentation, alleged error, and legal outcomes were abstracted during full case review by an independent screener. Cases related to men’s sexual health or fertility that named a urologist as the defendant were fully analyzed.

Results

A total of 553 Urology cases were extracted, with 23 men’s health related cases subsequently analyzed and summarized in Table 1. The most common conditions associated with litigation were erectile dysfunction (penile prosthesis) (39%), epidydimal pathology (13%), and varicocele (13%). The most common allegations were misdiagnosis (26%), surgical complication (22%), lack of informed consent (22%), and violation of standard of care (22%). Of the 23 cases, 57% ruled “no liability” in favor of the urologist, 39% ruled in favor of the plaintiff with a median award of $335,000 (IQR = 100,000-450,000), and one was settled for $316,338. Among cases ruled as negligent, performing the incorrect procedure, surgical complications, and violating the standard of care were prominent allegations. Florida (26%) and Pennsylvania (17%) had the most cases in this sample. Of note, there were no cases for penile plication, plaque excision, microsurgical cord denervation, vasectomy reversal, or sperm retrieval, and only one for vasectomy.

Conclusions

This study characterizes malpractice cases related to men’s sexual health naming urologists as defendants. Despite fear of litigation, this review of the Westlaw database revealed only 23 cases related to men’s health since 1970. Moreover, the majority of cases ruled in favor of the Urologist. Obtaining comprehensive informed consent, following national guidelines, and responding appropriately to surgical complications may minimize likelihood of litigation and maximize patient outcomes.

Disclosure

No.
(155) IT CAN ONLY GET WORSE: AN ANALYSIS OF FACTORS IMPACTING ONLINE PHYSICIAN REVIEWS
Authors: Miller J , Ahmed Z , Hammad M , Gryzinski G , Chawareb E , Yafi F
Published: December 2024

Introduction

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

Objective

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

Methods

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

Results

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

Conclusions

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

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast.
(173) SINGLE SURGEON EXPERIENCE WITH RESERVOIR PLACEMENT DURING PENOSCROTAL INFLATABLE PENILE IMPLANT SURGERY, IS A COUNTER INCISION NECESSARY
Authors: Gheiler E
Published: December 2024

Introduction

Reservoir placement during penoscrotal inflatable penile implant surgery (IPP) can be done via the primary incision or through a separate lower abdominal incision. Surgeons that do routine secondary incisions state risks of vascular, bowel or bladder injury. There is a distinct advantage in avoiding a secondary incision in terms of pain, added surgical times and possible wound infections.

Objective

I decided to review my cases over the last several years to determine the number of times a counter incision was necessary and to determine the true incidence of such stated risk factors. To help young surgeons determine the risks of reservoir placement in a real-world experience.

Methods

IPP done between 2008 and 2023 were retrospectively reviewed to determine frequency of counter incision and rates of complications due to reservoir placement. All IPP were performed by a single surgeon utilizing the penoscrotal approach.

Results

A total of 4,589 IPP were performed, 4223 Virgin and 366 removal and replacement. The first 3778 cases had the reservoir placed in the space of Retzius the next 611 done ectopically and the last 200 by a medially placed submuscular approach. One (0.02%) case of bladder injury was identified in the early ectopic experience, treated with catheter placement and contralateral reservoir placement. In 8 (0.17%) patients the reservoir herniated and needed replacement. None in the new approach. No cases of bowel or vascular injury were encountered. New reservoir placement technique is achieved in less than 1 minute. None of the cases required a counter incision.

Conclusions

Reservoir placement during penoscrotal IPP without a counter incision, is an extremely safe and efficient technique. We should encourage the new generation implanters to properly learn this approach and not scare them with rarely seen potential complications.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific.
(177) FUSED DOUBLE-CYLINDER PENILE PROSTHESIS PLACEMENT AFTER PHALLOPLASTY WITHOUT URETHRAL LENGTHENING: A NOVEL TECHNIQUE USING A 2-PIECE IPP
Authors: Sandhu S , Dadashian E , Mallavarapu S , Smith S , Garcia M
Published: December 2024

Introduction

Transgender men (TM) undergoing phalloplasty commonly desire erections for sexual activity. All U.S. FDA-approved inflatable penile prostheses (IPPs) are designed for cisgender anatomy. There is no gold-standard IPP-insertion technique post-phalloplasty. For TM seeking phalloplasty who don’t prioritize urinating from their penis-tip, phalloplasty without urethral lengthening (P-UL) offers similar cosmetic and functional outcomes with significantly lower risk-profiles. Also, the absence of a neourethra within the shaft affords sufficient room for 2-cylinders, instead of just one.

