bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stereotactic arrhythmia radioablation for ventricular tachycardia: a review of clinical trials and emerging roles of imaging
Authors: Kawamura Mariko , Shimojo Masafumi , Tatsugami Fuminari , Hirata Kenji , Fujita Shohei , Ueda Daiju , Matsui Yusuke , Fushimi Yasutaka , Fujioka Tomoyuki , Nozaki Taiki , Yamada Akira , Ito Rintaro , Fujima Noriyuki , Yanagawa Masahiro , Nakaura Takeshi , Tsuboyama Takahiro , Kamagata Koji , Naganawa Shinji 
Published: December 2024

ABSTRACT
Ventricular tachycardia (VT) is a severe arrhythmia commonly treated with implantable cardioverter defibrillators, antiarrhythmic drugs and catheter ablation (CA). Although CA is effective in reducing recurrent VT, its impact on survival remains uncertain, especially in patients with extensive scarring. Stereotactic arrhythmia radioablation (STAR) has emerged as a novel treatment for VT in patients unresponsive to CA, leveraging techniques from stereotactic body radiation therapy used in cancer treatments. Recent clinical trials and case series have demonstrated the short-term efficacy and safety of STAR, although long-term outcomes remain unclear. Imaging techniques, such as electroanatomical mapping, contrast-enhanced magnetic resonance imaging and nuclear imaging, play a crucial role in treatment planning by identifying VT substrates and guiding target delineation. However, challenges persist owing to the complex anatomy and variability in target volume definitions. Advances in imaging and artificial intelligence are expected to improve the precision and efficacy of STAR. The exact mechanisms underlying the antiarrhythmic effects of STAR, including potential fibrosis and improvement in cardiac conduction, are still being explored. Despite its potential, STAR should be cautiously applied in prospective clinical trials, with a focus on optimizing dose delivery and understanding long-term outcomes. Collaborative efforts are necessary to standardize treatment strategies and enhance the quality of life for patients with refractory VT.
(013) DISSATISFACTION AFTER INFLATABLE PENILE PROSTHESIS: A LONGITUDINAL STUDY
Authors: Guillen A , Bonakdarhashemi M , Dumbrava M , Pinkhasov A , Sevann H , Ziegelmann M 
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). While reported patient satisfaction with this surgery is high, there are a variety of factors that can influence patient satisfaction after PP surgery.

Objective
We aimed to identify factors responsible for patient dissatisfaction after PP surgery.

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 completed both surveys were included in the analysis.

Results
A total of 304 patients had a PP placement, of these 101completed at least the first survey. Patients reported using their PP a median of 4 (2-8) times per month at 6 months, and 5 (2-9) at 12 months (p = 0.651). Main reasons of lack of use of the PP can be seen in Fig. 1A. The most frequent reported reason was lack of interest from partner (20.3% at 6-months, 18.8% at 12-months). Patient reported reasons for dissatisfaction are seen in Fig. 1B. Examples include penile pain (19% at 6-months, 11% at 12-months), difficulty with orgasm (39% at 6-months, 37% at 12-months), unsatisfactory penile cosmesis (28% at 6-months, and 25% at 12-months), problems inflating of the prosthesis (14.9% at 6-months, and 21.5% at 12-months), and problems deflating of the prosthesis (33.7% at 6-months, and 31.6% at 12-months). Despite these concerns, most patients found PP easy to use (83.2% at 6-months, and 82.1% at 12-months) and a reported a very or somewhat natural sensation with their erections (66.4% at 6-months, and 62.8% at 12-months) Fig. 1C.

Conclusions
There was a higher than anticipated rate of penile pain, difficulty achieving climax, and unsatisfactory cosmesis that warrant further investigation. Despite this, the majority of patients found their PP easy to use and a reported natural sensation when having erections.

Disclosure
Yes, this is sponsored by industry/sponsor: Coloplast.
Clarification: Industry funding only - investigator initiated and executed study.
(046) SEXUAL OUTCOMES IN PATIENTS WHO UNDERWENT REZUM WITH TURP FOR MEDIAN LOBE
Authors: Bonakdar Hashemi M , Piraino J , Pinkhasov A , Guillen Lozoya A , Lybert D , Kohler T 
Published: December 2024

Abstract

Introduction
Treatment of patients with obstructive lower urinary tract symptoms has various side effects on their quality of sexual life.

Objective
This study aimed to compare the effects of Rezum and Rezurp (a combination of Rezum for lateral lobes and TURP for the median lobe) on erections, retrograde ejaculation, and subjective orgasm experience in patients with a significant median lobe.

