bluuebunny/crossref_metadata_2025_split huggingface dataset:
(153) CORRELATION BETWEEN SELF-AWARENESS OF PEYRONIE’S DISEASE AND CLINICAL DIAGNOSIS: A CROSS-SECTIONAL STUDY
Authors: Cavalcanti Filho M , Monteiro L , Lattanzi C , Fernandes G , Lemos C 
Published: December 2024

Abstract

Introduction
Peyronie’s Disease (PD) is a connective tissue disorder characterized by the growth of fibrous plaques within penile tissues. These plaques lead to various symptoms, including pain, acquired curvature, erectile dysfunction, indentation, narrowing, shortening, palpable plaques, and axial instability of the penis. These conditions can be together or isolated. PD becomes more prevalent with age and is estimated to affect 1–20% of men.

Objective
The objective of this study is to investigate the correlation between self-awareness of Peyronie’s Disease and clinical diagnosis during physical examination.

Methods
In our cross-sectional study, we examined men experiencing sexual dysfunction, focusing on their awareness of Peyronie’s disease. Participants were asked a direct question about their knowledge of the disease, with “yes” or “no”. A subsequent physical examination by a urologist confirmed the presence or absence of Peyronie’s disease. We divided according to the reason for the exam into erectile dysfunction, Peyronie’s disease and erectile dysfunction with Peyronie’s disease. All statistical and graphical analyses were performed using RStudio. This study provides insights into the correlation between patients’ awareness and the actual diagnosis of Peyronie’s disease.

Results
We evaluated 170 men from January to April 2024. Among them: A) 78 men had physical evidence of Peyronie’s Disease (PD) during the physical examination. B) 45 men self-reported awareness of having PD and presented with physical signs during the examination. C) 33 men had PD based on the physical examination but were unaware of this condition. The chi-squared test indicates that self-awareness of the presence or absence of PD is significantly related to the physical examination results (p &lt; 0.001).

Conclusions
Our findings revealed association between patients’ awareness of their condition and the confirmed clinical diagnosis, and another part of patients has a significant unaware of Peyronie diagnosis, demonstrated the important of physical examination with specialist.

Disclosure
No.
(156) THE IMPACT OF RELIGIOSITY ON SEXUALITY IN PROSTATE CANCER PATIENTS
Authors: Silva I , Naccarato A , Souza L , Barbuio ME , Denardi F , Matheus W , Ferreira U 
Published: December 2024

Abstract

Introduction
The Prostate Cancer (PCa) and its treatments side effects have repercussions on self-image by encompassing cultural, symbolic, social, and economic aspects present in the male identity construction. Psychosocial interventions are associated with the reduction of emotional stressors by allow patients to talk about their experiences, sensations, sexuality and return to everyday life despite of the limitations that the treatment imposes. Sexuality is approached not only as a sexual function, but also its culture values that make it up. It is unclear, until the present moment, how religion can interfere in the sexuality and sexual approach.

Objective
Evaluate the impact of religiosity on the sexuality in PCa patients, who went through radical prostatectomy, radiotherapy, androgen deprivation therapy and/or active surveillance and take part in a psychoeducational therapy group.

Methods
Application of a six questions questionnaire addressed to the patients, from their own perceptions, that includes their sexual desire, partner’s and self-satisfaction, how the partner reacts to the patient’s sexual side effects after treatment, how patient’s and partner’s religion interferes with sexual intercourse, with or without penetration.

Results
The questionnaire was applied in a group with 7 patients, 6 of whom were Catholic and 1 Evangelical, 2 did not have steady partners. All the seven patients recognized that their religion did not interfere in sexual intercourse. However, the religion of the partner interferes in sexual intercourse with penetration for one patient, and for two patients without penetration.

Conclusions
Although religiosity is part of social and cultural values, it has not been shown to interfere with the sexuality and sexual intercourse of the patients evaluated. The religiosity of their partners, on the other hand, showed some influence in 3 of the 7 patients evaluated.

