bluuebunny/crossref_metadata_2025_split huggingface dataset:
(314) 6-NITRODOPAMINE IS A MAJOR MEDIATION THAT POTENTIATES CONTRACTIONS OF HUMAN ISOLATED EPIDIDYMAL VAS DEFERENS INDUCED BY NORADRENALINE AND ELECTRIC FIELD STIMULATION
Authors: Lima A , Jabbour S , Britto-Júnior J , Antunes E , Fregonesi A , De Nucci G 
Published: December 2024

Abstract

Introduction
Contractions of the vas deferens have an important role in the propulsion of the spermatozoa and occur due to excitatory inputs from a network of sympathetic nerves. When stimulated, these nerves co-release noradrenaline and ATP as the primary chemical messengers. However, 6-nitrodopamine (6-ND) was recently identified as a novel mediator of rat and human epididymal vas deferens (HEVD) contractility providing a new insight on the physiological process of the male ejaculation.

Objective
We sought to investigate the interaction of 6-ND in contractions induced by noradrenaline and electric-field stimulation on the HEVD.

Methods
Human epididymal vas deferens was obtained from 35 patients aged 28-59 years old who had undergone vasectomy surgery at Hospital e Maternidade Salvalus, São Paulo, BR. The HEVD strips (1.5 cm) were mounted in a 10-mL glass chamber filled with a warm (37°C) and oxygenated (95%O2: 5%CO2) Krebs–Henseleit solution. The tissues were allowed to stabilize for 45 minutes under a resting tension of 10 mN, and the isometric tension was registered using a PowerLab system (ADInstruments). The HEVD strips viability was tested with potassium chloride (80 mM). HEVD strips were pretreated with 6-ND (0.1, 1, 10 and 100 nM for 30 min) and a cumulative concentration-response curve to noradrenaline was performed. Also, the strips pretreated with 6-ND and its respective controls were submitted to electric-field stimulation (EFS) (60 V for 20 sec, at 2–32 Hz in square-wave pulses, 0.3 ms pulse width, and 0.1 ms delay), using a Grass S88 stimulator.

Results
Pre-incubation with 6-ND 0.1 nM had no effect on the noradrenaline-induced contraction curve. However, at 1, 10 and 100 nM, 6-ND causes significantly leftward shift on the noradrenaline concentration-response curve (6-ND 100 nM; pEC50: 4.9 ± 0.1 vs 4.5 ± 0.2; Emax: 54.8 ± 3.2 vs 31.2 ± 3.3; 6-ND vs control, respectively; p &lt; 0.05. Similar results were found on contractions induced by EFS. Preincubation with 10 and 100 nM of 6-ND, but not 1 nM, significantly increased the contractions induced by EFS at the frequencies of 4 to 32 Hz.

Conclusions
The findings establish the 6-nitrodopamine as an important mediator of HEVD contractions by causing remarkable potentiation of noradrenaline and EFS induced- contraction.

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(008) SONIC HEDGEHOG TREATMENT SUPPRESSES LONG TERM PENILE REMODELING AFTER CAVERNOUS NERVE INJURY
Authors: Deng J , Triko A , Harrington D , Mcvary K , Podlasek C 
Published: December 2024

Abstract

Introduction
Cavernous nerve (CN) injury, which occurs in prostatectomy and diabetic patients, initiates penile remodeling, including smooth muscle apoptosis and increasing collagen in the corpora cavernosa, which are underlying causes of erectile dysfunction (ED); Sonic hedgehog (SHH) is a critical regulator of penile smooth muscle and SHH treatment suppresses corpora cavernosa remodeling that occurs with CN injury.

Objective
We examined if SHH treatment by peptide amphiphile (PA) in the first week after CN injury is sufficient to prevent long term penis remodeling and examined if apoptosis inhibitors also suppress penile remodeling.