Methods
This is a retrospective cohort study that includes patients who underwent Rezum and Rezurp between January 2021 and January 2024. Sexual outcomes were assessed at 3 months and a median follow up phone call was 33 months. Patients were queried: Any changes in erections (yes/no) and changes in ejaculation (yes/no). If yes to changes, patients were asked to further define and characterize their responses including specific effect on orgasm. The effect of surgery on sexual outcomes was explored by chi-square analysis with P ≤ 0.05 considered statistically significant.

Results
Sexual outcomes were obtained for 78/89 patients in the Rezurp and 97/107 patients in the Rezum group. There was no significant difference in baseline characteristics, including age, prostate volume, and medication regimens, between the two groups, as shown in Table 1. The results indicated that 78% (61/78) and 83% (86/97) of Rezurp and Rezum patients experienced no change in ejaculation. Total ejaculation loss was seen only in two Rezurp patients. Ejaculatory changes between the two groups were not significantly different, with 13.8% and 4.23% worsening for Rezurp and Rezum, respectively (P = 0.08). Changes in erections and orgasm satisfaction were not statistically significant between the two groups (P = 0.76 and 0.54, respectively). Subjective worsening in orgasm quality for Rezurp and Rezum was not different between groups (P = 0.54), with 6.4% and 4.1% worsening, respectively (Table 2).

Conclusions
Rezurp and Rezum have similar sexual function outcomes.

Disclosure
No.
(056) CHARACTERIZING CORPOROVENOCCLUSIVE DYSFUNCTION IN MEN AFTER RADIATION THERAPY FOR PROSTATE CANCER
Authors: Flores Martinez J , Ljubetic BM , Liso N , Elshafei A , Mulhall JP 
Published: December 2024

Abstract

Introduction
Radiation therapy (RT) for prostate cancer (PC) often leads to erectile dysfunction (ED).

Objective
We aimed to characterize corporvenocclusive dysfunction (CVOD) rates in men following RT for PC.

Methods
Study population consisted of (i) men after RT with or without androgen deprivation therapy (ADT) (ii) who developed ED (iii) with poor response to PDE5i and ICI, (iv) who had penile duplex Doppler ultrasound (DUS) (v) using a vasoactive agent redosing schedule. Arterial insufficiency (AI) was defined using a peak systolic velocity (PSV) &lt;30 cm/sec bilaterally and CVOD using end diastolic velocity (EDV) values ≥5 cm/sec bilaterally. Demographics, comorbidity, endocrine profiles and DUS parameters were recorded. The erection hardness scale (EHS) was used to evaluate ED before RT (1-4, 4 hardest erection). We used univariate (UV) and multivariable analyses (MV) to define factors predictive of CVOD. Variables included in the UV model: age, comorbid conditions (diabetes (DM), hyperlipidemia (HLD), obstructive sleep apnea (OSA), coronary artery disease (CAD), hypertension (HTN)), RT type - brachy (BT) vs external beam (EBRT), RT dose, EHS, and ADT duration. Factors that were significant on UV analysis moved forward into the MV model.

Results
156 men were analyzed. Median age was 69 (62, 74) years. Median RT dose 7020 (4000,10 000) Gy with 57% of men receiving EBRT and 43% received BT. 54% received ADT, with a median exposure of 15 (6, 24) months. 33% received ADT for ≥12 months. 4% had ≥3 vascular comorbidities: DM 21%, OSA 25%, smoking 47%. Median pre-RT EHS score 4 (3,4), 20% being ≤2. Median baseline PSA was 3.5 (0.4, 6) ng/mL. Pre-RT total testosterone (T) was 14 (8, 313) ng/dL. Median total T at the time of DUS was 350 (207, 457) ng/dL and 46% had low T. Median trimix dose administered at DUS was 75 (20, 100) units. 50% received 100 units. Median PSV was 43 (33, 56) cm/sec, median EDV 8 (0, 12) cm/sec. Erection reversal was requirted in 36% of men. CVOD was diagnosed in 59%. AI was diagnosed in 14%, CVOD+AI was observed in 7% of cases. On MV, the predictors of CVOD were older age, ADT duration ≥12 months, dyslipidemia (Table).

Conclusions
In men after RT for PC, CVOD was present in more than half of patients studied, with three significant predictors identified.

Disclosure
No.
(066) THE CORRELATION BETWEEN TOTAL AND FREE TESTOSTERONE LEVELS AND SELF-REPORTED SYMPTOMS IN MEN WITH LOW TESTOSTERONE LEVELS
Authors: Flores Martinez J , Ljubetic BM , Liso N , Mulhall JP 
Published: December 2024

Abstract

Introduction
The diagnosis of testosterone (T) deficiency requires the presence of a cluster of symptoms and/or signs combined with a documented a low total T level.

Objective
We aimed to evaluate the associations of low total and free T with self-reported symptoms.