Disclosure
No.
(164) EXPLORING FEMALE SEXUAL PREFERENCES WORLDWIDE: GYNEPHILIA, NON-HETEROSEXUALITY AND FLUIDITY
Authors: Camperio Ciani AS , Colledani D 
Published: December 2024

Abstract

Introduction
Social influences and a lack of clear self-awareness might hinder women from openly disclosing their non-heterosexual orientation. Implicit methods may offer more dependable data in such cases.

Objective
This study explored non-heterosexuality and gynephilia in a large, worldwide sample of women, using both implicit and explicit methods. Implicit measures would exhibit consistency across different cultures, while explicit measures were anticipated to vary due to social influences.

Methods
A total of 491 women were recruited via an online platform to partake in this cross-sectional study. Each participant, expressed consent to partecipate, completed a brief biographical questionnaire, the Autobiographical-Implicit Association Test (A-IAT), the Sexual Preference-Implicit Association Test (SP-IAT), and an explicit measure of sexual orientation. These responses were analyzed to investigate explicit sexual orientation and implicit gynephilia across six major geographical regions (Middle East and Africa, South America, North America, Asia, Europe, and Oceania). In the subsequent phase, 263 participants completed a new implicit sexual orientation measure (Autobiographical Sexual Orientation-Implicit Association Test, ASO-IAT) and provided information on their sexual behaviors through two questions. Additionally, participants were asked about their subjective assessments of the stimuli presented in the SP-IAT.

Results
Implicit measures revealed a higher prevalence of gynephilia (67.8%) compared to explicit non-heterosexuality (19.6%), with consistent findings observed across continents. These results imply that women may experience attraction towards other women even if it doesn’t always translate into a desire for sexual encounters. Furthermore, the findings indicate a notable degree of sexual fluidity within the female population.

Conclusions
Compared with explicit assessments of non-heterosexuality, implicit measures appear to be less influenced by social factors. However, while androphilia is a prerequisite for non-heterosexuality in men, gynephilia is not necessarily a proxy of non-heterosexuality in women. Women also reveal a greater propensity for sexual fluidity than men.

Disclosure
No.
(166) SERUM TESTOSTERONE LEVEL AS A PREDICTOR OF BIOCHEMICAL RECURRENCE IN MEN WITH PROSTATE CANCER
Authors: Mulhall J , Elshafei A , Flores J 
Published: December 2024

Abstract

Introduction
The literature has engaged in a discussion regarding the potential connection between total testosterone (TT) levels and biochemical recurrence (BCR) in individuals diagnosed with prostate cancer (PC).

Objective
We herein explore the relationship between preoperative TT levels and the BCR rates in these men.

Methods
We retrospectively reviewed the records of 1599 men with PC treated by RP. We excluded men who had androgen deprivation therapy (ADT) prior to RP or within 3 months after RP from the study. Morning TT levels measured by LCMS within 3 months of RP with low TT defined as &lt;300 ng/dl. BCR defined by two consecutive postoperative prostate specific antigen (PSA) levels of ≥0.1. Univariate analysis (UVA) was used to examine predictors of BCR. Variables included in the analysis were age, comorbid conditions pretreatment PSA, clinical T stage, biopsy GG, peri-operative TT, and adverse pathological features at RP (extracapsular extension (ECE), seminal vesical invasion (SVI), positive surgical margins (PSM), lymph node invasion (LNI)). Multivariable analysis (MVA) was conducted using those factors found to be significant on UVA.

Results
1599 men analyzed. Median age 63 (57, 68) years, median follow up of 62 (18115) months. Pre-RP PSA 6 (4,9) ng/ml, TT 447 (343, 575) ng/dl. Median GGG 2 (2, 3). 57% had ECE, 12% SVI, 22% PSM, 14% LNI. BCR occurred in 26% of men with a median time of 28 (5.7, 66.6) months. On MVA, higher biopsy GGG, clinical stage ≥T2b, higher pre-RP PSA, and adverse pathological features at RP were independent predictors of BCR, while peri-operative TT (≤300 ng/dl) was not associated with BCR. (Table) Additionally, we did not identify any association between extremely low TT levels (≤200 ng/dl) and BCR.

