bluuebunny/crossref_metadata_2025_split huggingface dataset:
(207) THE LANDSCAPE OF TESTOSTERONE REPLACEMENT THERAPY RESEARCH: A BIBLIOMETRIC AND PUBLIC ATTENTION ANALYSIS
Authors: Manafi E , Furtado T , Mills N , Eleswarapu S , Mills J , Andino J 
Published: December 2024

Abstract

Introduction
Testosterone Replacement Therapy (TRT) is a pivotal treatment for men with hypogonadism, aiming to alleviate symptoms of testosterone deficiency. Given the debates over TRT’s safety, particularly concerning prostate cancer and cardiovascular risks, it is crucial to understand the most influential research at both the academic setting as well as what lay audiences are being exposed to.

Objective
This bibliometric analysis aims to identify and analyze the most cited and impactful literature on TRT using two distinct metrics: Web of Science (WoS) citations and Altmetric Attention Scores (AAS), a metric that captures the online visibility of academic work.

Methods
A comprehensive literature search was performed using WoS and Altmetric Explorer with the keyword "testosterone replacement therapy." Two urology researchers screened the top 1000 papers from both databases to identify the top 100 relevant papers. Data extraction included citations, authorship, publication journals, language, study design, country, year of publication, and specific TRT topics. Altmetric scores were calculated based on a weighted algorithm considering various types of attention, such as news and social media mentions.

Results
From WoS, the highest cited paper was “The Decline of Androgen Levels in Elderly Men and its Clinical and Therapeutic Implications” (Kaufman and Vermeulen, 2005), with 786 citations. The median and mean citations for the top 100 papers were 145.5 and 195.2, respectively. The most frequent journal was the Journal of Clinical Endocrinology & Metabolism (JCEM), contributing 17 papers and 4350 citations. Most papers were in English and affiliated with institutions in the United States (47%), followed by Europe (29%). Studies focused on treatment dominated (61%), with evaluation (34%) and comorbidities (5%) following. From Altmetric Explorer, the median and mean Dimension citations were 52 and 94.96, respectively. The most frequent journal was also JCEM, and all papers were in English, primarily from the United States. The paper “Effects of Testosterone Treatment in Older Men” by Synder et al. (2016) possessed the highest Altmetric Score of 1691, with 660 Dimension citations. The most recent top paper, “Cardiovascular Safety of Testosterone-Replacement Therapy” (Lincoff et al., 2023), ranked second with Altmetric Score of 1217 and 61 Dimension citations.

Conclusions
While WoS citations reveal the historical foundations and established research trends for evaluation and management of testosterone deficiency, Altmetric scores offer insights into current public and academic interest, particularly around cardiovascular concerns. This dual bibliometric approach provides a detailed understanding of influential TRT literature which shaped its history and current clinical concerns across specialties – from urology to endocrinology and primary care.

Disclosure
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(208) SOCIAL MEDIA, BODY DYSMORPHIA AND RESISTANCE TRAINING: THE EMERGING WAVE OF ANABOLIC ANDROGENIC STEROIDS IN MEN
Authors: Guillen A , Bonakdarhashemi M , Pinkhasov A , Helo S , Kohler T , Ziegelmann M 
Published: December 2024

Abstract

Introduction
Resistance training by recreational sportspeople in fitness settings has become increasingly popular worldwide, moreover an increasing landscape of social media (SM) influencers in bodybuilding have arisen since 2021, specially on short-duration videos (clips). Some Image enhancer drug users, including anabolic androgenic steroids (AAS) are known to mistrust medical health professionals and seek out information and advice from online sources.

Objective
we aimed to quantitatively assess the quality of social media videos as an information source for AAS usage in the general population.

Methods
A search was performed on the most popular short-clips social media platforms in the US (TikTok, YouTube) with the most searched terms for AAS. The first 50 results with any search term listed by relevance were selected in each platform. Video features (views, likes, subscribers) and video sources were collected. Each video included in the study was assessed using DISCERN score to quantify the source quality.

Results
A total of 100 videos were included and analyzed. Most videos (84%) were from non-health professionals (influencers/clip source/podcasts), only 7% of the videos came from a health educator/physician. Most videos were rated as “very poor” (85%) and “poor” (7%) According to the DISCERN classification, there was a statistically significant difference (p &lt; 0.001) by both content creator type, and platform with the highest scores among physicians [37 (33-41)] and YouTube [19(17.7-30.2]. [Fig].