Methods
Bilateral CN crush was performed on adult (P115-120) Sprague Dawley rats that underwent one of three treatments using novel extended-release nanofiber PA hydrogels for delivery: 1.) SHH protein (n = 10), 2.) Mouse serum albumin (MSA) protein (control, n = 7), or 3.) Caspase 3 inhibitor (AC-DEVD-CHO, n = 10). Rats were sacrificed after 18-24 days. Additional rats underwent CN injury (n = 6), or CN injury and SHH PA treatment for 2 and 4 days (n = 8), sham controls (n = 3), and non-surgery controls (n = 3). Trichrome stain, hydroxyproline assay, and western analysis for -actin (smooth muscle) and GAPDH, were performed to examine smooth muscle retention and collagen abundance.

Results
Smooth muscle decreased with CN injury. Corpora cavernosa showed increased smooth muscle at 2, 4 and 18-24 days after CN injury with SHH PA treatment in comparison to MSA treated CN injured controls. Caspase 3 inhibited penis showed little smooth muscle preservation. Collagen was decreased 23% with SHH PA treatment (p &lt; 0.001), at 18-24 days after CN injury. Collagen was unchanged with caspase 3 inhibitor treatment (p = 1.000).

Conclusions
SHH treatment by PA in the first week after CN injury is sufficient to suppress penile remodeling, and to preserve penile smooth muscle over time, which is critical to prevent ED. It is important to know that treatments given at the time of CN injury have a sustained effect on preserving penile architecture, and thus erectile function, making them valuable for clinical translation.

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(015) NO, YOUR PENIS IS NOT SMALLER: A COMPARATIVE ANALYSIS OF PRE AND POSTOPERATIVE PENILE SIZE MEASUREMENTS FOLLOWING INFLATABLE PENILE PROSTHESIS PLACEMENT
Authors: Arnold PJ , Rust JO , Pereira TA , Good J , Bernie HL 
Published: December 2024

Abstract

Introduction
One of the most common concerns expressed by patients before and after inflatable penile prosthesis (IPP) insertion is the fear of penile length loss, which causes significant anxiety. Long-term erectile dysfunction (ED) can indeed result in penile length loss. Since many patients suffer from ED for several years before receiving an IPP, they might perceive a subjective decrease in penile length after surgery compared to their pre-ED younger state. Providing objective evidence of actual penile length is crucial for setting realistic patient expectations before surgery, which may optimize their experience and increase satisfaction post-operatively.

Objective
Compare the overall penile length and width before and after IPP placement. As a secondary objective, we compared penile length and girth outcomes using different prosthesis models.

Methods
Patients who underwent primary IPP implantation at a high-volume penile implant center in the United States between May 2023 and May 2024 were included in the study. Demographics and primary versus revision surgery were recorded. Both Boston Scientific (BSC) and Coloplast implants were utilized. All measurements were taken by the same surgeon intraoperatively using a flexible ruler, immediately before and after IPP placement. Measurements were taken from the pubic bone to the tip of the glans in a straight line. The initial measurements were taken with the penis maximally stretched, and the postoperative measurement was taken with the IPP fully inflated. The width was measured using the same flexible ruler at the base of the penis. Clinical significance for all statistical analyses was assessed at p &lt; 0.05. All statistical analyses were conducted using SPSS.

Results
A total of 151 patients were included in this analysis. Patients’ demographics are listed in Table 1. The mean post-implant length was significantly higher than the pre-implant length (15.24 cm vs. 14.71 cm, p &lt; 0.001). Postoperative width also increased compared to preoperative measurements (4.80 cm vs. 3.59 cm, p &lt; 0.001). For all implant brands, there was a significant increase in length post-operatively. Both Coloplast prostheses (Titan and Titan Narrow Base) and all BSC implants (LGX, CX, CXR) demonstrated similar improvements. Patients with a prior history of implant infection, or revision cases, more commonly received Coloplast implants.

