bluuebunny/crossref_metadata_2025_split huggingface dataset:
(009) ERECTION DURATION, FREQUENCY AND FIRMNESS: A DESCRIPTIVE ANALYSIS FROM A POPULATION-BASED STUDY USING A WEARABLE PENILE RING
Authors: Saffati G , Orozco Rendon D , Daily R , Khera M , Mulhall J 
Published: December 2024

Abstract

Introduction
Erectile function is a crucial aspect of male sexual health and well-being, influenced by various physical and psychological factors. Traditional assessment methods have relied heavily on subjective self-reports and laboratory-based techniques, which often fail to capture the full scope of erections in real-world settings. The emergence of wearable penile ring devices marks a significant advancement, enabling continuous, objective monitoring of erections in naturalistic environments.

Objective
This study aims to synthesize data collected from the FirmTech TechRing, a wearable penile ring device, and analyze the typical attributes of nocturnal erections.

Methods
The study employed a cross-sectional design, with data collected from July 2023 to June 2024. All patients who utilized the FirmTech TechRing for a minimum of four hours per night during this period were included. The device measures erection frequency, rigidity, and duration through embedded sensors. De-identified data were analyzed using descriptive and inferential statistical methods to assess typical attributes of nocturnal erections.

Results
A total of 774 participants were included, encompassing a total of 4653 recorded observations. The median recording duration was 7.75 hours (IQR: 6.67, 8.82 hours). Analysis revealed a total of 12 581 erections, with a median duration of 36.2 minutes (IQR: 22.0-57.8 minutes), as summarized in Fig. 1. Participants experienced a median of 2.72 erections (IQR: 2.0-3.5) per recording, with a median firmness score of 4.69 on a scale of 1 to 10 (IQR: 3.28-7.02). These findings align closely with previously reported ranges, underscoring the validity of the data obtained from penile ring devices.

Conclusions
This study offers an unprecedented glimpse into the objective characteristics of male erections in naturalistic settings. By leveraging the capabilities of wearable technology and objective data collection, researchers and clinicians can continue to unravel the complexities of penile physiology and develop more effective strategies for the prevention, diagnosis, and management of erectile dysfunction and other sexual health concerns.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: FirmTech.
(019) CONTEMPORARY FINDINGS REGARDING THE EFFICACY AND SAFETY OF THE “DRAIN AND RETAIN” MANEUVER FOR UROLOGIC PROSTHETIC RESERVOIRS DURING INFLATABLE PENILE PROSTHESIS REVISION SURGERY
Authors: Pereira TA , Rust JO , Good J , Alverman TA , Barham D , Egemba C , Gross MS , Hammad M , Hsieh M , Huynh A , Lentz AC , Nose B , Simhan J , Yafi F , Bernie HL 
Published: December 2024

Abstract

Introduction
Urologic prosthetic reservoirs (UPR) can become firmly adherent to surrounding structures, and their removal during revision surgeries carries significant risks. Over the last decade, the “drain and retain” maneuver has been increasingly implemented to safely leave decommissioned UPRs in place. The utility and safety of this technique have not been further explored in the literature following the original descriptive publications.

Objective
We sought to update the efficacy and safety of the “drain and retain” maneuver by analyzing a contemporary multi-institutional cohort.

Methods
Patients who underwent inflatable penile prosthesis (IPP) surgery at seven busy penile implant centers in the United States between July 2016 and June 2024 were reviewed. We compared patients who underwent revision IPP surgery and subtotal device removal with “drain and retain” to those who had complete component removal and exchange. Explant cases for infection and revision cases using the original UPR were excluded. Postoperative complications and infection rates were evaluated and compared to patients receiving primary IPP surgery as a control group.

Results
1201 primary IPP cases and 231 revision cases were included. Among the revision cases, 112 (48.5%) utilized the "drain and retain" technique, while 119 (51.5%) involved complete reservoir removal. Patient demographics are listed in Table 1. There were no statistically significant differences in postoperative infection rates (p = 0.897) among the groups (Table 2). Similarly, there were no statistically significant differences in postoperative infections when stratified by different prosthesis types (p = 0.987). Regarding non-infections complications, there were no significant differences between the “drain and retain” group compared to revision cases where all components were removed. (p = 0.393) (Table 3).