Objective

To describe 1) Our technique for insertion of a 2-piece IPP in TM using a fused, double-cylinder technique, and 2) To evaluate our outcomes over a 6-year period.

Methods

1) Retrospective, single-center chart review of TM undergoing IPP insertion post-phalloplasty over 6-years. 2) We illustrate our technique for placement of 2-piece AMS Ambicor™ IPP using 2-cylinders, for TM post-P-UL (URL: https://youtu.be/9u7MMP0li4g).

Results

28 patients underwent 34 IPP-implants between April/2017-Oct/2023 (Mean Age = 40.8 years±13.8(SD). 17/28 (60.7%) patients underwent P + UL, and 11/28 (39.3%) underwent P-UL. All had ipsilateral testicle prosthesis implant beforehand. IPP implants used were AMS 700™ 3-piece (first 5/34 = 14.7%; all 1 cylinder), or AMS Ambicor™ 2-piece IPP (all subsequent 29/34 = 85.3%; [22/29 (76%) = 1 cylinder and 7/29(24%) = 2 cylinders). 2/34(5.9%) IPP’s required explant: infection, 1/38(2.9%); and traumatic-injury wound-dehiscence 3-weeks postoperatively: 1/38(2.9%). Our technique for 2-piece IPP insertion in TM after P-UL: (Fig. 1). Both cylinders fitted completely into a Dacron vascular graft is secured to Obturator ramus with 2-0 Ethibond sutures. The IPP pump fits into the explanted testicle site.

Conclusions

Our “2-cylinders in a single sock” technique has key advantages: 1. Pre-IPP ipsilateral testicle implant expands the neoscrotum, making a capsule-lined pocket to protect the pump; 2. The Dacron vascular-graft fuses and allows anchoring of both cylinders, increasing stability/reducing migration; 3. Two-cylinders yield a more symmetric-appearing, fuller erection (+17% erection girth); 4. Our small, 4-cm parascrotal incision provides adequate exposure, and maintains good cosmesis. The approach we describe here provides excellent functional and cosmetic results.

Disclosure

No.
(180) DOES PRE-VAGINOPLASTY BILATERAL ORCHIECTOMY COMPROMISE SCROTAL SKIN LENGTH USING A SINGLE MEDIAN RAPHE INCISION? DESCRIPTION OF OUR SURGICAL TECHNIQUE AND INTRA & POST-OP OUTCOMES
Authors: Stelmar J , Dadashian E , Mallavarapu S , Sandhu S , Smith S , Garcia M
Published: December 2024

Introduction

Gender-affirming bilateral orchiectomy (GABO) has many benefits pre-vaginoplasty including lowering required feminizing hormone-therapy dosage (presumably cardiac protective), immediate elimination of Testosterone production, and, reduced dysphoria. Though there is no gold-standard GABO technique, some have questioned whether GABO through a single median-raphe incision might reduce the net area of scrotal skin available at future full-depth vaginoplasty to line the canal.

Objective

We aimed to: 1) Compare intraoperative scrotal skin-graft measurements and postoperative neovaginal depth among vaginoplasty patients based upon pre-vaginoplasty GABO status; and 2) Describe our own single-incision technique for GABO.

Methods

A single-center retrospective chart review identified transgender women undergoing vaginoplasty with neovaginal canal using penile+scrotal skin between August/2017-May/2023. Subjects were grouped based upon pre-vaginoplasty GABO with median-raphe incision, vs. orchiectomy during vaginoplasty. We measured available scrotal skin before and during vaginoplasty (tubularized length). We describe our specific technique for simple bilateral orchiectomy using a scrotal median-raphe incision.

Results

57 patients were identified. 40/57 (70%) underwent bilateral orchiectomy at time of vaginoplasty (mean age 36.6 ± 12.6Y (SD)), while 17/57 (30%) underwent pre-vaginoplasty GABO (mean age 37.4 ± 12.8Y (SD)). Fig. 1 There was no statistically-significant difference in preoperative scrotal skin or intraoperative tubularized scrotal skin lengths. Our technique uses a 2.5 cm incision at the base of the penoscrotal junction, to deliver both testicles. After skeletonizing the spermatic cord, the entire cord is clamped as a single packet 2 cm from the external ring. A spermatic cord block is performed before the cord is suture-ligated twice with 0-Vicryl. Remaining hemostasis is secured with bipolar-Bovie. The skin is closed with a running 5-0 Vicryl. Mean operative-time = 29 minutes. (Full-video: https://youtu.be/t5fq-MrUKoY).