Conclusions
Both BSC and Coloplast IPPs improve mean penile size, including length and width measurements, irrespective of model type, immediately after surgery compared to preoperative measurements. This topic of potential loss of penile length is an essential preoperative counseling point for inflatable penile prosthesis patients.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific; Coloplast; BK Ultrasound.
(038) SATISFACTION AFTER COLLAGENASE CLOSTRIDIUM HISTOLYTICUM MAY BE IMPACTED BY THE ACCURACY OF PATIENT-PREDICTED PENILE CURVATURE
Authors: Miller J , Hammad M , Saffati Grunhaus G , Rendon D , Hinojosa-Gonzalez D , Kronstedt S , Angulo-Llanos L , Garrett G , Sandler M , Tran D , Raheem O , Masterson T , Khera M , Yafi F 
Published: December 2024

Abstract

Introduction
Intralesional injection of collagenase clostridium histolyticum (CCH) remains one of the most common, non-surgical, treatment options for Peyronie’s disease (PD). While CCH is often linked to high patient satisfaction rates, discrepancies between a patient’s measured and subjective penile curvature may lead to lower patient satisfaction.

Objective
To determine the impact of discrepancies between subjective and measured penile curvature and patient satisfaction following CCH.

Methods
Patients receiving CCH for PD from four Urology clinics were reviewed between 2013 and 2024. Patient charts were reviewed for patient-reported penile curvature prior to treatment, urologist-measured penile curvature before and after CCH, complications during treatment, and patient-reported treatment satisfaction. Patients were deemed over-estimators or under-estimators if their predicted penile curvature was over or under 15 degrees respectively when compared to a urologist’s measurement. Associations between subjective improvement following CCH and accuracy of penile curvature prediction were tested using multiple regression, controlling for age, absolute change in urologist-measured penile curvature before and after treatment, and complications during treatment.

Results
221 patients received CCH for PD with an average age of 57 years (range: 23– 79 years). The average penile curvature as measured by a urologist prior to CCH was 45.7 degrees (range 10– 110 degrees). The average penile curvature by patient estimation was 47.9 degrees (range 10– 110 degrees), with 153 patients (69.2%) accurately estimating their penile curvature within 15 degrees. Overall, 38 (17.2%) and 30 patients (13.6%) overestimated and underestimated their penile curvatures by greater than 15 degrees, respectively. Overall, 128 patients (57.9%) noted satisfaction with treatment, with increases in the absolute change of penile curvature being significantly associated with improved satisfaction (p = 0.002). Patients who underestimated their baseline curvature were with higher post treatment satisfaction rates (OR 5.62, p = 0.005) compared to all other patients. Patients who accurately predicted or overestimated their baseline penile curvature were with similar satisfaction rates (p &gt; 0.05). (Table 1).

Conclusions
In this series, satisfaction with CCH was higher in patients who initially underestimated their penile curvature. While further work is needed to reproduce and further examine these associations, discrepancies between patient and urologist estimates of penile curvature may have important implications in the treatment of PD.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Endo International.
(052) A NOVEL PATIENT-COMPLETED CARDIOVASCULAR DISEASE SCREENING INSTRUMENT FOR MEN PRESENTING WITH ERECTILE DYSFUNCTION
Authors: Kehm A , Staff I , Mclaughlin T , Dougherty K , Bieniek J 
Published: December 2024

Abstract

Introduction
Erectile dysfunction (ED), a prevalent condition commonly due to penile vascular changes, is increasingly recognized as an early warning sign of cardiovascular disease (CVD). Despite the association, ED is not incorporated as an algorithm variable in commonly used CVD screening tools, leaving a gap in comprehensive risk assessment. Urologists, who often see men for ED, would be uniquely positioned to assess cardiac risk, but often do not have access to the required data inputs commonly included in the existing screening tools (eg, lipid panels, family history of early cardiac disease). To address this gap, we initiated a QI process which included the development of a novel patient-completed CVD screening questionnaire for men presenting to urology with ED.

Objective
This project aims to describe the newly developed patient-completed CVD screening questionnaire for men with ED, its workflow implementation, and initial screening patterns.

