bluuebunny/crossref_metadata_2025 huggingface dataset:
(205) 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.
(208) GLOBAL WEB TRENDS ANALYSIS OF SEX TOYS
Authors: Deger MD , Akgül B
Published: December 2024

Introduction

Pleasure is one of the most notable reasons people take part in sexual activity. Sex toys and devices may improve and broaden sexual pleasure while also adding alternatives and excitement to sexual intercourse. As a result, they are popular among women, men, and transgender individuals all around the world.

Objective

This study examined the trends about the most popular preferred sex toys by nation/region from 2009 using data from Google Trends (GT).

Methods

Since 2004, data on the global search traffic for a given Google query, including time period and category trends, has been provided by GT. GT can generate a “line graph” that displays how interest in a certain region has changed over time. The relative search volume (RSV), which ranges from 0 to 100, is used to index search values for certain terms. RSV 100 displays the largest search trends, while RSV 50 represents half of the searches. The top 5 sex toys used globally were chosen as search phrases. These were “dildo”, “vibrator”, “strap-on”, “anal plug” and “masturbator”. From 1 January 2009 to 30 June 2023, the data was included as “worldwide” under the “global” enquiry category. Using linear regression analysis, each polynomial trend line was evaluated. If the p-value was less than 0.05, the result was deemed significant.

Results

In the linear regression analysis, the trends by strength were sorted as follows: dildo, vibrator, strap-on, anal plug, and masturbator. In 2018, vibrator surpassed strap-on and came in second, while the regression analysis showed a positive trend for dildo between 2009 and 2016 (p = 0.014). It had a negative trend after 2016. Strap-on was the only one to have a downward trend (p = 0.029) Regression analysis revealed positive trends for vibrator and masturbator (p = 0.030, p = 0.045). The upward trends have continued uninterruptedly since 2009 (Table 1).In global trends, the dildo had strong trends in Northern Europe, vibrator in Eastern Europe, strap-on in the Aegean region, anal plug in South America, and masturbator in Central Europe (Fig. 1).

Conclusions

People from all around the world use the internet to acquire sex toys and devices with increasing interest in order to improve their sexual pleasure and add alternatives and excitement to sexual intercourse. In this sense, various industries can use web trends as a useful indicator for sales policies. Considering their compatibility with technological development, clinical use and side effect profiles, the most important trend increase was in favor of vibrators, followed by masturbators. Future studies should evaluate the balance of negative and positive effects of different types of sexual products and sales policies with objective scales in line with these results.

Disclosure

No.
(212) ASSESSING THE ROBUSTNESS OF SILDENAFIL CITRATE ORODISPERSIBLE FILMS: A MULTI-FACETED STABILITY STUDY
Authors: Jannini EA , Vignesh SO , Hassan T
Published: December 2024

Introduction

Sildenafil citrate Orodispersible film (ODF) is a novel formulation designed to better address the needs and expectations of men with erectile dysfunction (ED). Ensuring the stability of pharmaceutical products is crucial to maintain their efficacy, safety, and quality throughout their shelf-life.

Objective

This study aimed to perform a stress test on sildenafil ODF by exposing it to elevated temperatures (60 degrees Celsius) mimicking extreme storage conditions and evaluate its physical and chemical stability.

Methods

This test was conducted in Kyukyu Pharmaceutical Co., Ltd, Toyama Plant, Japan. A thin pale red colored ODF containing 50 mg sildenafil was formulated to dissolve in the oral cavity. Three batches of samples were subjected to a stability study at 60°C stress for three weeks. They were assessed for the amount of active pharmaceutical ingredient assay (95.0% −105.0% of labelled amount), degradation, disintegration, dissolution rate (over 80% for 45 mm) and water content.

Results

All test items met the specifications and showed negligible differences between the samples. The amount of degradation products demonstrated an increasing trend over time in all conditions, but all met the specification. The purity testing for degradation product (0.2% or less) showed significant (p value <0.05) at initial and 60°C in all the three samples.

Conclusions

The process was evaluated across a range of manufacturing conditions, and all intermediates and sildenafil ODF showed consistent performance that yields a consistent product meeting all specifications at release and after three weeks of storage under stressed conditions. These results indicate the robust performance of the sildenafil ODF across a range of manufacturing conditions. In addition, the water content stayed in a tight range regardless of the film casting parameters, and this remains true of the packaged product even after 3 weeks at 60°C.

Disclosure

Yes, this is sponsored by industry/sponsor: Kyukyu Pharmaceutical Co., Ltd, Toyama Plant, Japan and Viatris Inc.

Clarification: Industry initiated, executed and funded study.

Any of the authors act as a consultant, employee or shareholder of an industry for: Viatris Inc.
(220) EPIDEMIOLOGICAL PROFILE OF PATIENTS UNDERGOING PENILE DOPPLER ULTRASOUND AT A FEDERAL UNIVERSITY HOSPITAL IN BRAZIL
Authors: Fernandes Negris Lima V , Almeida G , Gamberini P , Milanez C , Fitaroni ML , Borges C
Published: December 2024

Introduction

Erectile Dysfunction (ED) refers to the inability to achieve or sustain a satisfactory erection for sexual intercourse. In Brazil, the estimated prevalence of ED among adults aged 40 to 70 years is notably high at 42.1%. For the evaluation of primary erectile dysfunction and preoperative assessment of Peyronie’s disease, Penile Doppler ultrasound, involving drug-induced and audiovisual self-stimulation, is recommended.