Conclusions

Our pre-vaginoplasty GABO technique using a single median raphe incision provides excellent access for high ligation and provides excellent cosmesis. We found no statistically-significant difference in net tubularized scrotal-skin length length or post-op vaginal depth across study groups. We offer pre-vaginoplasty GABO, by our technique, to all vaginoplasty patients facing a surgery wait-time of >4 months.

Disclosure

No.
(182) MALLEABLE PENILE PROSTHESIS IMPLANTATION UNDER LOCAL ANESTHESIA: SURGICAL TECHNIQUE AND EARLY EXPERIENCE
Authors: Mass Lindenbaum M , Harlamova D , Werneburg G , Bajic P
Published: December 2024

Introduction

Penile prosthesis (PP) is the gold-standard therapy for medication-refractory erectile dysfunction (ED) and traditionally is performed under general anesthesia. Subcoronal malleable penile prosthesis (MPP) implantation, which requires minimal dissection, can be performed under local anesthesia, particularly in patients with risk factors for general anesthesia, on anticoagulation therapy or antiplatelet therapy, or with a preference for local anesthesia.

Objective

We propose a technique of MPP implantation under local anesthesia and present two cases performed at our institution.

Methods

The surgical technique and details of the clinical cases are demonstrated in the video. Both patients received pre-operative analgesia with or without anxiolytic oral medication, an intra-operative block, and post-operative analgesia for two weeks. At 3-month and 1 month postoperative follow-up, respectively, both patients reported satisfactory results.

Results

The surgical technique and details of the clinical cases are demonstrated in the video. Both patients received pre-operative analgesia with or without anxiolytic oral medication, an intra-operative block, and post-operative analgesia for two weeks. At 3-month and 1 month postoperative follow-up, respectively, both patients reported satisfactory results.

Conclusions

MPP implantation under local anesthesia is a viable and safe option for patients who are unable or unwilling to undergo general anesthesia. Cessation of anticoagulation is not required via the subcoronal approach, and patients can reliably be discharged the same day without risks related to general anesthesia. A larger cohort and multi-center adaptation are necessary to fine-tune an optimal protocol for enhancing the patient experience with these cases.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast, Boston Scientific.
(190) VOICES OF VULVODYNIA: QUALITATIVE ANALYSIS OF PATIENT EXPERIENCES ON REDDIT
Authors: Grutman A , Perelmuter S , Perez A , Meurer J , Contractor M , Mathews E , Shearer K , Burnett L , Uloko M
Published: December 2024

Introduction

Although vulvodynia is a prevalent condition, diagnosis and effective treatment remain elusive. As a result, individuals with vulvodynia may turn to the internet for medical information and advice. Online peer support groups can therefore provide further insight into the experience of individuals with vulvodynia and highlight gaps in current health care delivery.

Objective

This study sought to evaluate content related to vulvodynia discussed on the popular internet forum Reddit. Unlike prior research on vulvodynia, this article captures the experiences of individuals with vulvodynia told in their own words.

Methods

The subreddits “r/vulvodynia” and “r/vestibulodynia” were selected for analysis in May 2023. Threads were sorted from most to least popular and data from the top 70 posts from each subreddit was extracted and analyzed. Qualitative analysis was used to identify themes and assess attitudes towards shared experiences.

Results

At the time of analysis, the “r/vulvodynia” and “r/vestibulodynia” subreddits had 7,245 and 685 members, respectively. Of all posts analyzed, 45.7% had positive valence. Of all analyzed threads, the most commonly identified discussions centered around symptoms (28.9%), treatments (28.8%), followed by sexual experiences (16.0%), erasure/disbelief (15.3%), representation/media (6.1%), and humor (5.1%). The core themes of treatments (57.1%), sexual experiences (53.2%), and representation (77.8%) had the highest proportions of positive attitudes in analyzed threads. The themes of erasure (58.3%), symptoms (57.6%), and disbelief (57.1%) had the highest proportions of negative attitude threads.