Conclusions
To our knowledge, this is the most extensive study assessing the safety of leaving UPR in place during IPP revision surgery. The "drain and retain" strategy is a safe approach for IPP revision surgery. It avoids the potential morbidity of dissection into the retropubic space while maintaining infection and complication rates comparable to primary IPP cases.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific; Coloplast; BK Ultrasound.
(035) EFFICACY AND SAFETY OF COLLAGENASE CLOSTRIDIUM HISTOLYTICUM TREATMENT IN PATIENTS WITH VENTRAL PENILE PLAQUES
Authors: Saffati G , Orozco Rendon D , Hinojosa-Gonzalez DE , Kronstedt S , Miller JA , Moukhtar Hammad MA , Yafi FA , Angulo-Llanos L , Garret GM , Sandler MD , Tran DV , Masterson TA , Raheem O , Khera M 
Published: December 2024

Abstract

Introduction
Peyronie's disease (PD) is an acquired connective tissue disorder characterized by the formation of fibrous plaques within the tunica albuginea of the penis. Previous studies have demonstrated the efficacy and safety of Collagenase Clostridium Histolyticum (CCH) injections for the treatment of PD; however, few of these studies analyzed the impact of plaque location on treatment outcomes.

Objective
This study aimed to evaluate the efficacy and safety of CCH injections for the treatment of PD in patients with ventral penile plaques.

Methods
This study was approved by our Institutional Review Board, and is a multi-center, retrospective study investigating those who received CCH injections for the treatment of PD. Clinical and demographic data were extracted from patients' medical records. The study included only those patients who received CCH injections. Patients were stratified by plaque location. Main outcomes were adverse events from CCH (bruising, swelling, pain, hematoma, penile fracture, loss of length, new erectile dysfunction (ED)), satisfaction, change in curvature, and conversion to surgery after CCH treatment.

Results
In total, 550 patients met inclusion criteria. Among them, 54 patients had a ventral plaque, while the remaining 496 patients had a non-ventral plaque. Mean age of the ventral plaque cohort was 57.55 ± 11.08 years, compared to 56.52 ± 9.14 years in the non-ventral plaque group. There was no significant difference in change in penile curvature between ventral and non-ventral plaques, with a mean change of 27.76 ± 21.3 degrees vs 22.66 ± 18.55 degrees, p = 0.13, respectively. Patients with ventral plaques were more likely to experience newfound ED compared to patients without ventral plaques (p = 0.001). No significant difference was found for other side effects experienced between the two cohorts (Table 1).

Conclusions
CCH injections significantly improved penile curvature in both ventral and non-ventral plaque groups, with no significant difference in the rate of side effects between these two groups.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Disclosures: Consultant for AbbVie, Marius, Tolmar, Endo, Petros, Boston Scientific, Coloplast, Halozyme Investor: Sprout.
(041) IN CLINIC VERAPAMIL INJECTIONS FOR PEYRONIE’S DISEASE: A RETROSPECTIVE STUDY ON PATIENT SEXUAL SATISFACTION
Authors: Campbell J , Mcmartin C , Ory J , Power L , Patel P 
Published: December 2024

Abstract

Introduction
Peyronie’s disease (PD) is an acquired curvature of the penis that affects 5-10% of men and is associated with psychological distress. Intralesional Clostridium collagenase (Xiaflex) and interferon have been removed from Canada, leaving verapamil as the only effective therapy available to our patients. The results of intralesional verapamil (ILV) are variable depending on dosing, injection protocols, and practitioner technique. Surgical treatment of PD endorses substantial risk of penile length loss and erectile dysfunction, which most patients prefer to avoid.

Objective
We aimed to evaluate our experience with ILV to determine whether off-label ILV provides satisfactory results to men with PD and avoids more invasive interventions.

Methods
This is a retrospective multicenter cohort study of 224 men who completed ILV treatment between January 1st 2021 and December 31st 2023 performed by three urologists. Dorsal penile block was performed, and verapamil was injected using FAN technique into PD scar. Subjective clinical data was retrieved from initial consultation and follow-up visits through our electronic records.

Results
Mean age was 57 years old, with a majority of men having an upward curvature (56.7%) between 30-45° (43.8%). Mean onset of the curvature was 20.5 months before the initial consult, with a disease stability of 11.3 months. Risk factors including erectile dysfunction (44.2%), diabetes (19.1%) and active smoking (20.6%) were evaluated. The curvature was initially impairing sexual intercourse for 59% of patients. After ILV treatment protocol, 81.3% of patient’s curvature were subjectively improved, with 94.6% of men being able to engage in sexual intercourse, an increase of 35.6%. Only 14.3% required subsequent surgical treatment for their PD.