Methods
Our multidisciplinary men’s health team including cardiology developed an ED-CVD questionnaire suitable for the urological office setting (Figure). A goal was to minimally disrupt normal workflows, therefore the form was made to be patient-completed. The point-based screening tool provides a cardiac risk score based on epidemiological studies and validated algorithms. A score of 4 or above indicates potentially increased CVD risk. Descriptive statistics were used to describe findings from screening implementation including questionnaire scores, preventive cardiology referrals, and referral completion.

Results
Between June 1, 2022 and May 31, 2024, a total of 427 men presenting to three urologists with erectile dysfunction have been screened with the ED-CVD questionnaire. Preventive cardiology referral was recommended for 76 (17.8%) men with ED and an elevated ED-CVD score (≥4) who had not seen a cardiologist in the past three years. Each positively-screened man was contacted by a nurse navigator who reviewed the reason for CVD screening and offered cardiology referral. A total of 39 (51.3%) of these men accepted cardiology referral with 31 completing evaluation to date.

Conclusions
A CVD screening and referral workflow can be easily implemented into the urology outpatient setting. Over 17% of men presenting with ED had a positive screening on an ED-CVD questionnaire without recent cardiology evaluation and more than half accepted a referral to preventive cardiology. Future efforts will examine the findings of cardiac evaluation to inform potential questionnaire validation.

Disclosure
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(057) IS POOR SLEEP ASSOCIATED WITH POOR SEX? AN ANALYSIS OF SEXUAL DYSFUNCTION IN MEN WITH SLEEP DISORDERS UNDERGOING FERTILITY TESTING
Authors: Seyer A , Nolte D , Kenfield S , Belarmino A , Civello D , Smith J , Helo S 
Published: December 2024

Abstract

Introduction
Sleep disorders can negatively impact multiple facets of health including sexual function. In men undergoing fertility testing, optimization of general health is of utmost importance to maximize fertility outcomes.

Objective
To determine the relationship between sleep disturbance and sexual function in men undergoing fertility testing.

Methods
This study evaluated men undergoing fertility testing who completed an at-home semen analysis kit 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. Sleep disturbance level (normal, mild, moderate, or severe) was derived using a validated survey assessment, developed by the Patient-Reported Outcomes Measurement Information System (PROMIS), which queried sleep quality, sleep depth, and restoration associated with sleep. The sexual function survey assessed libido, orgasmic and ejaculatory dysfunction, Erection Hardness Score, and IIEF-5 score. Descriptive statistics were reported and chi squared tests were used to test for independence of categorical variables with statistical significance reported at the 0.05 alpha level.

Results
Of the 1919 men included in this analysis, 7.7% were assessed to have a mild level of sleep disturbance and 4.4% had moderate to severe sleep disturbance. Compared to those with “normal” levels of sleep disturbance, those with mild to severe levels more often reported low libido (20.7% vs. 13.8%; p = 0.01), ejaculatory dysfunction (31.3% vs. 19.9%; p &lt; 0.01), and orgasmic dysfunction (15.3% vs. 5.1%; p &lt; 0.01). Of men with mild to severe sleep disturbance, 28.3% reported pursuing treatment for erectile dysfunction compared to those with normal levels of sleep disturbance (17.8%; p &lt; 0.01). Further, only 57.2% of men with mild to severe sleep disturbance were assessed to have “No signs of ED” compared to 71.0% of men without elevated levels of sleep disturbance (p &lt; 0.01).