Objective

This study aims to provide insights into the epidemiology of patients undergoing penile Doppler ultrasound at a Federal University Hospital.

Methods

This retrospective study gathered data from the electronic medical records of 165 patients who underwent the examination between March 2021 and March 2023, using the Phillips Affiniti 50G device and erotic material for audiovisual stimulation. Pharmacological induction with 10 mcg/ml Alprostadil, 30 mg/ml Papaverine, and 1 mg/ml Phentolamine. Initially, 0.1 ml of this mixture was applied to the penile shaft, with subsequent adjustments made to achieve the best maximal erection.

Results

The participants ages ranged from 20 to 80 years, with an average of 59.8(±11,42) years. Marital status distribution showed 132 married and 33 were single. Ethnically, there were 57 white, 69 individuals of mixed race, and 39 black. The average Body Mass Index was 26.6(±4,13). The majority of patients identified as heterosexual (160 patients), while 3 homosexual, and 2 bisexual. Prevalent medical conditions included 51 cases of hypertension, 31 cases of diabetes, and 13 cases of both. Additionally, 62 patients had radical prostatectomy. Out of the 138 patients that performed the exam with the report of erectile dysfunction, 54 were diagnosed with arterial insufficiency and 09 had venous leakage. Among the 42 exlcusive clinical report of Peyronie’s, 6 patients were identified arterial insufficiency and 01 had venous leakage, 76% exhibited a uniplanar curvature, primarily located in the dorsal region. The average curvature angle was 47°(±19,5).

Conclusions

Erectile dysfunction was significantly more prevalent than Peyronie’s disease. Among Peyronie’s patients, uniplanar curvature, especially in the dorsal region, was the most common deformity type.

Disclosure

No.
(221) ERECTILE DYSFUNCTION: THE CANARY IN THE COALMINE OF MEN’S HEALTH AND IMPULSION IN PUBLIC POLICIES
Authors: Jannini EA , Vignesh SO , Hassan T
Published: December 2024

Introduction

The onset of erectile dysfunction (ED) is attributed to organic and nonorganic factors that can mirror the state of an individual’s general health. Public health policies have the potential to leverage ED as a marker for non-communicable diseases that burden healthcare systems worldwide. Recognizing ED as an early warning sign facilitates reframing of public health policies to integrate preventive strategies, screening, and education campaigns.

Objective

This study aims to address the interconnectedness of men’s health issues with ED to reduce morbidity and enhance men’s quality of life.

Methods

We developed an expert consensus on addressing ED within the framework of public health policy, which requires an understanding of its multifaceted etiology and implications. We reviewed the epidemiology of ED, its association with systemic health conditions, and the imperative for public health policymakers to prioritize men’s sexual health as a window to overall well-being.

Results

Public health policies must advocate for comprehensive sexual health education that demystifies ED and encourages early medical consultation. Policy interventions should make recommendations for incorporating ED screening into routine health check-ups, subsidizing treatment options to enhance accessibility, promoting public awareness campaigns on the link between lifestyle factors and ED, and strengthening mental health support systems that recognize the psychological impact of ED.

Conclusions

ED, as an early detector of potential health threats, provides a unique opportunity for public health practitioners to broaden the scope of men’s health initiatives. By harnessing the predictive value of ED for more severe conditions, public health policies can galvanize an integrative health movement that promotes longevity and well-being for men, ultimately serving the community at large. Public health policies that acknowledge the sentinel role of ED offer a strategic entry point for addressing systemic health concerns, thus improving outcomes for individuals and populations.

Disclosure

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

Clarification: Industry initiated, executed and funded study.

Any of the authors act as a consultant, employee or shareholder of an industry for: Viatris.
(230) A NEW TECHNIQUE OF MODIFIED PROSTATE W-POINT MASSAGE
Authors: Wang Q
Published: December 2024

Introduction

Palpation and fluid extraction of the prostate are necessary means for the clinical diagnosis of prostate diseases.

Objective

To introduce a new modified technique of Prostate W-point Massage(PWM) and explore its effectiveness in the diagnosis and treatment of prostate diseases.

Methods

A total of 200 patients with prostatic inflammation and hyperplasia were randomly divided into experimental group and control group. The patients in the control group were treated with traditional prostate massage method, the patients in the experimental group were massaged with the modified Prostate W-point Massage method (the massage path was similar to the letter W), to analyze the effectiveness of two massage techniques on the success rate of prostatic fluid extraction and the therapeutic effect of prostatic diseases.

Results

There was no significant difference between the two groups before massage (P > 0.05). The success rate of prostate massage fluid extraction in the experimental group was higher than that in the control group (p < 0.05), and the effective rate of clinical symptom relief in the experimental group was higher than that in the control group (p < 0.05).