Conclusions
We conclude that our ILV treatment protocol helps men regain their ability to engage in sexual intercourse, provides a subjective lesser degree of curvature and reduces the need to undergo more invasive interventions.

Disclosure
No.
(044) ASSESSING THE EFFICACY OF INTRAURETHRAL BIMIX GEL AS AN ADJUNCT THERAPY IN 55 ERECTILE DYSFUNCTION PATIENTS
Authors: Cruz J , Farias A , Defauwes N , Prabhakar P , Martinez D , Caso J 
Published: December 2024

Abstract

Introduction
Erectile dysfunction can affect men from ages 40 to 70, with a range of 30% to 50% of the population experiencing this inability to achieve and sustain an erection (1). Erectile dysfunction can have a myriad of problems with risk factors such as obesity, smoking, and age, to name a few. The traditional treatments for ED are oral therapy, injections, and penile prostheses, but in some cases, these may not be effective.

Objective
To evaluate the effectiveness of intraurethral Bimix gel as an adjunct to therapy in 56 patients diagnosed with ED.

Methods
A retrospective chart review of patients who were prescribed intraurethral Bimix gel for a diagnosis of ED as an adjunct following primary therapy were selected. This yielded a total of 55 patients with a mean age of 61 (range, 25-85) years. The patients were prescribed intraurethral Bimix gel because of their unsatisfactory response to oral therapy. The efficacy of the gel was evaluated by comparing the Sexual Health Inventory for Men (SHIM) scores before and after the treatment with a Wilcoxon signed rank test.

Results
The mean SHIM score prior to intraurethral Bimix gel was 9.62 (range, 0-24), and following the Bimix gel administration was 11.93 (range, 1-25) (p &lt; 0.001). The patients had a favorable response to the intraurethral Bimix gel therapy. This therapy offers a good alternative to patients and an easier mode of administration for patients who are wary of intracavernosal injections. One of the common side effects reported was a mild burning sensation at the administration site during the application and absorption period. There were no other adverse effects.

Conclusions
Intraurethral Bimix gel is a good alternative adjunct to primary oral therapy for erectile dysfunction which can be used together with the initial therapy or as a booster during the act of sexual intercourse as a salvage option. References 1. Khera, M., & Goldstein, I. (2011). Erectile dysfunction. BMJ Clinical evidence, 2011.

Disclosure
No.
(074) OFFICE-BASED MICRODISSECTION TESTICULAR SPERM EXTRACTION FOR NONOBSTRUCTIVE AZOOSPERMIA RESULTS IN HIGH SPERM RETRIEVAL RATES
Authors: Seyer A , Walker D , Ainsworth A , Shenoy C , Babayev S , Stewart E , Khan Z , Zhao Y , Helo S 
Published: December 2024

Abstract

Introduction
Microdissection testicular sperm extraction (microTESE) is performed in men with nonobstructive azoospermia who desire sperm retrieval for use in IVF. This procedure can be performed in the operating room or in the clinic with local analgesic.

Objective
To report office-based microTESE sperm retrieval, fertilization, and livebirth rates.

Methods
A review was conducted of all patients who underwent office-based microTESE for nonobstructive azoospermia with a partner that who underwent concurrent oocyte retrieval for an intended in-vitro fertilization (IVF) intracytoplasmic injection (ICSI) cycle 2022-2024. All male partners underwent Y chromosome microdeletion testing, karyotype analysis, and hormonal testing preoperatively. Patients with a diagnosis of hypogonadism were offered medical therapy and those diagnosed with a varicocele were offered varicocelectomy prior to microTESE. Office-based microTESE was performed using a surgical operating microscope, spermatic cord block, and oral anxiolytic. Female partners underwent oocyte retrieval with oocyte cryopreservation prior to microTESE. Oocyte warming and ICSI was performed only following the collection of motile sperm from the fresh microTESE samples. Relevant demographic and clinical data were collected for patients and their partners. Descriptive data analysis was performed and reported as mean ± standard deviation.