Conclusions
TT was not associated with biochemical recurrence in men after RP.

Disclosure
No.
(167) CONTEMPORARY HIGH-LEVEL RADIATION THERAPY PROSTATE CANCER TRIALS MAY UNDERESTIMATE THE RISK OF BIOCHEMICAL RECURRENCE
Authors: Mulhall J , West M , Flores J 
Published: December 2024

Abstract

Introduction
Prostate specific antigen (PSA) is an important tool for the diagnosis of prostate cancer and detection of biochemical recurrence (BCR) after treatment. Secretion of PSA is a testosterone (T) dependent process. When T levels are below saturation point, PSA levels may be artificially low. T recovery rates after ADT cessation are variable and often fail to normalize. Recent data suggest that PSA levels should be indexed to T levels. The Radiation Therapy Oncology Group (RTOG, now NRG) has performed numerous clinical trials of radiotherapy (RT) with androgen deprivation therapy (ADT) in this population. Herein, we explore whether the RTOG trials have indexed post-treatment PSA to T levels.

Objective
The clinicaltrials.gov (CTG) website was reviewed for RT/ADT clinical trials run by the RTOG/NRG over the past decade. For studies with results, manuscripts were reviewed; for the others the CTG protocol was reviewed. Demographic, oncologic, and treatment characteristics such as age, baseline PSA, Gleason grade, and length of treatment were collected if available. Data were reviewed assessing for mention of T measurement at time of post-treatment PSA checking, as well as assay suggested and time of day adherence for T measurement.

Methods
The clinicaltrials.gov (CTG) website was reviewed for RT/ADT clinical trials run by the RTOG/NRG over the past decade. For studies with results, manuscripts were reviewed; for the others the CTG protocol was reviewed. Demographic, oncologic, and treatment characteristics such as age, baseline PSA, Gleason grade, and length of treatment were collected if available. Data were reviewed assessing for mention of T measurement at time of post-treatment PSA checking, as well as assay suggested and time of day adherence for T measurement.

Results
15 clinical trials that met the study criteria were identified (Table). 14 029 patients have been enrolled. Median age was 64 (IQR [interquartile range] 2.5) years, median PSA was 0.5 (IQR 3.8), median Gleason grade group was 2 (IQR 1). 6/15 (40%) made no mention of T measurement whatsoever. None of the manuscripts published to date reported any T levels. One study had T recovery after ADT in the CTG results. Only 4/10 (40%) protocols stipulated that T should be measured concurrently with PSA, for an overall 27% T measurement performance rate. Only 1 protocol stipulated the type of assay and time of day (morning) measurement. 9/15 (60%) did not require regular follow up testosterone measurements for patients on ADT, while only 2/15 (13%) studies required a baseline T level to be measured.

Conclusions
Routinely indexing testosterone to PSA levels after high level RT/ADT trials is uncommon. This renders the BCR data unreliable, potentially underestimating BCR rates in these trials.

Disclosure
No.
(172) AN ANALYSIS OF THE EFFICACY OF MULTILAYERED REPAIR AND RECONSTRUCTION USING COMBINED TISSUE PEDICLE FLAPS FOR ABDOMINAL WALL DEFECTS IN ADULT BLADDER EXSTROPHY PATIENTS
Authors: Dilixiati D , Azhati B , Waili A , Li W , Reheman A 
Published: December 2024

Abstract

Introduction
Classic bladder exstrophy (CBE), an exceedingly rare congenital anomaly, is frequently accompanied by a profound and severe manifestation of genitourinary malformations. Classic bladder exstrophy has persistent deleterious effects on the urinary, reproductive, and sexual health of patients, which, if not managed judiciously, can culminate in renal impairment, infertility, and sexual dysfunction due to inadequate treatment.

Objective
In this study, we conducted a retrospective analysis of cases involving adult classic bladder exstrophy(CBE) accompanied by the absence of the abdominal wall. Specifically, we focused on the utilization of multilayer flaps for reconstructive purposes. Additionally, we aimed to share our clinical treatment experience pertaining to similar challenges, thereby providing valuable insights to complement the surgical management of this rare disease.