Conclusions

1. The application of the PWM technique in patients with prostate diseases is effective, which not only increases the success rate of fluid extraction, but also helps to relieve the clinical symptoms of various prostate diseases. 2. At the same time, PWM can promote erection and sexual pleasure. After the prostate disease was cured, most of them asked to continue massage.

Disclosure

No.
(238) SEXUAL AROUSAL DISORDER: THE 2024 STUDY
Authors: Vastrad B
Published: December 2024

Introduction

Sexual Arousal Disorder (SAD) is a prevalent and distressing condition characterized by the persistent or recurrent inability to attain or maintain adequate sexual excitement. Despite its significance, SAD remains poorly understood, with limited research addressing its multifaceted aetiology and effective Management strategies. Understanding the underlying mechanisms of SAD is crucial for the development of targeted interventions to alleviate the associated distress and enhance sexual well-being.

Objective

This study aimed to investigate the prevalence, correlates, and psychosocial factors associated with sexual arousal disorder in a diverse population sample. Additionally, we sought to explore the potential efficacy of various treatment modalities in managing SAD and improving sexual functioning, and well-being.

Methods

A cross-sectional study was conducted among a representative sample of individuals aged 18 to 75 years, recruited from diverse demographic backgrounds. Participants completed validated questionnaires assessing sexual function, psychological well-being, relationship satisfaction, and demographic variables. Clinical interviews and standardized assessments were conducted to assess/diagnose SAD according to established criteria. Statistical analyses, including regression models and correlation analyses, were employed to examine the relationships between SAD and various factors.

Results

Our findings revealed a significant prevalence of sexual arousal disorder within the study population, with notable associations with psychological distress, relationship dissatisfaction, and comorbid mental health conditions. Moreover, demographic factors such as age, gender, and relationship status demonstrated differential impacts on the prevalence and manifestation of SAD. Importantly, we identified specific psychosocial factors that significantly contributed to the development and persistence of SAD, highlighting the importance of addressing contextual influences in treatment interventions. Furthermore, our investigation into management modalities indicated promising outcomes for psychotherapy, pharmacotherapy, and combination approaches in alleviating symptoms of SAD and enhancing sexual satisfaction, the Quality Of Life (QOL), the Quality Of Life-Style (QOLS) and the Quality Of Life Years (QOLY).

Conclusions

This study contributes to the growing body of literature on sexual arousal disorder by elucidating its prevalence, correlates, and treatment implications within a diverse population sample. Our findings underscore the complex interplay of biological, psychological, and social factors in the etiology and maintenance of SAD, emphasizing the need for comprehensive and individualized approaches to assessment and intervention. By addressing the multifaceted nature of SAD, clinicians and researchers can advance the development of targeted and effective interventions to improve Quality Of sexual health, Quality Of Life and overall well-being.

Disclosure

No.
(241) VENTRAL CORPORAL REINFORCEMENT USING PERICARDIUM ALLOGRAFT (TUTOPLAST®) IN A PATIENT UNDERGOING URETHRECTOMY PROCEDURE WITH AN INFLATABLE PENILE PROSTHESIS IN PLACE: CASE REPORT
Authors: Mahdi M , Leung S , Pettaway C , Wang R
Published: December 2024

Introduction

Erectile dysfunction (ED) is a common consequence following radical cystectomy (RC), with inflatable penile prostheses (IPP) placement considered as the gold standard for refractory cases. Urethral recurrence post-RC necessitates urethrectomy, which poses challenges for patients with in place IPP. The thinning of the ventral tunica albuginea during urethrectomy may increase the risk of corporal disruption and IPP cylinder aneurysm, affecting device functionality.

Objective

To introduces a novel surgical technique using Tutoplast, a human-derived pericardium allograft, for corporal reinforcement during urethrectomy in the presence of in-situ IPP.

Methods

74-year-old male, with history of robotic-assisted RC and IPP presented with recurrent blood per urethra. Imaging revealed urethral masses (Fig. A). The patient underwent total urethrectomy, resulted in significant thinning of the ventral tunica albuginea. The decision was then made intra-operatively to repair and reinforce the thin tunica albuginea to prevent the risk of tunica and device aneurysm or mechanical failure. The thin tunica albuginea was covered with Tutoplast graft. Two graft pieces were used and sutured to the lateral, superior and inferior aspects of both corpora, covering a total area of 3 x 10 cm (Fig. B). To ensure IPP cylinders integrity during graft suture, we inflated them to minimize kinks and we used a pick-up instrument to catch and raise the corpora for safe needle passage.

Results

Final pathology of the urethra showed high-grade papillary urothelial carcinoma with invasion of the corpus spongiosum, negative margins. At the six weeks follow up visit, patient was recovering well. Cycling of the IPP done smoothly and the patient was given permission to start using the device. Patient was seen again at six months; he was using the implant without issues and the examination showed good functionality of the implant (Fig. C).

Conclusions

Corporal reinforcement using Tutoplast during urethrectomy in patients with existing IPP presents a simple and cost-effective solution to mitigate the risks of corporal disruption and IPP cylinder aneurysms. The positive outcome demonstrated in this case report warrants further studies on larger patient populations and longer follow-up periods to assess the long-term outcomes of this technique.