Conclusions
Image-centric social media use is positively associated with the use of AAS. Despite the increasing number of information, the overall quality was poor. The misleading, inaccurate and incomplete information may pose a health risk to the viewers. Further efforts in health policies are strongly encouraged to assess this problem.

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(209) TIKTOK FOR LOW T: THE CURRENT LANDSCAPE OF TESTOSTERONE REPLACEMENT THERAPY MISINFORMATION AND SUPPLEMENTATION ON A POPULAR VIDEO PLATFORM
Authors: Cheng L , Huang S , Hwang K 
Published: December 2024

Abstract

Introduction
Due to challenges diagnosing young men with “low T” secondary to non-specific presenting symptoms, patients have turned towards self-managed forms of treatment obtained from non-medical resources like TikTok without proper risk of future side-effects.

Objective
Understand the current landscape of symptomatic hypogonadism (i.e., “low T”) content and treatment options on TikTok, the fast-growing social media platform in popularity.

Methods
Using a proprietary TikTok application program interface (API) program, we queried the most-viewed TRT-related videos based on associated hashtag created from October 2022 – 2023. Videos in a language other than English, lacking textual or verbal content, or deemed unrelated to TRT were excluded. Included videos were subsequently analyzed by two independent reviewers based on the AUA Testosterone Deficiency Guidelines (AUA-TDG).

Results
Of 562 videos, 50 videos by 22 unique creators met inclusion criteria; since their creation, these videos garnered more than 15 million views, almost 1 million likes, and 35 K shares. While 36% of these videos mentioned TRT would improve erectile function, lean body mass, and/or depressive symptoms (AUA-TDG 14,) only four mentioned inconclusive evidence around TRT improving cognitive function (AUA-TDG 15) or encouraging lifestyle modification prior to starting TRT (AUA-TDG 21). No videos analyzed mentioned the long-term impact of exogenous testosterone on future fertility (AUA-TDG 16). Of the 22 unique creators, only one was an MD trained in family medicine. Most videos (72%, n = 36) were made by companies advertising their supplement.

Conclusions
Patients are increasingly turning towards non-medical institutions for low T information and supplementation. By the time patients seek medical care, it may be due to improperly advised negative side effects. Given the lack of educational, non-commercial videos about TRT benefits and risks on popular content platforms like TikTok, we urge physicians to actively engage in creating accurate and holistic content to reach patients currently consuming healthcare disinformation.

Disclosure
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(212) INVESTIGATING THE ROLE OF ALCAM AS A GENE OF INTEREST IN ERECTILE DYSFUNCTION
Authors: Christensen B , Pastuszak A , Hotaling J , Wessells H 
Published: December 2024

Abstract

Introduction
Erectile Dysfunction (ED) is a common and psychologically damaging condition, impacting 20% of all men and 33% of men over age 50, increasing at 10% per additional decade of age, and costing billions of dollars per year to treat. Since the introduction of PDE5 inhibitors (PDE5i) in 1998, no novel therapies for ED have been introduced, despite substantial research to understand ED molecular mechanisms. Identification of genes associated with ED would provide a deeper understanding of underlying mechanisms and could provide targets for additional therapies. We previously identified Activated Leukocyte Cell Adhesion Molecule (ALCAM) as a candidate ED gene in men with diabetes. In order to understand the potential role of ALCAM in ED development, we have created lentiviral gRNA vectors for the up- and down-regulation of ALCAM in an in vitro setting. Subsequent to up- and down-regulation of ALCAM, we will perform PCR in order to identify changes in down-stream regulation of genes and pathways that may be implicated in ED progression.

Objective
To determine the down-stream influence of ALCAM regulation on genes and pathways that may be implicated in ED progression.

Methods
For down-regulation of ALCAM, gRNAs were delivered to fibroblasts with a nuclease deficient (d) dCas9-KRAB system adapted from Streptococcus pyogenes. For upregulation, gRNAs were delivered to fibroblasts expressing the dCas9-VPR system adapted from Streptococcus pyogenes. Gene regulation via these systems was assessed using qRT-PCR. RNA sequencing and analysis will be performed by the High-Throughput Genomics and Bioinformatic Analysis core at the University of Utah.

