bluuebunny/crossref_metadata_2025_split huggingface dataset:
(177) FUSED DOUBLE-CYLINDER PENILE PROSTHESIS PLACEMENT AFTER PHALLOPLASTY WITHOUT URETHRAL LENGTHENING: A NOVEL TECHNIQUE USING A 2-PIECE IPP
Authors: Sandhu S , Dadashian E , Mallavarapu S , Smith S , Garcia M 
Published: December 2024

Abstract

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

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

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

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

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

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

Abstract

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

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

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

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

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

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

Abstract

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

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

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

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

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

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

Abstract

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

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

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

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

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

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

Abstract

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

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

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

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

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

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

Abstract

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

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

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

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

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

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

Abstract

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

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

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

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

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

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

Abstract

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

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

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

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

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

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

Abstract

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

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

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

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

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

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