Disclosure

No.
(244) THE IMPACT OF FUNCTIONAL TRAINING AND EMS ON WOMEN’S WELL-BEING AND REPRODUCTIVE HEALTH IN TERMS OF SEXUAL SATISFACTION
Authors: Zborowska K , Krzysztofik S , Violetta S
Published: December 2024

Introduction

Physical activity is important for both the physical and mental health of women, especially after childbirth. Therefore, it is important to adapt physical activity to individual conditions and gradually increase the intensity and load.

Objective

Celem badania jest ocena aktywności fizycznej i oceny dna miednicy w zakresie wpływu innowacyjnego treningu EMS na dobrostan kobiet i aspekty dotyczące sfery seksualnej. The aim of the study is to evaluate physical activity and pelvic floor assessment in terms of the impact of innovative EMS training on women’s well-being and aspects related to the sexual sphere.

Methods

Ten women after giving birth and after the postpartum period were included in the study. They were recruited as part of the Childbirth School classes. Women were introduced to EMS technology training and functional training, which was performed once a week for a period of 6 months. The assessment of the tested parameters was performed in the following time interval: Stage 0 - preliminary examination; Stage 1: examination after 3 months; Stage 2 – examination after 6 months. The following parameters were examined: Assessment of general physical fitness (in order to select the appropriate level of functional training and EMS and to assess general physical activity and its changes over time); Assessment of muscle strength - EMG; Assessment of pelvic floor structures: EMG Biofeebeck - intravaginal and ultrasoundsonofeedback; Questionnaires: MSEI - Multidimensional Self-Assessment Questionnaire, FSFI - Assessment of Sexual Functioning; Questionnaire for the Assessment of Urogynecological Dysfunctions; Gynecological and obstetric history questionnaire; Rosenberg Self-Esteem Scale; Body Assessment – BES; Assessment of BMI parameters and body mass composition, SF-36 Quality of Life Questionnaire.

Results

The study showed that postpartum women who attended training using EMS technology achieved higher physical fitness and improvement in the functionality of the pelvic floor significantly faster. It has also been shown that training using EMS technology has a positive impact on women’s sexual quality and satisfaction, which translates into their overall well-being in terms of everyday functioning and body assessment.

Conclusions

Training using EMS technology allows for greater effectiveness, comfort and more precise personalization of training for women with special needs after childbirth in a shorter period of time.

Disclosure

No.
(245) THE USE OF THE 75CC CLOVERLEAF PENILE IMPLANT RESERVOIR AS A STANDARD FOR ALL CYLINDER LENGTHS, INCLUDING LONG CYLINDERS
Authors: Mahdi M , Majzoub A , Wang R
Published: December 2024

Introduction

The Titan inflatable penile prosthesis (IPP) utilizes a Cloverleaf reservoir system that comes in two different sizes: 75 cc and 125 cc. The larger reservoir is used for longer cylinders, and in such cases, patients need more time and efforts to inflate the device. Moreover, Larger reservoirs might be associated with higher incidence of reservoir palpability and discomfort especially in the cases of ectopic placement.

Objective

We aim to evaluate the outcome of a technique utilizing the 75 cc reservoir for all cylinder sizes, in which larger cylinders are partially filled with an extra 10-30 cc of saline to compensate for the needed amount of saline.

Methods

Patients who underwent Titan Coloplast IPP using 75 cc reservoir were included. They were classified into group 1 {cylinders <20 cm (n = 104)} and group 2 {cylinders ≥20 cm (n = 107)}. Data regarding patients’ characteristics, surgical details and procedure outcomes including complication rates and patient satisfaction were retrieved. Patients’ satisfaction was reported using The Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) score. Baseline characteristics and complication rates were compared using Chi-square test. T-test was used to evaluate the difference in the satisfaction rate between the 2 groups.

Results

There was no significant difference between the 2 groups with regards to patients’ baseline data. (table 1). During follow up, the overall early and late complication rates in the entire sample were 1.5% and 7.6% respectively. 16 patients developed late complications, including mechanical failure (n = 11), corporal erosion (n = 2), cold glans (n = 2) and chronic pain (n = 1). Comparing the early & late complication rates between the two groups, there was no statistically significant differences (P = 0.386 and P = 0.753 respectively). While the mechanical failure rate was higher among group1 (6.7% vs. 3.7%), the difference was not statistically significant. The satisfaction score means were 93.5% and 87% for patients in group 1 and group2 respectively, the difference didn’t reach a statistically significance level. (P = 0.25).

Conclusions

Using 75 cc IPP reservoir for large cylinders with the addition of extra amount of saline to the cylinders is feasible with no significant negative outcome. Using such technique achieves easier and faster device inflation, associated with less chance of reservoir palpability and bothersome, and might help to give more options for reservoir placement location.