Results
Final values for vector efficiency for up- and down-regulation of ALCAM are pending. Final vectors used will be chosen from four potential vectors each for up- and down-regulation. RNA sequencing will be performed pending final modification of cells with chosen vectors, though results from similar studies suggest that differential gene expression will range from 5,000-10,000 differentially regulated genes which will then be evaluated with pathway analysis.

Conclusions
Previous studies by our group have identified ALCAM as a potential gene of interest in the regulation of ED. Analysis of down-stream regulation of genes and pathways implicated in ED progression following regulation of ALCAM will shed additional light on the potential role of ALCAM in ED pathogenesis.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Paterna, Contraline.
(213) MICROSURGICAL DEVELOPMENT IN FRESH CADAVER - A NEW ERA FOR SURGICAL LEARNING
Authors: Campos LR , Oliveira KM , Savio LF , Kulumbu KM , Campos ME , Reis AB 
Published: December 2024

Abstract

Introduction
Microsurgical skills are indispensable for good patient outcomes and a successful surgeon career in male reproductive medicine. The development of these surgical skills is a long hard-earned process with hours of practice and dedication. The learning curve in acquiring microsurgical skills defines the need for training outside the operating room and training models are becoming a crucial step in the progress of the apprentice towards performing live operations. Several surgical simulation techniques are available offering different degrees of realism. One of these techniques is based on learning through fresh cadaver models providing visual and tactile learning closer to real-life anatomy. In this fresh frozenncadaver model, following our preservation protocol, the viability of all the structures of the male reproductive system allowed for microsurgery training with vasovasostomy and other local surgical treatments, with the appearance of a conventional operating room with a genuine patient.

Objective
Describe the most realistic and innovative simulation model of these applicable educational tools for urological microsurgery using a fresh frozen cadaver.

Methods
Microsurgical training was performed with 3 microsurgically qualified urologists and 3 trainees in a fresh frozen cadaver. A step-by-step of vasovasostomy surgery and other procedures were performed in the simulation model, from the physical examination to the last stitch in the skin.

Results
All the reproductive system structures in the fresh frozen cadaver were presented in the same way as in a live patient (Fig. A and B). The texture, the consistency of the anatomic tissues and even the coloring were preserved, enabling urologists in training to perform vasectomy reversals on the model, realistically simulating conventional surgery (Fig. C and D).

Conclusions
The training of vasectomy reversal on the fresh frozen cadaver, stored at low temperatures and treated with cryopreservatives and antimicrobials provides more realistic learning. The preservation of the cadaver gives it a great physical similarity to a live patient. It also allows the surgeon in training to maintain all the surgery times, from the skin incision to the final suture. A new tool has emerged with strong real-life characteristics for training urologists in microsurgery.

Disclosure
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(228) PARTNER SATISFACTION AFTER PENILE PROSTHESIS PLACEMENT IN PATIENTS WITH ERECTILE DYSFUNCTION
Authors: Dumbrava M , Guillen A , Pinkhasov A , Ziegelmann M , Kohler T , Helo S 
Published: December 2024

Abstract

Introduction
Penile prosthesis (PP) implantation is associated with high patient satisfaction and improved sexual quality of life in medically refractory erectile dysfunction (ED). Despite the current surgical advances and patients’ satisfactions after PP implantation, there has been paucity of data on reported partner satisfaction. We aimed to evaluate changes in partner satisfaction after PP placement.

Objective
We aimed to evaluate changes in partner satisfaction after PP placement.

Methods
We initiated a registry of patients undergoing surgery for placement of a PP. After consent, Perioperative study assessments and follow-ups were conducted. After surgery, patients were directed to fulfill a survey at 6 months and 12 months. Patients who fulfilled both items were included in the analysis.

Results
A total of 304 patients had a PP placement, of these 101 completed the survey. At 6 months, 62 patients (61.4%) reported a moderate to high partner’ satisfaction, and this positive response was sustained at 12-months (82.3%). 73.3% of partner’s reported no-pain after 6 months and this increased to 79.7% after 12 months. 67.3% of partners stated they would recommend the procedure to a friend or family at 6-months. This increased significantly to 84.8% at 12-months (p = 0.012).

