bluuebunny/crossref_metadata_2025_split huggingface dataset:
(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

Abstract

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.
(256) INFLUENCE OF SOCIOPOLITICAL AND ECONOMIC ISSUES ON VASECTOMY DECISIONS: A QUALITATIVE STUDY AMONG PATIENTS
Authors: Cheng L , Natesan D , White K , Jarlenski M , Chang J , Hwang K 
Published: December 2024

Abstract

Introduction
In recent years, vasectomy rates have strongly positively correlated with the emergence of societal and economic issues, such as The Great Recession and rising unemployment rates. Since 2020, there have been numerous events of sociopolitical and economic importance in the U.S., including the emergence of COVID-19 as a global pandemic; subsequent domestic consumer price inflation; and the reversal of federal protections for the right to abortion under Roe v Wade. Following the June 2022 reversal, vasectomy interest rose significantly despite no direct impact to male contraception. This increase suggests an understudied influence of societal issues on individuals’ reproductive healthcare decisions.

Objective
Our objective was to explore patient perspectives of how recent sociopolitical and economic issues (ie, Dobbs v Jackson ruling, post-COVID consumer price inflation) influenced their vasectomy decision and timing.

Methods
We interviewed 20 men aged 18 years or older who had initiated a vasectomy consult or appointment after June 2022. Participants were purposively selected based on their age (those 30 years or younger); men with no biological children at time of vasectomy; and men who indicated on an intake survey that sociopolitical or economic issues factored into their vasectomy decision. A qualitative descriptive thematic analysis approach was used to develop a codebook that included deductive and inductive coding. The constant comparative method was used to review coding and identify similar and differing themes across participant experiences.

Results
Many participants expressed that outside of personal reasons for pursuing vasectomy, sociopolitical and economic issues were significant motivators for their vasectomy decision and timing. Several described how increased discourse and uncertainty around all forms of contraception access following Dobbs fostered their desire to be “proactive” through vasectomy. Others lamented the unprecedented difficulty providing for a child given significant economic inflation of food costs and other necessities.

Conclusions
Recent sociopolitical and economic issues significantly influenced male patients’ decisions to undergo a vasectomy despite no direct impact to male contraception options. Future research directions include intersectional exploration with patients from diverse racial, cultural, and geographic backgrounds.

Disclosure
No.
(261) DIGITAL PROMOTION OF INFERTILITY COVERAGE FOR TRAINEES IN UROLOGY RESIDENCY PROGRAMS
Authors: Kassab J , Garcia Keeme-sayre A , Oppenheimer A , Rasun S , La T , Andino J , Lipshultz L 
Published: December 2024

Abstract

Introduction
Physicians face significantly higher rates of infertility than the general public and over 50% of medical residents express concerns over their own fertility. This highlights a pressing issue within the medical community, particularly among those in surgical training programs. Addressing these concerns is crucial for the well-being and future planning of medical professionals, especially as certain institutions have begun to offer coverage for fertility services in employer-sponsored insurance plans.

Objective
To evaluate the accessibility of online information describing infertility coverage for resident physicians by accredited United States urology residency programs.

Methods
Utilizing the AUA’s listing of accredited U.S. Urology Programs, we investigated each program website to assess for mention of fertility benefits and coverage offered for trainees. Regardless of the information found at the primary program websites, we conducted a second inquiry via a thorough internet search to find any mention of fertility coverage offered at individual institutions. Fertility benefits were defined as coverage for any of the following: fertility evaluation, intrauterine insemination (IUI), in-vitro fertilization (IVF), surgical treatment, egg/sperm storage, fertility medications, and/or adoption services. The programs were then sorted into four groups depending on available online information: 1.) No mention of fertility benefits; 2.) Information regarding coverage was alluded to but behind a required institutional login or portal; 3.) Fertility benefits/coverage was mentioned on the website and is offered to its trainees; 4.) Fertility benefits/coverage was mentioned on the website but is not offered to its trainees. Descriptive statistics were performed on the dataset using SPSS.

Results
Of the 156 urology program websites, nearly 75% did not mention fertility coverage options at all (Figure One). On their main residency website, 15.4% mentioned that they provide fertility coverage for their residents, 2.6% explicitly mentioned that they do not provide fertility care through their insurance plans, and in 8.3%, fertility coverage information was not accessible due to institutional login/portal. Lastly, through the broader search, 42.3% of institutions with an associated urology program did not mention fertility benefits. In 48.7% of health systems, fertility benefits were mentioned and offered.