Disclosure

No.
(252) IMPACT OF SUBINGUINAL MICROSURGICAL VARICOCELECTOMY ON MALE INFERTILITY: FEMALE AGE, SEMINAL PARAMETERS, SERUM TESTOSTERONE AND PREGNANCY RATE - RETROSPECTIVE COHORT AT A UNIVERSITY HOSPITAL IN RIO DE JANEIRO
Authors: Moreira Crelier G , Oliveira Da Rosa K , Carvalho Menezes M , De Teófilo E Figueiredo Filho R , Mario Costa Lara C , Luiz Schiavini J , Vinícius Oliveira Vasconcelos C , Ribeiro Júlio Junior H , Damião R
Published: December 2024

Introduction

Varicocele is the most common identifiable cause of male infertility, and varicocelectomy is the most commonly performed surgery for its treatment. This condition has an impact on infertility cases and sperm quality. Microscopic varicocelectomy is the gold standard treatment for varicocele because it allows preservation of the testicular artery and lymphatic vessels, ligament of the spermatic veins, and a significant reduction in complications. This retrospective cohort aims to evaluate the effects of microscopic varicocelectomy on seminal parameters, serum testosterone, and pregnancy rate in the context of male infertility in 39 patients operated on at a university hospital in Rio de Janeiro.

Objective

This retrospective cohort aims to evaluate the effects of microscopic varicocelectomy on seminal parameters, serum testosterone, and pregnancy rate in the context of male infertility in 39 patients operated on at a university hospital in Rio de Janeiro.

Methods

This study is a retrospective cohort conducted between January 2016 and February 2023, based on 39 men who underwent subinguinal microscopic varicocele repair in the context of conjugal infertility. Pre- and post-operative analyses of seminal parameters were based on the criteria of the World Health Organization from 2010. Post-operative semen analysis and serum testosterone were performed 3 to 6 months after varicocelectomy. The pregnancy rate was observed through interviews until February 28, 2023.

Results

Subinguinal microscopic varicocelectomy is associated with a significant increase in testosterone levels and an improvement in semen parameters, all with statistical significance. Testosterone showed an average increase of 84.2 (±14.7) ng/dL. The average age of the partners was 34 (22-42) years. The pregnancy rate also increased significantly, with 51.3% of couples achieving pregnancy at the time of this study.

Conclusions

In this cohort, infertile men with clinical varicocele who underwent subinguinal microscopic varicocelectomy showed a significant increase in testosterone levels, improvement in semen parameters, and a significant reduction in the proportion of azoospermia. The female factor is presumed to have influenced the lower fertility rates observed within the studied group. Additionally, there was an increase in the occurrence of pregnancy in couples with conjugal infertility.

Disclosure

No.
(259) ASSESSMENT OF THE IMPACT OF SURGICAL CORRECTION ON THE SEXUAL FUNCTION OF MEN WITH PEYRONIE’S DISEASE
Authors: Borges Cabral Junior J , Mikaelly Da Silva Gomes V , Antônio De Souza Filho C , Augusto Irineu Aguiar Ramos L , Ariel Pires Cavalcanti Zeca A , De Albuquerque Pereira De Oliveira R , Conceição De Souza R , Henrique Sales Lins T , Jose Cardoso Cavalcante F
Published: December 2024

Introduction

Peyronie’s disease is an acquired condition characterized by the formation of fibrotic plaques in the penis, resulting in curvature that can cause pain during erections and affect penetration ability. Surgical correction is indicated when conservative treatment fails and sexual activity is compromised, impacting the patient’s quality of life and sexual satisfaction. Sexual intercourse problems can lead to emotional distress, social isolation, and affect the relationship with the partner, ultimately impacting the sexual function of these patients.

Objective

Evaluate the effect of surgical correction of Peyronie’s disease on male sexual function.

Methods

A prospective study was conducted on patients undergoing Peyronie’s correction surgery at a tertiary hospital in northeastern Brazil in 2023. Patients completed the International Index of Erectile Function (IIEF-5) before and 6 months after procedure, evaluating erectile dysfunction (ED) and satisfaction with intercourse. ED severity was categorized based on scores: severe (1-7), moderate (8-16), and mild (17-21).

Results

Five patients underwent surgery, with four completing six-month follow-up. Mean age was 43 years (range: 25-57). Intraoperative penile curvature averaged 60 degrees, with 50% presenting dorsal curvature. Fifty percent reported residual curvature, yet all noted subjective improvement in sexual satisfaction post-surgery. Postoperative penetrative ability was 100%. Preoperatively, 50% had severe ED, 25% moderate, and 25% mild. Postoperatively, 50% had no ED, and 50% had mild dysfunction. Techniques included Yachia’s (25%), Nesbit’s plication (50%), and bovine pericardial graft (25%). Half had a history of penile fracture. Curvature degree did not determine postoperative dysfunction persistence. Patients with mild ED were older and had comorbidities. No deaths or increased morbidity occurred post-surgery.

Conclusions

The results show that surgical correction of Peyronie’s disease is safe and enhances patient function and sexual satisfaction, promoting improved quality of life post-procedure.