Methods
We conducted a retrospective analysis of 12 adult patients diagnosed with CBE who underwent initial treatment between June 2013 and January 2020. All patients underwent multi-layer reconstruction to address their abdominal wall defects. This involved utilizing shallow flaps derived from the superficial fascia of the abdomen and incorporating myofascial flaps composed of the anterior sheath of the rectus abdominis and aponeurosis of the external oblique muscle. The flaps size ranged from (9 cm × 11 cm) to (13 cm × 15 cm).

Results
Abdominal wall reconstruction in the 12 patients with CBE resulted in an absence of wound dehiscence recurrence, urinary obstruction, or urinary tract infection. All patients expressed satisfaction with the aesthetic outcome of their abdominal wall based on self-evaluation. They reported a successful resumption of normal life and work activities without experiencing any restrictions. The married patients expressed contentment with their sexual function.

Conclusions
The utilization of a multi-layered reconstruction technique involving multiple flaps in adults with congenital classic bladder exstrophy allows for successful restoration of urinary function, as well as the attainment of sufficient abdominal wall strength to support daily life and work activities, while preserving sexual function. However, it is important to approach the evaluation of surgical outcomes with caution due to the rarity of this condition and the lack of objective assessment measures.

Disclosure
No.
(175) SEXUAL HEALTH IN THE ERA OF ARTIFICIAL INTELLIGENCE: A REVIEW OF THE LITERATURE
Authors: Abou Chawareb E , Lu S , Chen H , Lee J , Hammad M , Miller J , Azad B , Yafi F 
Published: December 2024

Abstract

Introduction
Artificial Intelligence (AI) has witnessed significant growth in the field of medicine, leveraging machine learning (ML), artificial neuron networks (ANNs), and large language models (LLMs). These technologies have found applications across various medical specialties, proving effective in disease diagnosis, education, and prevention, while raising ethical concerns and potential challenges. However, their utility in sexual medicine remains relatively unexplored.

Objective
In this review, we aim to provide a comprehensive summary of the current status of AI in the field of sexual medicine.

Methods
A comprehensive electronic search was conducted using MeSH keywords, including “artificial intelligence (AI),” “sexual medicine,” “sexual health,” and “machine learning.” Two investigators screened articles for eligibility within the PubMed and MEDLINE databases, with conflicts resolved by a third reviewer. Articles in the English language that reported on AI in sexual medicine and health were included. A total of 49 full-text articles were systematically analyzed based on predefined inclusion criteria. Data extraction included information on article characteristics, study design, assessment methods, and outcomes.

Results
The initial search yielded 554 articles relevant to AI in sexual medicine and health. Upon assessing the full text of 56 articles for eligibility, seven studies unrelated to AI in sexual health were excluded, resulting in 49 articles for systematic review. The analysis revealed AI’s accuracy in preventing, diagnosing, and decision-making in sexually transmitted diseases (16 of 17 articles). AI also demonstrated the ability to diagnose and offer precise treatment plans for male and female sexual dysfunction and infertility (10 of 10 articles), accurately predict sex from bone and teeth imaging (5 of 5 articles), and correctly predict and diagnose sexual orientation and relationship issues (17 of 17 articles). AI emerged as a promising modality with significant implications for the future of sexual medicine.

Conclusions
Further research is essential to unlock the potential of AI in sexual medicine. AI presents advantages such as accessibility, user-friendliness, confidentiality, and a preferred source of sexual health information. However, it still lags behind human healthcare providers in terms of compassion and clinical expertise.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Sprout.
(176) ADVANCING SEXUAL HEALTH: PROSPECTION OF ARTIFICIAL INTELLIGENCE FOR DIAGNOSIS, TREATMENT, AND COMMUNICATION
Authors: Tunes De Paula A , Mazoni Costa R , Ferreira Arantes Da Costa T , Nunes De Brito D , Kretli Santos L , Luiza Mendonça De Amorim A , Eduardo Fernandes Tavora J 
Published: December 2024

Abstract

Introduction
Sexual dysfunctions, particularly erectile dysfunction (ED), significantly affect individuals’ quality of life. Advances in artificial intelligence (AI) provide promising tools for enhancing diagnosis and treatment in this sensitive field. By improving interactions between patients and providers, AI applications could transform approaches to sexual health, offering more precise and effective communication.