Conclusions
Despite growing concerns in the medical community about the fertility impact of demanding residency programs and delaying childbearing, there is a lack of transparency regarding fertility coverage on urology residency websites. Clear and accessible information regarding infertility coverage would enable trainees to make more informed decisions when selecting the rank of residency programs, ensuring that they can adequately plan for their personal and professional futures.

Disclosure
No.
(282) A PROPOSED SURGICAL TECHNIQUE TO CREATE A NATURAL-APPEARING RECESSED VAGINAL INTROITUS WITH GENDER-AFFIRMING “SHALLOW-DEPTH VAGINOPLASTY” (VULVOPLASTY) UTILIZING A PEDICLED ADVANCEMENT FLAP
Authors: Shiang A , Dadashian E , Sandhu S , Mallavarapu S , Smith S , Garcia M 
Published: December 2024

Abstract

Introduction
Feminizing genital gender-affirming surgery (fgGAS) options include vaginoplasty with- (“full-depth vaginoplasty”), or without neovaginal canal (“vulvoplasty” or “shallow-depth vaginoplasty (SDV)”). If a transgender woman does not desire receptive vaginal intercourse, SDV is an excellent option, eliminating lifelong dilation/douching and lower complication risks. Achieving “normal appearing” feminine anatomy is critical for these patients. Currently, techniques for SDV rely on a full thickness skin graft.

Objective
1) To better understand decision-making factors when undergoing SDV. 2) To describe a novel technique used to create a recessed vaginal introitus. 3) To evaluate patient perceptions of appearance as compared to cisgender vulvae.

Methods
Patients undergoing fgGAS between 04/2017-07/2022 were included. Of the patients undergoing SDV, an anonymous electronic survey querying decision-making factors and overall post-operative satisfaction was undertaken. In addition, our novel technique is described.

Results
110 patients underwent fgGAS. Of these, 35/110 (32%) underwent SDV. Priorities: Achieving an appearance “comparable to” cisgender vulvae was ranked second highest after “elimination of male genital anatomy” (Fig. 1a). Technique: To achieve a recessed skin-lined vaginal introitus, gathering sutures create a “dimple” from penile/scrotal skin flap based off the posterior perineum, tethered to the tendon of the bulbospongiosus muscle, behind the urethral bulb (Fig. 1b-e). Attractiveness (Fig. 1f): When compared to cisgender vulvae of similar age/weight, 26/26 (100%) patients reported their vulvae had “similar” or “somewhat similar” appearance to cisgender vulvae. 24/26 (92%) of patients found their vulvae to be either “similarly or more attractive”, and 2/26 (8%) found their vulvae to be “less attractive” as compared to cisgender vulvae.

Conclusions
Women opting for SDV greatly consider cosmetic appearance which must be indistinguishable from cisgender female anatomy. This appears to be offered by this technique. In addition, this technique offers women the opportunity to have external anatomy in line with their gender identity, and for women not interested in using a vaginal canal for receptive vaginal intercourse, this option foregoes the added risks and commitment to lifelong dilation and douching.

Disclosure
No.
(297) PENILE CALCIPHYLAXIS PRESENTING WITH TERTIARY HYPERPARATHYROIDISM: A CHALLENGING CASE REPORT
Authors: Sávio LF , Cardoso JF , Campos L , Taromaru E 
Published: December 2024

Abstract

Introduction
Penile calciphylaxis (PC) is an uncommon and potentially life-threatening syndrome with an estimated 6-month mortality rate. PC is characterized by the obstruction of small vessels within the subcutaneous adipose tissue and dermis of the penis. The precise etiology of calciphylaxis is not entirely understood, but it is frequently associated with conditions such as end-stage kidney disease (ESKD), chronic kidney disease (CKD), and the use of medications like warfarin. Symptoms of PC may include pain, discoloration, and the formation of non-healing ulcers on the penis. Management of PC involves controlling medical risk factors to mitigate vascular calcification, alongside interventions such as surgical debridement, penectomy, and local wound care.

Objective
We report a case of a patient with ESKD who presented with necrotic ulcers of his penis and was found to have tertiary hyperparathyroidism.