Disclosure

No.
(262) CORRELATION OF PENILE GRAYSCALE PHARMACO-ULTRASONOGRAPHY WITH ERECTILE TISSUE COMPOSITION IN MEN WITH ERECTILE DYSFUNCTION
Authors: Kim NN , Goldstein SW , Goldstein I
Published: December 2024

Introduction

Percentage of corporal smooth muscle and corporal connective tissue within penile erectile tissue was determined by histomorphometric assessment of biopsies removed during penile prosthesis insertion. Previous studies have shown that these histomorphometry data correlated with pre-operative pharmacocavernosometry testing during complete smooth muscle relaxation. At 50-55% corporal connective tissue (CCT) content, corporal veno-occlusive function was found to be normal. When CCT content was 60-75%, corporal veno-occlusive function significantly worsened in an exponential relationship. Above 75% CCT content, there was no recordable corporal veno-occlusive function. Pre-operative grayscale ultrasonography (GUS) during complete smooth muscle relaxation is a less invasive in-office diagnostic assessment for ED than pharmacocavernosometry. It has been previously reported that hypoechoic areas in GUS are indicative of regions of erectile tissue fibrosis.

Objective

We examined for the first time whether findings on pre-operative GUS could correlate with histomorphometry data on CCT content in the same manner that pharmacocavernosometry correlated with CCT content.

Methods

Pre-operative proximal shaft axial plane GUS images were obtained using a 15.4 MHz probe (Aixplorer), gain setting 45%, dynamic range 70 dB. Percent hypoechoic area within the corporal cavernosa was assessed by computer-assisted image analysis using Image J (Fig. 1). During penile prosthesis surgery, erectile tissue from the proximal shaft was biopsied for histological analysis (n = 12). Formalin-fixed (10%), paraffin-embedded tissue sections (5 μm) were stained with Masson’s trichrome. Photomicrographs were analyzed by Image J using the Masson trichrome vector of the color deconvolution plugin.

Results

Percent hypoechoic area was poorly correlated to percent CCT area by linear regression analysis (r2 = 0.287). However, a non-linear regression model, an exponential growth curve, provided a better fit (r2 = 0.672) with an inflection point at 40% CCT area (Fig. 2). The abrupt shift is similar to the previously reported corporal veno-occlusive function curve using pharmacocavernosometry.

Conclusions

Estimation of percent hypoechoic area on pre-operative GUS images during complete smooth muscle relaxation may be a useful, non-invasive assessment of CCT content to predict corporal veno-occlusive function. Larger cohorts of ED patients are needed to verify the clinical utility of GUS.

Disclosure

No.
(264) HARD-FLACCID SYNDROME: A SURVEY OF SEXUAL MEDICINE PRACTITIONERS’ KNOWLEDGE AND EXPERIENCE
Authors: Gryzinski G , Hammad MA , Alzweri L , Azad B , Barham D , Lumbiganon S , Serefoglu E , Yafi F
Published: December 2024

Introduction

Hard-flaccid syndrome (HFS) is a condition of male sexual dysfunction (MSD) that has become a relatively new focus in online forums and urologic conferences. It is a poorly understood syndrome characterized by chronic pain, a partially rigid penis while in a flaccid state, and erectile dysfunction. HFS primarily affects men in their second and third decade of life, but its exact pathophysiology remains uncertain, with hypotheses suggesting a combination of physical and psychological factors. Consequently, an evidence-based understanding of HFS is lacking within the sexual medicine community.

Objective

Identify and quantify the current level of understanding of HFS in the sexual medicine academic society.

Methods

A survey was provided to sexual medicine practitioners at the 2023 American Urological Association (AUA) Annual Meeting who attended a plenary focusing on sexual medicine. Each survey form included a screening question to determine familiarity with HFS. If they were familiar with HFS, there were multiple additional questions querying experience with HFS in their patients, modalities of diagnosis, preferred therapy options, in addition to others. These answers were then extracted onto a spreadsheet and analyzed.

Results

According to the registration reports from the 2023 AUA conference, there were 37 attendees at the sexual medicine plenary. A total of 36 survey responses were submitted. Of these, 35 were urologists and 1 responder was a mental health professional. 23 of the 36 respondents (64%) had seen patients with HFS in their practice. Practitioners who had not seen HFS did not complete the rest of the survey. Among the respondents, 8 (35%) acquired knowledge about HFS through colleagues, 6 (26%) mentioned medical journals, 4 (17%) mentioned conferences, 4 (17%) mentioned patients, and 1 (5%) stated that they first heard about it from an online pelvic floor therapist. Regarding the diagnostic approach for HFS in their practice, 17 responders considered clinical history, 16 relied on patient self-diagnosis, and 1 utilized imaging, although the specific imaging modality was not specified. Most respondents (74%) indicated that they had seen 1-10 patients with HFS, with 4 and 2 respondents reporting 11-20 and 21-50 patients, respectively. In terms of their beliefs about HFS as a legitimate condition, 12 responders expressed confidence in its existence, while 7 remained uncertain. Most respondents (11) suggested pelvic floor therapy as the optimal approach, with 10 recommending combination therapy.

Conclusions

This analysis highlights the ongoing lack of familiarity with HFS among professionals. This project provides valuable insights into the current understanding of this complex condition. The outcome emphasizes the critical need for continued education and research on HFS to improve diagnostic accuracy, enhance patient care, and develop effective treatment strategies.