Objective
The aim of this study is to assess the feasibility, accuracy, and patient trust in AI tools for managing sexual dysfunctions. This involves analyzing various AI technologies such as machine learning, neural networks, and deep learning, examining their application across different types of sexual dysfunctions including erectile dysfunction and desire disorders, and evaluating their effectiveness and accuracy.

Methods
A systematic review was conducted, sourcing articles from the last five years using PubMed with keywords tailored to capture the intersection of AI with sexual health diagnostics and treatments. Terms used included “Artificial Intelligence,” “sexual dysfunction,” “erectile dysfunction,” “sexual health diagnosis,” “machine learning,” and “deep learning.” Articles from the last five years, in English, were included.

Results
Eleven studies met the inclusion criteria and were analyzed. AI tools displayed high diagnostic accuracy, with models providing in-depth analysis of ED-related queries. The accuracy of epidemiological information was consistent across evaluations. Treatment information, while generally reliable, showed variability in reproducibility and was often presented at a level too complex for the general population. Notably, AI models such as ChatGPT versions 3.5 and 4 demonstrated superior performance in clarity and depth of response compared to other tools like BARD, with statistical significance.

Conclusions
AI’s integration into the management of sexual dysfunctions offers significant potential to enhance both diagnostic processes and patient communications. AI-driven platforms, particularly newer models of ChatGPT, deliver accurate and repeatable results that are instrumental in addressing patient queries. Continuous improvement is essential to ensure the readability and accessibility of AI-generated content, thereby broadening its utility across diverse patient demographics. This study highlights the ongoing need for advancements in AI to align with evolving patient requirements in sexual health care.

Disclosure
No.
(186) IDENTIFYING PREDICTORS OF BONE DENSITY LOSS IN MEN WITH LOW TESTOSTERONE
Authors: Flores Martinez J , Ljubetic BM , Liso N , Mulhall JP 
Published: December 2024

Abstract

Introduction
Bone density loss (BDL), is associated with low testosterone (T).

Objective
We aimed to identify predictors of BDL in this cohort of patients.

Methods
The sample included (i) men ≥50 years old (ii) with low total T levels (&lt;300 ng/dL using LCMS on 2 early morning blood draws) (iii) who had dual-energy X-ray absorptiometry (DEXA) within 6 months of T measurement. Men with prior T therapy were excluded. On DEXA, osteopenia was defined as a T score − 1.1 to −2.5, osteoporosis T score lower than −2.5. Additionally, demographics and comorbidity data, diabetes, sleep apnea, coronary artery disease (CAD), hypertension, dyslipidemia and smoking status were collected. We report rates and attempt to define predictors of any BDL using multivariable analysis (MVA), including age, comorbidities ≥3 (yes), and total T levels ≤100 ng/dL (yes).

Results
512 men were analyzed, mean age of 65 ± 5 years. Median total T was 223 (175, 262) ng/dL, free T 4.5 (2.8, 7.9) ng/dL, and estradiol 17 (13, 23) pg/mL. 6% had a total T ≤ 100 ng/dL. Median number of comorbidities was 2 (1, 3). 57% hypertension, 57% dyslipidemia, 40% reported OSA, 24% had diabetes, and 8% reported CAD. 34% of the men had ≥3 comorbidities. 44% were former or current smokers. BDL was present in 36% of the patients. 91% had osteopenia, and 9% had osteoporosis. On MVA, significant predictors of BDL were older age, presence of ≥3 comorbidities and the presence of total T ≤ 100 ng/dL (Table 1).

Conclusions
In our cohort of men with low T, one third had BDL, and we have identified key predictors of this occurrence, older age, higher number of comorbidities and profoundly low T.

Disclosure
No.