Methods
A 69-year-old male patient was referred to our institution due to a distressing necrotic lesion encompassing 60% of the glans penis over the preceding two months. His medical history includes tertiary hyperparathyroidism, diabetes, hypertension, cardiomyopathy, and ESRD (grade V). The patient underwent renal transplantation; however, two years after the transplant, he lost kidney function and returned to dialysis. Laboratory analyses revealed significantly elevated levels of parathyroid hormone (PTH) at 1350 pg/ml, calcium at 1.34 mmol/L, and vitamin D at 30 ng/ml. A pelvic CT scan revealed a pervasive pattern of calcification within the aorta, branches of the celiac axis, and penile vessels (Fig. 1 and 2). Patient was initially started on broad-spectrum antibiotics, including ciprofloxacin, azithromycin, and ceftazidime with any improvement. Cultures from the blood and gangrenous site were negative.

Results
Treatment with sodium thiosulfate was initiated in conjunction with daily PDE-5-inhibitors for 2 – months before complete parathyroidectomy. Pain score from the penile ulcers started to regress along with the complete reepithelization of the ulcer. At 2 – years of follow up from the initial treatment patient is still alive with any other new onset of the ulcers.

Conclusions
PC represents a significant life-threatening condition in patients with ESRD with a compromised overall survival as reported in the literature. The uniqueness of our study lies in the combined use of a PDE-5 inhibitor along with parathyroidectomy to overcome the nature of the disease, leading to improved patient quality of life. Nonetheless, due to severity of the disease there’s need for.

Disclosure
No.
(312) WHAT DO WE KNOW ABOUT ADULT BABY DIAPER LOVER (ABDL) SEXUALITY? A SCOPING REVIEW
Authors: Haymovitz E , Rosenman J , Karpman H , Haggarty A 
Published: December 2024

Abstract

Introduction
Adult Baby Diaper Lovers (ABDL) is a lifestyle, an identity, and community by and for consenting adults who share a common fetish in diapers. Paraphilic infantilism, or 'Adult Baby Syndrome', is the historic term used to describe this fetish, and it refers to a mental illness (Stekel, 1930; Pate & Gabbard). These terms are no longer politically correct, as the ABDL experience is no longer classified by the DSM 5 or ICD as a paraphilia (Murphy, Bradford, and Fedoroff, 2020).

Objective
The purpose of this study was to explore what is known about ABDL health and mental health by conducting a scoping review of the literature in the social and medical sciences.

Methods
The four presenters employed Covidence software and expansive search terms to screen and extract data from research articles identified in SCOPUS, MEDLINE, and Psychino. Search terms were: TITLE-ABS-KEY ((fetishism OR infantilism OR {Adult Baby?Diaper Lovers} OR abdl OR ab?dl OR (paraphili* W/2 infantilism) OR {Adult Baby Syndrome} OR "Diaper fetish*" OR diaperism OR (diaper AND (sex* OR kink)) OR autonepiophilia OR ageplay) AND (adult)).

Results
Discrepancies were resolved by consensus. After duplicates were removed in Covidence software, the protocol yielded 909 articles, 647 in Scopus, 359 in MEDLINE, and 92 in PsycINFO, and after thorough screening, these resulted in 42 studies for systematic review. Among books articles reviewed were theoretical explorations of psychological infantilism in Russia, a book on the psychoanalytic underpinnings of psychosexual infantilism from Germany, and several contemporary works addressing ABDL directly.

Conclusions
The majority of the literature on diaper fetishism and ABDL is historically associated with the period of time during which there was a diagnostic category available for paraphilic infantilism, and more recently, an identity category for ABDL. However, there remains a noticeable gap in the literature on the subject., Several foreign language articles and books, including those from Russia, Poland, and Germany, when taken together, do seem to comprehensively address the subject of psychosexual infantilism and diaper fetishism, the majority of North American literature appears to be associated with psychoanalytic case studies or the sensationalized subject heading of "adult baby syndrome". We conclude that this construct is woefully misunderstood, stigmatized, and hidden, because of poor coverage in the scientific literature.

Disclosure
No.
(313) PENILE PROSTHETIC PIONEER: F. BRANTLEY SCOTT
Authors: Ffurtado T , Lavold A , Loeb C , Bash J , Andino J , Jayadevan R , Mills J 
Published: December 2024

Abstract

Introduction
Dr. F. Brantley Scott (1930-1991) was a pioneer of prosthetic urology in the early 1970s, revolutionizing the treatment of erectile dysfunction (ED) and urinary incontinence. This abstract explores the life and groundbreaking contributions of Dr. Scott, emphasizing his development of the artificial urinary sphincter (AUS) and inflatable penile prosthesis (IPP).

Objective
To provide a comprehensive review of the history of Dr. F. Brantley Scott.