Disclosure

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(286) ASSESSMENT OF THE SITUATION REGARDING THE HEALTH OF TRANSGENDER PEOPLE IN HEALTHCARE IN POLAND. RETRANSITION OF TRANSGENDER PEOPLE. KNOWLEDGE AND OPINION OF TRANSGENDER PEOPLE ON REPRODUCTIVE HEALTH AND CANCER PREVENTION
Authors: Zborowska K , Jorg D , Chrapkiewicz B , Krzysztofik S
Published: December 2024

Introduction

As a result of negative and traumatic experiences of transgender people related to access to health care in Poland, many of them give up necessary health care services and emphasize their willingness to retransition. Due to the lack of procedures in this area, these people express a negative attitude towards medical and psychological care.

Objectives

The aim of the work is to assess the health care system in Poland in the field of reproductive health, cancer prevention and the retransition process of transgender people.

Methods

Transgender people in Poland were included in the study. 140 transgender people were examined, including 80 transgender men (in.20 retransition) and 60 transgender women. The study used an original questionnaire to examine knowledge and opinion, as well as standardized questionnaires assessing the quality of life and self-esteem.

Results

The study showed that transgender people have very average knowledge of reproductive health prevention. Knowledge in the field of cancer prevention is very low. In the field of reproductive health care, they show no interest due to the lack of support from the health system in Poland and due to their own socioeconomic conditions. Additionally, in terms of opinions, they point to the lack of knowledge in this area on the part of medical staff. The care of transsexual people in Poland is based mainly on diagnosis and implementation of the treatment process in the field of transition, as well as professional psychological care in which the topic of reproductive health is discussed. In the field of medical care - gynecological aspects of reproductive health in terms of protection of reproductive cells or exposure to hormonal treatment in the field of anticancer prevention, no screening tests have been introduced. In Poland, there are no guidelines regarding the retransition process. Transgender people are deprived of professional care.

Conclusion

In order to ensure professional health care and a safe and friendly environment for transgender people in Poland, it is recommended to train medical staff in the field of cultural competence.

Disclosure

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(288) PATIENT-REPORTED PAIN DURING HYALURONIC ACID PENILE GIRTH ENHANCEMENT PROCEDURES: A CROSS-SECTIONAL STUDY
Authors: Gutierrez Claure LA , Cavalcanti Filho MT , Lemos C , Lattanzi C , Rodrigues D , Ramalho G , Monteiro L
Published: December 2024

Introduction

Penile girth enhancement is a procedure sought by men aiming to increase penile circumference. However, concerns about pain often deter patients from undergoing the procedure, as it is perceived to be painful.

Objective

The objective of this study is to quantify the pain experienced during the penile girth enhancement procedure with hyaluronic acid.

Methods

A cross-sectional, single-center study included men who sought private care to realize penile girth enhancement from March to June 2024. During the procedure, patients reported pain using the Visual Analogue Scale, a multidimensional tool that assesses pain intensity, providing a comprehensive pain profile for effective clinical management (variable 0-10, 0 = no pain, 5 = moderate pain and 10 = worst pain). All statistical and graphical analyses were performed using RStudio.

Results

We evaluated 128 men. The patients have an average age of 44.46 years (23-77). All patients have the chief complaint of the penile circumference. The VAS minimum 0, first quartile 1.0, median 2.0, mean 1.9, maximum 5.0 and third quartile 2.0. The percentage distribution across VAS has 0 = 0.8%, 1 = 25.8%, 2 = 57.0%, 3 = 8.6%, 4 = 6.2%, 5 = 1.6%. None of the patients related pain 6 to 10.

Conclusions

In this pilot study, our findings suggest that the penile girth enhancement procedure with hyaluronic acid is associated with minimal pain levels (98,4%). This indicates that the procedure is well-tolerated and presents a viable option for men seeking penile girth enhancement with manageable pain levels.

Disclosure

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(292) THE ROLE OF PRE-SYNAPTIC β1-ADRENOCEPTORS IN RAT ISOLATED EPIDIDYMAL VAS DEFERENS CONTRACTILITY
Authors: Oliveira DL , Rios Campitelli R , Britto Júnior J , Tiago Lima A , Fregonesi A , Antunes E , De Nucci G
Published: December 2024

Introduction

The absence of a low-affinity site for propranolol after reserpinisation or rauwolscine treatment suggests a dependence on intact catecholamine stores and α2-adrenoceptors, reflecting β-blockers’ action. In guinea-pig vas deferens, β-adrenoceptor activation increases noradrenaline release while decrease ATP release. Isoprenaline reduces nerve-induced responses in rat vas deferens.

Objective

To investigate the effect of presynaptic beta 1 adrenergic agonists in rat vas deferens.

Methods

Adult male Wistar rats were euthanized with isoflurane, then epididymal vas deferens were isolated, placed in Krebs–Henseleit’s solution, and mounted in tissue baths for isometric tension recording using a PowerLab system. The effect of β-adrenoceptor agonist RO363 (100 nM), and antagonists betaxolol (1 μM), metoprolol (1 μM), and atenolol (1 μM) on adrenaline (ADR), noradrenaline (NA) and dopamine (DA) induced contractile responses was assessed. Electric-field stimulation (EFS) and the effect of the sodium channel antagonist tetrodotoxin (TTX 1 μM) were also evaluated. All the procedures were approved by an Ethic Committee. Data were analyzed using nonlinear regression to determine pEC50 values and expressed as mean ± SEM.