Conclusions

This is the first analysis of Reddit content related to vulvodynia. However, results are limited by the number of posts analyzed, an inability to access user demographics, and the study's cross-sectional nature. Findings reveal robust discussions on Reddit regarding vulvodynia. Analyzed content suggests that Reddit provides a unique forum for peer-to-peer caretaking in the form of advice, an outlet for frustration, and a means to find community through shared experiences.

Disclosure

No.
(199) INFLUENCE OF DIETARY HABITS AND HYDRATION ON ERECTILE HEALTH: A SURVEY STUDY
Authors: Abou Chawareb E , Hammad MA , Lumbiganon S , Azad BK , Yafi NR , Osman M , Yafi FA
Published: December 2024

Introduction

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

Objective

To investigates the potential role of diet and fluid intake on erectile dysfunction development and severity.

Methods

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

Results

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

Conclusions

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

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Sprout.
(219) THE IMPACT OF TRANEXAMIC ACID ON HEMOGLOBIN LEVELS AND OPERATING TIME IN AQUABLATION FOR BENIGN PROSTATIC HYPERPLASIA: PRELIMINARY RESULTS FROM A RETROSPECTIVE CASE–CONTROL STUDY
Authors: Eid N , Hillelsohn J
Published: December 2024

Introduction

Benign prostatic hyperplasia (BPH) is the leading cause of lower urinary tract symptoms in men. While transurethral resection of the prostate (TURP) has been the standard surgical intervention, new techniques like Aquablation are becoming more common. Aquablation utilizes a resective waterjet which avoids thermal tissue damage but has little coagulative effect during the active treatment cycle, and heat directed coagulation cannot be performed. Tranexamic acid (TXA) is known for its antifibrinolytic properties and is used in many surgeries to minimize perioperative blood loss. However, its effects on outcomes of Aquablation has not yet been studied.

Objective

The objective of this study is to determine whether the administration of TXA at the start of the Aquablation procedure reduces perioperative blood loss and impacts operating time, as evidenced by changes in hemoglobin levels and operating time.

Methods

We reviewed the cases of 20 patients who underwent Aquablation performed by a single surgeon (J.H.) between August 2022 and June 2024. Ten patients received TXA during the procedure (TXA group), and ten did not (non-TXA group). Patients were matched based on age, prostate size, and use of anticoagulants or antiplatelets. Preoperative hemoglobin (pre-Hgb) was recorded within 25 days before surgery, and postoperative hemoglobin (post-Hgb) was recorded on postoperative day 1 (POD1). Operating time was also documented. Statistical analyses included paired and independent t-tests to compare changes in Hgb and operating time between groups. Analyses were performed using SPSS 29 (IBM Corp., Armonk, NY).

Results

The TXA group showed a significantly smaller reduction in hemoglobin levels (mean change -0.51) compared to the non-TXA group (mean change -1.65), with a t-value of 2.58 and a p-value of 0.025. There was no significant difference in mean operating time between the TXA (52.3 minutes) and non-TXA (52.2 minutes) groups (p = 0.966).

Conclusions

Preliminary results suggest that TXA use in Aquablation for BPH is associated with a significantly smaller reduction in hemoglobin levels, indicating less blood loss during the waterjet resection portion of the case. There was no significant impact on operating time. These findings contribute to the ongoing study on the benefits of TXA in urologic surgeries. Future research with larger sample sizes and randomized controlled trials is necessary to validate these results.

Disclosure

No.
(221) PREDICTORS OF INTRA CORPORAL TRIMIX DOSAGE IN PATIENTS POST-PROSTATE CANCER TREATMENT USING PENILE DOPPLER ULTRASOUND READINGS AND CLINICAL PARAMETERS
Authors: Mahdi M , Majzoub A , Khalafalla K , Slovacek H , Jacob J , Wang R
Published: December 2024

Introduction

Intracorporeal injection (ICI) therapy is a well-established treatment for erectile dysfunction (ED), particularly after oral medications fail to produce satisfactory results. However, determining the optimal ICI dose can be challenging for patients, often leading to under dosing which results in suboptimal response or overdosing with an increased risk of priapism.

Objective

This study aims to explore whether pre-treatment clinical data and in-office penile Doppler ultrasound (PDU) parameters could guide ICI dosing for Trimix penile injections.