Methods
Extensive web-based research and historical accounts by those who knew him provided the primary source of information.

Results
Born in Pearsall, Texas in 1930, Dr. Scott embodied the larger-than-life Texan spirit with charm and brilliance, and he was often seen in his signature cowboy boots, massive belt buckle, and cowboy hat. His journey took him from an undergraduate at the University of Texas at Austin to Baylor College of Medicine where he completed his urology residency, ultimately rising to become a full professor at Baylor and chief of urology at the VA Hospital and St. Luke’s Episcopal Hospital in Houston. Dr. Scott’s devotion to teaching and mentorship fostered the development of eponymous implant luminaries Drs. William Furlow, John Mulcahy, and Steven Wilson. He popularized urodynamics for bladder function assessment and played a pivotal role in the development of the AUS. While tinkering with AUS hydraulics, he used a silicone elastomer from the US space program to develop the first IPP, initially known as the Scott prosthesis. Despite the prevailing belief in the psychological origins of impotence, he challenged the status quo and brought prosthetic urology into the limelight. While not the first to patent the IPP (credited to Dr. Barish Strauch), Dr. Scott’s collaboration with American Medical Systems (AMS) made the IPP a reality for patients. Dr. Scott’s patient selection process for IPP included comprehensive psychiatric evaluations and nocturnal penile tumescence measurements in sleep labs, revealing the connection between REM sleep and nocturnal erections. A true renaissance man, he was a pilot, author, artist, sculptor, rancher, musician, engineer, and entrepreneur. He retired in 1990 to pursue his passion for flying, but tragically lost his life during a test flight of a self-constructed plane near his Texas home in 1991.

Conclusions
Dr. F. Brantley Scott was a true visionary and pioneer of prosthetic urology. His groundbreaking work developing the AUS and IPP, combined with his larger-than-life Texan spirit, continue to influence urology, honoring his legacy as an innovative brilliant figure in the field.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific, Endo Pharmaceuticals and Halozyme Therapeutics.
(325) SINGLE-PORT ROBOTIC APPROACH TO RETRIEVAL OF MIGRATED INTRAVESICAL INFLATABLE PENILE PROSTHESIS RESERVOIR
Authors: Fakes C , Huang J , Stocks B , Johny A , Lipshultz L , Link R 
Published: December 2024

Abstract

Introduction
Migration of an IPP reservoir into the bladder is a rare, but known complication of penile prosthesis surgery with few documented cases over the past 25 years. Management options include retrograde removal via a penoscrotal/infrapubic approach without cystotomy closure and prolonged foley placement, versus an antegrade, open approach via an open cystotomy, closure of the bladder defect, and a similarly prolonged foley placement. The patient is a 67-year-old male with a non-functional IPP. He underwent a complete IPP explanation and replacement with a new device via a penoscrotal approach. The surgery was uncomplicated, and the patient was discharged home on post-operative day 1. The patient presented to the Emergency Department 4 days later with erythema spreading from the surgical site, concerning for cellulitis and possible infection. A CT scan demonstrated significant soft tissue changes as well as migration of the IPP reservoir into the urinary bladder. The decision was made to proceed with complete explantation of the penile prosthesis. Due to the complexity of the patient’s surgical history, body habitus, and the reservoir location, we proceeded with robotic-assisted laparoscopy via a transvesical approach using the Da Vinci SP platform.

Objective
We present a novel approach for removal of an intravesical IPP reservoir and cystotomy closure using the Da Vinci SP platform.

Methods
This video details the surgical approach to IPP explantation and removal of migrated intravesical IPP reservoir. The Single-Port Da Vinci robotic system was used for an intravesical approach to removal of the migrated reservoir and closure of the iatrogenic cystotomy.

Results
Post-operatively, the patient’s hospital course was complicated by an ileus which resolved with 3 days of nasogastric tube and bowel rest, as well as a popliteal DVT for which he was started on Eliquis. He was discharged on post-operative day 7 and foley catheter was removed post-operative day 10.

Conclusions
There were several benefits to using the single-port robotic approach. We had better visualization of the iatrogenic cystotomy than would have been possible via an open or laparoscopic approach. The single-port robot also required a much smaller incision than an open approach, allowing decreased morbidity of the procedure. Finally, there was the benefit of shorter foley catheter duration, as it was removed after 10 days. In conclusion, the single-port robotic approach was a successful and less morbid approach to retrieval of a migrated intravesical IPP reservoir.

Disclosure
No.