Conclusions
Penile prosthesis placement is associated with high partner satisfaction rates, with a sustained positive perception over time when comparing 6 and 12-month follow-up outcomes. Further study is warranted to assess partner satisfaction after penile prosthesis implantation.

Disclosure
Yes, this is sponsored by industry/sponsor: COLOPLAST.
Clarification: Industry funding only - investigator initiated and executed study.
(230) EXPLORING HOW BMI SHAPES THE SUCCESS OF INFLATABLE PENILE PROSTHESIS SURGERY: MULTI-CENTER STUDY INSIGHTS
Authors: A Moukhtar Hammad M , Gross MS , Miller J , Abou Chawareb E , Andrianne R , Burnett AL , Amini E , Gross K , Hatzichristodoulou G , Lentz A , Osmonov D , Modgil V , Perito P , Hotaling JM , Park SH , Pearce I , Sadeghi-Nejad H , Sempels M , Suarez-Sarmiento Jr. A , Van Renterghem K , Warner JN , Ziegelmann M , Hsieh TC , Azad B , Karthikeyan H , Jenkins L , Jones J , Simhan J , Yafi FA ,   on behalf of the PUMP (Prosthetic Urology Multi-institutional Partnership) collaborators, Barham DW 
Published: December 2024

Abstract

Introduction
Obesity, defined as an elevated Body Mass Index (BMI) &gt;30, is a prevalent public health concern with far-reaching implications for various medical procedures and outcomes. In the context of inflatable penile prosthesis placement (IPP), where patient well-being and surgical success are of paramount importance, the impact of obesity on postoperative and intraoperative complications warrants thorough investigation.

Objective
We aimed to investigate the impact of BMI on both postoperative and intraoperative complications in an international, multi-institutional cohort of patients who underwent IPP placement.

Methods
We performed a retrospective chart review of 4,398 cases. These cases were divided into two distinct groups based on BMI: less than 30 (n = 2,260) and greater than or equal to 30 (n = 2,138). The study assessed various surgical factors as well as complications, including overall complications, corporal scarring, incontinence, intraoperative complications, proximal perforation, distal perforation, proximal crossover, distal crossover, and urethral injury.

Results
Our analysis revealed that there were no statistically significant differences in intraoperative or postoperative complications between the two BMI categories. Notably, proximal corporal measurement was significantly higher for &gt;30 BMI group with 1858 (86.9%) compared to 1919 (84.9%) for &lt;30 BMI group, (p = &lt; 0.001). The incidence rates for overall complications (30.2% vs. 28.7%; p = 0.164), corporal scarring (18.2% vs. 16.7%; p = 0.36), incontinence (3.53% vs. 3.13%; p = 0.076), intraoperative complications (1.94% vs. 1.68%; p = 0.253), and specific complications all exhibited no significant differences. Similarly, post-operative complications, including both non-infectious (6.99% vs. 6.22%; p = 0.215) and infectious (2.61% vs. 1.87%; p = 0.165) complications, did not significantly vary between BMI categories.

Conclusions
Our findings indicate that BMI does not exert a statistically significant influence on postoperative and intraoperative complications in the context of high-volume prosthetic urology. In the absence of any other differences between patients of differing BMIs, the IPP industry may need to consider device specific alterations with pump tubing length in obese patients.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast, Clarus Therapeutics, Antares Pharma, Acerus.
(232) AGGRESSIVE REHABILITATION POST-IPP EXCHANGE: WE BLEW A GASKET
Authors: Calopedos R , Suarez-Sarmiento A , Perito P 
Published: December 2024

Abstract

Introduction
In our center, the majority of men undergoing virgin IPP are engaging in sexual activity from 14-21 days post-operatively. Our standard protocol in these patients is to leave cylinders completely deflated post-operatively without compressive dressing or foley catheter. A 10Fr Jackson Pratt closed suction drain is left for 48-72 hours. At 10-14 days patients are taught to cycle their device. In November 2023, we implemented an accelerated rehab to coitus algorithm for patients undergoing simple device exchanges as well. We interrogated the effect of this protocol change in IPP exchanges over a 6-month period.

Objective
To interrogate an accelerated post-IPP rehab protocol in simple exchange cases.