Methods

A retrospective chart review was done for patients with ED following prostate cancer treatment. 233 Patients who underwent PDU and then started a standard dose of Trimix ICI (Alprostadil 30mcg/ml, phentolamine 1 mg/ml, papaverine 10 mg/ml) with a minimum 6 months follow-up were included. Data regarding pre-treatment patients’ clinical parameters, PDU reading (dose of the procedure ICI, blood flow velocities, cavernosal artery diameter, plaques presence) and the initial and follow up doses of ICI Trimix (per unit, each 1 ml has 100 units) was retrieved. Pearson correlation coefficient was used to measure the linear correlation between the different variables of clinical parameters/PDU readings and the required dose of Trimix ICI at 3-6 months follow up visit.

Results

Table 1 presents the baseline clinical characteristics of the sample. Among the patients, 51.9% were hypertensive, 17.2% were diabetic. Additionally, 76.9% underwent radical prostatectomy or cystoprostatectomy, 24.5% had a history of radiation therapy, and 18% had undergone Androgen Deprivation Therapy. The required Trimix ICI dose during follow-up showed significant positive correlations with patient age (0.199, p = 0.003) and Hemoglobin A1c (HbA1c) levels (0.223, p = 0.04). Conversely, it exhibited a significant negative correlation with the initial clinical response (degree of erection) during clinic PDU/ICI (-0.04, P = 0.00) (Table 2). None of the PDU parameters correlated with the follow up Trimix dosage.

Conclusions

In patients with ED following prostate cancer treatment who require ICI therapy, the patient age, HbA1c and clinical response during clinic PDU/ICI can predict the required dose of ICI to induce a satisfactory erection. Using such clinical parameters can guide the urologists in prescribing the proper dose of ICI to achieve a satisfactory erection.

Disclosure

No.
(223) TOPICAL ADMINISTRATION OF MED3000 GEL SIGNIFICANTLY IMPROVES ALL ASPECTS OF THE SEXUAL ENCOUNTER PROFILE FOR BOTH MEN AND THEIR PARTNERS
Authors: Yafi FA , Honig S , Brock G , Fisher M
Published: December 2024

Introduction

There is a significant unmet need for an erectile dysfunction (ED) treatment that is efficacious and well-tolerated, works quickly, and facilitates intimacy. MED3000 is a, FDA-cleared, over-the-counter topical gel that is applied to the glans penis by the patient or partner.

Objective

To assess responses to MED3000 in men and their partners using the Sexual Encounter Profile (SEP).

Methods

MED3000 was tested in a 12-week, multicenter study that included patients with a clinical diagnosis of ED for >3 months according to the NIH Consensus Statement. Subjects or their partners were instructed to apply MED3000 immediately prior to sexual intercourse and were required to have at least 4 intercourse attempts in each of the three 4-weekly periods during treatment (weeks 1-4, 5-8, and 9-12). Subjects and their partners were instructed to complete the SEP after each sexual intercourse attempt. Mean percentages of subjects and partners answering yes at baseline and mean values and changes from baseline for each 4-week period and for the entire 12-week study were determined. Baseline results and those from the entire 12-week study were compared with paired t-tests. With Bonferroni correction, p < 0.005 was the accepted value for statistical significance. Efficacy analyses were conducted using all subjects who made use of the treatment at least once.

Results

A total of 250 subjects (mean age ± standard deviation (SD) = 46.8 ± 12.5 years, duration of ED = 27.5 ± 36.5 months, 59.2%, 28.0%, and 12.8% with mild, moderate, or severe ED, respectively) were treated with MED3000 and all were included in the analysis. For partners, 249 were White and 1 was Asian and the mean age was 43.4 ± 11.9 years. Use of MED3000 resulted in significant improvements in all 5 SEP questions for both subjects and partners over 12 weeks (Table 1). Improvements from baseline for all SEP Questions for both subjects and their partners achieved statistical significance by 4 weeks (P < 0.001). In addition, changes from baseline for SEP Questions 2 and 3 for men exceeded the minimum clinically important difference (MCID, 4 points) for these questions.

Conclusions

This multicenter study shows that use of MED3000 resulted in statistically significant improvement from baseline for all SEP questions for both subjects and their partners, including achievement of erections, insertion of the penis, successful intercourse, and satisfaction with hardness of erections and overall sexual experience.

Disclosure

Yes, this is sponsored by industry/sponsor: Haleon.