Results
Ten patients underwent 11 office-based microTESE procedures. One patient had repeat microTESE following an unsuccessful IVF/ICSI cycle. Overall sperm retrieval rate was 70% for first time microTESE with mean search time 197.2 ± 96.5 min. Amongst couples with successful sperm retrieval, normal fertilization rate was 42%. Early cleavage arrest was seen in 84% of normally fertilized oocytes with a 16% blastocyst rate. Embryo development arrested entirely in two couples, while the remaining five couples had at least one blastocyst on day 5 and underwent embryo transfer. Of these, four resulted in a clinical pregnancy (36%). Three couples had a successful live birth and one has an ongoing pregnancy with ultrasound-confirmed fetal heartbeat.

Conclusions
Our small series demonstrates high sperm retrieval rates from office-based microTESE. Fertilization rates, clinical pregnancies and live birth rates are comparable with those reported in the literature. Given the financial cost associated with microTESE and IVF/ICSI for nonobstructive azoospermia patients, office-based microTESE may be a solution to make the process more financially accessible for couples.

Disclosure
No.
(078) VASAL FLUID MICROSCOPIC APPEARANCE AND GRADE AS A PROGNOSTIC MARKER FOR PATENCY IN REDO-VASECTOMY REVERSALS: A RETROSPECTIVE REVIEW OF SURGICAL OUTCOMES
Authors: Mubarak M , Mukherjee A , Jesuraj N , Shaw W , Jesuraj M 
Published: December 2024

Abstract

Introduction
Due to a myriad of reasons, vasectomy reversal (VR) is requested by up to 6% of men who have previously had a vasectomy. Current surgical and technical advances in VR have led to high patency and pregnancy rates. However, there remains a subset of patients who desire natural conception but fail VR. Redo-VR is a feasible option to achieve paternity for this specific subset of patients.

Objective
This study aims to evaluate our own experience with redo-VR patients and factors contributing to a successful outcome in the form of patency rates.

Methods
This is a retrospective review of a prospectively updated patient database. Patients who had a redo vasectomy reversal with either a vasovasotomy (VV) or a vaso-epididymostomy (VE) were included in the review. Outcomes of interest included patient age, partner age, obstructive interval (OI), intra-operative vasal fluid microscopy findings and post-operative patency rates. The Silber 1977 grading system was used to describe vasal fluid microscopic findings. Data was extracted and organised using Microsoft Excel, and further analysis was done using SPSS v29. A p-value of &lt;0.05 was considered significant.

Results
Seventy two (72) patients were eligible for review and had complete records. The average age was 48.8 +/- 7.6 years, with an average partner age of 32.9 +/-4.2 years. The average number of years since the initial vasectomy or OI was 10 years. The majority (63.8%) had bilateral vasovasostomy. Vasal microscopic fluid appearances are described in the figure with less than half having Silber Scale 1. The overall patency rate of the redo-reversal procedures was 82%. A Cochrane-Armitage test demonstrated that Silber classification of vasal fluid on microscopy did not predict successful outcomes (p = 0.66). Patients with redo-VE had lower patency rates.

Conclusions
Redo-VR is a feasible option for patients seeking natural conception after a vasectomy and an unsuccessful reversal procedure. Our findings demonstrate post-operative patency rates similar to primary VR patency rates described in the literature. Silber scale does not reliably predict outcomes.

Disclosure
No.
(085) OPTIMAL RESTORATION OF SPERMATOGENESIS FOLLOWING TESTOSTERONE THERAPY USING HCG AND FSH
Authors: Stocks B , Oppenheimer A , Huang J , Lipshultz L 
Published: December 2024

Abstract

Introduction
Testosterone monotherapy impedes spermatogenesis and often renders the male user azo- or severely oligospermic. Prior studies have demonstrated that rescue Human Chorionic Gonadotropin (HCG) and Clomiphene Citrate therapy can restore semen parameters, but report that just under half of men will respond favorably.

Objective
In the present study, we hypothesized that direct gonadotropic stimulation with HCG and purified Follicle Stimulating Hormone (FSH) (in lieu of indirect clomiphene-mediated FSH release) would result in improved recovery of spermatogenesis in oligospermic men with a history of testosterone use. Secondarily, we questioned whether concomitant use of Testosterone therapy during HCG/FSH “rebooting” of the testicles would dampen spermatogenic recovery as compared to those ceasing Testosterone therapy.