Methods
This is a retrospective review of virgin IPP insertions and exchange cases that occurred between November 2023 and May 2024. Inclusion criteria were uninfected revision cases for existing device malfunction for which all components were exchanged. In the month of November, post-op protocols were identical for virgin and exchange cases, except that two closed-suction drains were used in the latter. Data on post-operative course, complications and time to sexual activity were collected. Of note, post-exchange rehabilitation protocol was modified in December 2023. Following identification of 2 complications, all exchange cases were advised to leave device completely deflated for 6 weeks.

Results
In this 6-month period, there were 156 virgin IPP insertions. Of these men, 85% had engaged in sexual activity from 14-21 days post-operatively. All 156 remain without complication until the end of June 2024. There were 40 device exchanges in this period, all of which were successfully exchanged via infrapubic incision to Coloplast Titan IPP irrespective of the primary surgical approach or device. 6 exchanges occurred in November 2023 when the accelerated rehabilitation protocol was instituted. Of these 6 cases, 2 (33%) developed proximal cylinder herniation through the corporotomy site within 2 weeks of initiating sexual activity. This was the first exchange for both men. Neither patient, aged 58 and 70 years, have medical conditions that would impair normal healing. For the subsequent 34 exchanges, who did not activate their IPP for 6 weeks, there were no cylinder herniations. All 34 men were able to successfully cycle their device at 6 weeks without de-novo deformity.

Conclusions
While an accelerated rehabilitation protocol is safe for virgin cases, we observe that a longer duration of time is required for healing following non-virgin cases. Even in the absence of systemic factors or localised infection, the corporal tunica appears to behave differently following initial intervention and requires longer for corporal integrity to re-establish.

Disclosure
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(251) WHICH PATIENTS CHOOSE SHOCKWAVE THERAPY? AN ANALYSIS OF PATIENT DIRECTED UTILIZATION OF LISWT AT AN ACADEMIC INSTITUTION
Authors: Hartman-Kenzler J , Griffin S , Mishra A , Berg W 
Published: December 2024

Abstract

Introduction
Low-intensity shockwave therapy (LiSWT) is an increasingly popular treatment for mild to moderate erectile dysfunction (ED). While considered investigational, a wide range of patients are progressively seeking and obtaining LiSWT in a variety of settings overseen by a wide range of providers in various medical and non-medical settings.

Objective
Assess which patients are more likely to elect for LiSWT when administered and overseen by fellowship trained sexual medicine providers in an academic medical setting.

Methods
Retrospective review of consecutive patients suspected of having arterial insufficiency predominant ED presenting for diagnostic Duplex Doppler ultrasound of the penis with intention to undergo LiSWT. Patient demographics, comorbidities, baseline, in-treatment, and post treatment sexual health inventory for men (SHIM) score, prior ED treatments, and insurance status was collected. Patients who elected to undergo LiSWT were compared to those who did not. Patients were specifically counseled on expected outcomes based on prior published efficacy data for baseline SHIM score and ED severity based on peak systolic velocity. All patients who utilized LiSWT underwent a standard protocol using the Storz Duolith SD1 with 6 consecutive weekly sessions of 3,000 shocks per session at 0.25 mJ/mm2 at 6 Hz divided between the penile shaft and crura.

Results
100 consecutive patients with vasculogenic ED received a diagnostic Duplex Doppler ultrasound in the office. Of these patients, 22 elected to undergo LiSWT. Patients who elected to have LiSWT were older compared those who did not (58 versus 52 years old, p &lt; 0.05). There was no statistically significant difference in ethnicity, baseline SHIM score, maximum arterial blood flow on doppler US, or insurance type/status. The most commonly cited barrier to pursuing treatment was cost compared to expected outcomes. Baseline mean PSV in the LiSWT cohort was 37.5 cm/s versus 42.9 cm/s in the non LiSWT group. 100% of patients in either group had prior PDE5i exposure.

Conclusions
In an academic practice with fellowship trained sexual medicine urologists, there does not appear to any significant differences patients who decide to undergo LiSWT. Many patients choose to pursue LiSWT despite low normal PSV or mild arterial insufficiency ED. Despite extensive counseling, most patients appear eager for non-invasive treatment alternatives to PDE5i, even with a lack of definitive evidence in efficacy. The biggest barrier to treatment remains cost for many patients.

Disclosure
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