Results

The data showed that RO363 had no effect on DA but caused a concentration-dependent leftward shift on the NA and ADR curves, abolished by TTX pretreatment. RO363 enhanced tissue contraction in response to EFS across all frequencies. Atenolol, betaxolol and metoprolol abolished the effect of RO363 on NA and ADR curves.

Conclusions

Findings reveal that the β1-adrenoceptor agonist RO363 selectively modulates contractile responses to NA and ADR, indicating a specific interaction with these neurotransmitters sensitive to sodium channel blockade by TTX. The abolition of RO363’s effect by β1-adrenoceptor antagonists further underscores the specificity of β1-adrenoceptor involvement. Results suggest that β1-adrenoceptors are crucial in regulating neurotransmitter-induced contractility in the vas deferens, potentially through mechanisms dependent on intact catecholamine stores and α2-adrenoceptors. This study enhances understanding of adrenergic modulation in male reproductive physiology and may inform future research on pharmacological manipulation of vas deferens contractility.

Disclosure

No.
(298) HYALURONIC ACID FOR PENILE GIRTH ENHANCEMENT: BRAZILIAN EXPERIENCE
Authors: Cavalcanti Filho M , Rodrigues D , Gutierrez Claure L , Lattanzi C , Lemos C , Fernandes G , Monteiro L
Published: December 2024

Introduction

In recent years aesthetic injection techniques with soft tissue fillers have become popular worldwide due to their effectiveness and safety. Penile girth enhancement is a significant aspiration for many men and is considered to symbolize masculinity and sexual prowess. Furthermore, according to the literature, girth appears to be more important for sexual satisfaction.

Objective

To demonstrate the penile girth pre and post the application of hyaluronic acid.

Methods

A retrospective, single-center study included men who sought private care to realize penile girth enhancement from March to June 2024. All patients signed an informed consent form. Excluded men with dysmorphophobia, active inflammatory-infectious genital lesion, and prior application of another filler. Penile girth was measured with a tape measure at baseline and follow-up appointment.

Results

103 patients were included in this analysis. The male participants had an average age of 45.0 ± 10.2 (26-77) years. The average stretched penile length (SPL) was 14.0 ± 1.9 cm, the initial circumference was 10.0 ± 1.3 cm. Mean injected volume was 8.1 ± 1.6 ml and the final average circumference was 11.3 ± 1.3 cm, the average difference in circumference was 1.5 ± 2.2 cm. The follow-up appointment mean was 22 days. Compared a mean with a basal girth and after 1 application the Test t result was significant p < 0.001. There was no association in the linear regression between the post circumference and amount injected (R2 = 0.01, p = 0.304) and in the difference before/after and amount injected (R2 = −0.01, p = 0.466). There were no inflammatory signs or serious adverse reactions in all cases, and no patient requested a reversal of the procedure.

Conclusions

Our study suggests that Hyaluronic acid injections is an effective option for men desiring non-surgical enhancement, with an average girth increase of 1.5 cm. Further research is needed as the procedure can be sequential, with several sessions generating gains in circumference with each session.

Disclosure

No.
(306) SEXUALITY OF YOUNG WOMEN WITH CERVICAL CANCER. DOES HEALTH CARE IN POLAND PROVIDE SUPPORT FOR PSYCHOSEXUAL TREATMENT OF WOMEN WITH CERVICAL CANCER?
Authors: Zborowska K , Chrapkiewicz B
Published: December 2024

Introduction

Every year, approximately 2.5 thousand people are diagnosed with cervical cancer. Polish women, of whom approximately 1.6 thousand die. Currently, cervical cancer is the seventh cause of cancer deaths among women in Poland, and current statistics alarm that this disease increasingly affects young and professionally active women.

Objective

The aim of the study was to assess sexual activity and effective support in the field of sexological care in women of reproductive age diagnosed with cervical cancer.

Methods

The study involved 30 women aged 22 to 35 who were diagnosed with cervical cancer. The patients underwent long-term care from the moment of cancer diagnosis until recovery for a period of one year. The study identified the cause of the cancer - HPV virus in 80%, verified the quality of life of the MSEI, the assessment of the STAI drug and the sexual functioning of the FSFI, as well as an original questionnaire that verified the opinion in the field of medical and sexological-psychological care provided.

Results

The study showed that women who received sexological and psychological care achieved higher indicators in terms of quality of life (p = 0.000) and in terms of engaging in sexual activity (p = 0.001) and higher sexual satisfaction (p = 0.000). The study also showed a very high level of dissatisfaction with the state medical care in the field of psychological and sexological services and showed that patients did not know about HPV infection in the field of cervical cancer prevention. All patients were not vaccinated against HPV and there were stereotypes in this regard among their beliefs.

Conclusions

Cervical cancer is directly related to persistent infection with the human papillomavirus (HPV), which requires the introduction of appropriate support and preventive measures among young women in terms of vaccination and vaccination of the appropriate preventive group. In Poland, there is a very big problem in vaccinating young women suffering from cervical cancer.

Disclosure

No.