Clarification: Industry funding only - investigator initiated and executed study.
(225) INVESTIGATING RELATIONSHIPS BETWEEN MASTURBATION FREQUENCY AND SEXUAL DYSFUNCTION IN MEN UNDERGOING FERTILITY TESTING
Authors: Seyer A , Nolte D , Kenfield S , Belarmino A , Civello D , Smith J , Helo S
Published: December 2024

Introduction

Male masturbation is a scarcely discussed topic in male sexual health. In the context of trying to conceive, male masturbation may impact overall sexual function and ultimately fertility outcomes.

Objective

To evaluate the relationship between masturbation frequency and sexual function amongst men undergoing fertility testing.

Methods

We performed a review of a prospectively maintained database of men utilizing a mail-in semen analysis test system developed by Fellow Health, Inc. Men ≥18 years were included if they consented to participate in research and completed survey questionnaires on both their quality of life and sexual function. Men reported their typical weekly masturbation frequency (0, 1-2, 3-4, 5-6, or ≥ 7 times per week) as part of the sexual function questionnaire. Descriptive statistics were reported and chi-squared tests were used to determine statistical significance at the 0.05 alpha level.

Results

Of the 2,034 men included, most reported masturbating one to two times per week (41.2%). Nearly one-fourth (21.6%) reported never masturbating, and only 14.2% reported a frequency of more than four times per week. Mean semen volume did not differ significantly by masturbation frequency (p = 0.07). Of note, patients were instructed to abstain from ejaculation for 48 hours prior to sample collection. Men who reported masturbating most frequently (≥7 times per week) were least likely to report ejaculatory dysfunction (12.0% vs. 21.0% for all others combined; p = 0.04), but most likely to report orgasmic dysfunction (12.0% vs. 5.7% for all others combined; p = 0.02). Interestingly, men who reported masturbating most often (≥7 times per week) were both most likely to report having sex less than once per week and most likely to report having sex ≥7 times per week when compared to other strata of masturbation frequency.

Conclusions

Those with higher masturbation frequency also had better ejaculatory function, but worse orgasmic function. Men who masturbate most frequently (>7 times per week) were most likely to report having sex less than one time per week and also most likely to report having sex >7 times per week, which may be reflective of differences in libido in this group.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Fellow Health.
(233) FIRST SINGLE SURGEON SAFETY AND PATIENT SATISFACTION STUDY FOR THE NEW RIGICON INFLA10® INFLATABLE PENILE PROSTHESIS
Authors: Cinar N , Saribacak A , Atwater B , Gross M , Wilson S , Culha M
Published: December 2024

Introduction

Rigicon is a newer inflatable penile prostheses (IPP) manufacturer that has produced the Infla10® IPP for countries outside the United States (US) since 2019. Federal Drug Administration (FDA) studies for approval of Infla10® in the US are presently underway. This study aims to report the first efficacy and safety study of the newly available Rigicon Infla10® inflatable penile prosthesis (IPP).

Objective

This study aims to report the first efficacy and safety study of the newly available Rigicon Infla10® inflatable penile prosthesis (IPP).

Methods

A single surgeon’s first 58 patients who underwent Rigicon Infla10® IPP implantation between 2019 and 2023 were included. Most patients (70%) received the Infla10 X (girth expansion) cylinder, and 30% received the Infla10 AX (length and girth expansion) model. Follow-up ranged from 4 to 42 months (median 19 months).

Results

Reoperation was required in 5 patients (8.6%). Complication rates were 1.7% urethral erosion (n = 1), 1.7% infection requiring explant (n = 1), and 5% mechanical malfunction due to tubing breakage at pump junction (n = 3). The tubing issue was addressed by the manufacturer, resulting in no additional mechanical concerns. Kaplan–Meier analysis demonstrated rates of cumulative survival of the device at 12 and 24 months were 96.6% and 93.8%, respectively. Overall, 53 patients (91.4%) were satisfied and would recommend the procedure. Diminished satisfaction was due to perceived penile shortening in 3 patients (5.1%), and difficulty learning pump cycling in 2 patients (3.4%).

Conclusions

This single surgeon series demonstrates high rates of patient satisfaction with appropriate early safety from revision. While very new in the marketplace, the Infla10® IPP shows early comparable efficacy and safety from revision compared to competitive 3-piece devices previously available for decades.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Rigicon, Uramix, Coloplast, International Medical Devices.