Methods
We performed a retrospective cohort study and identified 288 patients prescribed injections of 3000 IU HCG three times a week (TIW) and 75 IU FSH TIW from January 2020-March 2024 (we termed this therapy “reboot”). We then excluded those patients without prior use of testosterone replacement therapy (TRT), those with only one documented semen analysis, and those starting with normospermia (&gt;15 million [M] sperm per mL). Our final cohort included 77 patients meeting these strict criteria, 50 of whom were not on concurrent testosterone replacement therapy during reboot (No TRT), and 27 of whom were (Concurrent TRT). Patient demographics, testicular size, hormone levels, and semen analyses during treatment were then compared between groups. Student’s t-test and One or Two-way ANOVA with multiple comparisons were used. P &lt; 0.05 deemed significance.

Results
Within our cohort, 74% of all treated patients demonstrated an improvement in their semen parameters (mean duration of treatment 7 months); mean sperm concentrations increased from 2.2 M/mL to 15.2 M/mL after reboot (p &lt; 0.0001 by paired t-test). Of those patients starting with azoospermia, 64.9% demonstrated return of sperm and 13.5% reached normospermia. Of those starting with severe oligospermia (&lt;5 M/mL), 58.3% reached normospermia, and of those starting with oligospermia (&gt;5 but &lt;15 M/mL) 87.5% reached normospermia. Concurrent TRT during HCG/FSH reboot did not dampen spermatogenic recovery: 2.2 M/mL to 16.8 M/mL in the No TRT group and 2.2 M/mL to 12.3 M/mL in the Concurrent TRT group (p &lt; 0.0001 by paired t-test).

Conclusions
We report the largest retrospective cohort study to date investigating the utility of gonadotropic HCG/FSH “reboot” therapy in restoring spermatogenesis in men with a history of testosterone use. Setting the groundwork for future prospective studies, we report improved recovery of spermatogenesis with this therapeutic regimen vs. conventional HCG/clomiphene citrate therapy. Moreover, we demonstrate that concurrent TRT does not impede HCG/FSH mediated spermatogenic recovery.

Disclosure
No.
British Perceptions of Cyprus and the Production of Ceramics from 1809 to 1920
Authors: Reeve Anna 
Published: December 2024

Abstract
The advent of British administration of Cyprus in 1878 brought this Mediterranean island to the attention of the British public, whose perceptions and beliefs formed an important context for the development of Government policy. This article draws on representations of Cyprus in British-made ceramics from 1809 to 1920, to explore what the idea of Cyprus conveyed to their manufacturers and consumers both before and after the events of 1878. It also considers the impact of the arrival of ancient Cypriot pottery on the British auction market and in museums from around 1870, especially the efforts made in South Kensington and Staffordshire to provide access to Cypriot ceramics as models for design. It investigates how artists and designers drew on these antiquities in creating their own work, leading to their circulation in new forms beyond antiquarian networks. It examines a range of ceramic productions, from mass-produced transferware and souvenir ornaments to art pottery, analysing their forms and decoration, and exploring how these relate to their social and cultural contexts. Material culture, such as ceramics, offers a fresh way of exploring changes in perceptions and attitudes towards Cyprus over time.
The influence of the cloud virial parameter on the initial mass function
Authors: Mathew Sajay Sunny , Federrath Christoph , Seta Amit 
Published: December 2024

ABSTRACT
Crucial for star formation is the interplay between gravity and turbulence. The observed cloud virial parameter, $\alpha _{\mathrm{vir}}$, which is the ratio of twice the turbulent kinetic energy to the gravitational energy, is found to vary significantly in different environments, where the scatter among individual star-forming clouds can exceed an order of magnitude. Therefore, a strong dependence of the initial mass function (IMF) on $\alpha _{\mathrm{vir}}$ may challenge the notion of a universal IMF. To determine the role of $\alpha _{\mathrm{vir}}$ on the IMF, we compare the star-particle mass functions obtained in high-resolution magnetohydrodynamical simulations including jet and heating feedback, with $\alpha _{\mathrm{vir}}=0.0625$, 0.125, and 0.5. We find that varying $\alpha _{\mathrm{vir}}$ from $\alpha _{\mathrm{vir}}\sim 0.5$ to $\alpha _{\mathrm{vir}}&lt; 0.1$ shifts the peak of the IMF to lower masses by a factor of $\sim 2$ and increases the star formation rate by a similar factor. The dependence of the IMF and star formation rate on $\alpha _{\mathrm{vir}}$ is non-linear, with the dependence subsiding at $\alpha _{\mathrm{vir}}&lt; 0.1$. Our study shows a systematic dependence of the IMF on $\alpha _{\mathrm{vir}}$. Yet, it may not be measurable easily in observations, considering the uncertainties, and the relatively weak dependence found in this study.