Conclusions
Sleep disturbance is associated with reduced libido, ejaculatory, orgasmic, and erectile function in men undergoing fertility testing. Providers should assess for sleep-related symptoms during initial evaluation to optimize fertility potential.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Fellow Health.
(059) A NOVEL APPROACH TO REDUCING ANXIETY AND INCREASING PREPAREDNESS IN PATIENTS UNDERGOING INTRACAVERNOSAL INJECTION TRAINING
Authors: Strumeier S , Ernst N , Huwe V , Nelson C , Mulhall J , Amaya B , Flores J 
Published: December 2024

Abstract

Introduction
According to the World Journal of Urology, ICI demonstrate efficacy in approximately 54-100% of patients (Duncan et al., 2019). A barrier to adequate ED treatment is the high correlation between anxiety and ICI (Duncan et al., 2019). Nelson et al. (2013) notes that despite several reports of patient anxiety related to penile injections, anxiety has rarely been assessed. At the present time, there are limited studies evaluating anxiety and perceived preparedness of men with erectile dysfunction scheduled to undergo penile injection training (ICI).

Objective
The purpose of this quality improvement project was to evaluate anxiety and preparedness while pending medical procedure trainings such as ICI.

Methods
This project utilized a pre- and post- test survey design comparing anxiety and preparedness prior to the initial penile injection appointment and after a video education intervention. The Pre- test survey was administered to the patient at home prior to the patient watching the video intervention. The intervention was a eight-minute recorded video demonstrating ICI on a penile model. The video was sent via link to a patient portal once the pre- test survey was completed. Post- test surveys were then administered at time of visit to assess anxiety and preparedness for the ICI training appointment. Time spent face to face with patients comparing those who watched the video intervention and those who did not were also compared.

Results
A total of 78 participants who met inclusion criteria were identified and recruited. 58 participants completed the pre- and post- test survey using a validated Likert tool to assess anxiety and perceived preparedness. 22 men were excluded for incomplete data collection or failure to watch the video intervention. 19 of the excluded men who did not watch the video were utilized to compare time spent face to face with patient. There was no decrease in anxiety before intervention and after, however preparedness amongst individuals increased after the video. Additionally, time spent face to face with the provider decreased post video education.

Conclusions
Findings suggest a video intervention to prepare patients prior to their penile injection training visits have a clinical and statistical impact on men undergoing penile injection training. However, there is no conclusive evidence to support a video intervention’s impact on patient anxiety prior to the ICI injection training.

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(061) CASE SERIES: PERSISTENCE OF FUNCTIONAL PENILE CAVERNOSAL TISSUE FOLLOWING EXPLANT OF PENILE PROSTHESIS
Authors: Huang J , Stocks B , Tran L , Oppenheimer A , Lipshultz L 
Published: December 2024

Abstract

Introduction
Placement of a penile prosthesis is a safe, reliable treatment for erectile dysfunction. Unfortunately, regardless of patient satisfaction, some prostheses must be removed for select indications. It is widely believed that after explant of a penile prosthesis, patients will have no chance of penetrative intercourse without another penile prosthesis. Implantation of a penile prosthesis disrupts the inner corporal cavernosal sinusoidal tissue, and it is believed that remaining tissue cannot attain meaningful erections. However, we have observed several patients with varying degrees of persistent erectile function following explant, challenging this dogma.

Objective
We present a series of patients who pursued medical management of erectile dysfunction following penile prosthesis explant.

Methods
We identified all patients at our practice that underwent explant of penile prosthesis and wished for salvage of erectile function from June 2023 to December 2023. Chart review was performed to abstract demographic and clinical data. Descriptive statistics were not applicable.

Results
Following explant of penile prosthesis, 4 patients were motivated to continue management of erectile dysfunction. Three of these patients underwent penile duplex ultrasonography, results in Table 1. Arterial sufficiency is demonstrated in each ultrasound. One patient progressed to salvage medical management with intracavernosal injections and attained functional erections.

Conclusions
The patients identified demonstrate evidence of functional, viable corporal cavernosal tissue several years following penile prosthesis placement. Our data presents both objective and subjective evidence of successful erectile potential. This is a small case series with short-term follow up, but these results directly counter the current paradigm-some patients can experience efficacious medical management of erectile dysfunction following explant of penile prosthesis. Further investigation with larger patient cohorts is warranted to better define treatment options for patients’ sexual health following prosthesis explantation.

Disclosure
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