Methods
The study population included men who (i) completed a survey assessing 11 low T symptoms (low energy, afternoon fatigue, reduced strength/endurance, reduced exercise response, reduced work productivity, muscle loss, fat gain, irritability, feeling depressed, and cognitive problems) during the initial office assessment (ii) had T assessment using LCMS and (iii) had free T measured by equilibrium dialysis (iv) conducted within one month of survey completion. Men with prior previous T treatment were excluded. Low T was defined as total T &lt; 300 ng/dl. Spearman’s correlation assessed the relationship between the number of reported symptoms and total T and free T levels. This analysis was performed for the entire cohort (n = 467) and a sub-analysis excluded patients who reported sleep apnea (n = 262).

Results
467 men were included. Median age was 63 (57, 70) years old. 14% had diabetes, 44% had OSA, and 28% reported ≥3 comorbidities. Median total T was 358 (258-486) ng/dL, median free T 10 (7-13) ng/dL. 35% had low T. Median T symptom number was 3 (0, 6). 30% reported ≥6 symptoms. The most prevalent symptoms reported were feeling tired (53%), low energy (47%), reduced exercise response (39%), reduced strength (38%), and muscle loss (37%). Spearman’s correlation analysis showed a small significant negative correlation for both total T and free T to the number of self-reported symptoms (Table).

Conclusions
While statistically significant, the correlations were very weak suggesting that in men with low T levels, there appears to be little correlation between symptomatology and T levels, supporting the non-specificity of these symptoms.

Disclosure
No.
(080) EXPLORING INFERTILITY RISK AND SEMEN PARAMETERS IN YOUNG ADULT CANCER SURVIVORS
Authors: Langston D , Fendereski K , Halpern J , Iko I , Aston K , Emery B , Ramsay J , Horns J , Hotaling J 
Published: December 2024

Abstract

Introduction
Cancer treatment can affect fertility, but assessing infertility risk accurately remains challenging, leading to inconsistent discussions during cancer care. This study aims to assess semen analysis parameters, the gold standard for male fertility evaluation, in young adult oncology patients undergoing fertility preservation interventions post-treatment for the four most common cancers in this age group: testicular, lymphoma, central nervous system (CNS), and melanoma.

Objective
To examine the impact of common YA oncologic diagnoses on future fertility.

Methods
We evaluated semen analysis changes in Adolescent Young Adult (AYA) oncology patients, aged 15-39, who underwent fertility evaluation. Using a statewide patient database linked to the Subfertility Health Assisted Reproduction and Environment (SHARE) databases, we identified patients who had one or more semen analyses before and after diagnosis between 1998-2017. Multivariate analyses tested the influence of time from cancer diagnosis and cancer type on semen parameters (concentration, total sperm count, total motility).

Results
The cohort included 58 individuals, primarily Non-Hispanic White (94.8%), with testis-related conditions being most common (46.6%), followed by lymphoma (24.1%), CNS disorders (20.7%), and melanoma (8.6%). Mean age at diagnosis was 29 years. Semen parameters showed no significant difference post-diagnosis compared to pre-diagnosis, though concentration and total sperm count trended downward. Sperm concentration was significantly lower in the testis diagnosis group mean 17.3 M/mL, SD 13.2) versus CNS (mean 87.8, SD 79.3, P = 0.04), with a trend toward decrease relative to lymphoma and melanoma. Total motility was significantly lower in the testis diagnosis group (mean 50.4%, SD 26.4) versus CNS (mean 65.5%, SD 19.6, P = 0.02) and a trend toward decreased motility relative to the melanoma group (mean 66.5%, SD 17.8, P = 0.09).

Conclusions
AYA survivors of testis conditions showed decreased semen health parameters compared to other common cancer diagnoses. Fertility discussions with AYA survivors should consider developmental stage and emotional resilience. Multidisciplinary care teams are crucial for offering optimal fertility advice and care given the limited understanding of cancer treatment impacts on fertility outcomes.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: StreamDx, Inherent Bioscience, Turtle Health, Maimus, Carrot Fertility.
(091) RATE OF RETURN OF SPERM AMONG MEN WITH AZOOSPERMIA POST VASECTOMY REVERSAL
Authors: Hans R , Savage J , Brearton K , Warner R , Helo S , Trost L 
Published: December 2024

Abstract

Introduction
Limited data exist on semen parameters post vasectomy reversal. Specifically, no studies have rigorously evaluated the likelihood of sperm return following discovery of azoospermia at some time point post vasectomy reversal.

Objective
To evaluate the rate of return of sperm among men who experience an azoospermia result post vasectomy-reversal.

Methods
A large, prospective dataset has been maintained of men undergoing vasectomy reversals at a single center from 2019 to the present. Men who had at least two post-operative semen analyses were included for review. The data were then analyzed in a manner to identify those who experienced a 0 count at varying time points and then either went on to continue to have 0’s beyond that point or who experienced a return of sperm.

Results
A total of 3414 men underwent a vasectomy reversal since 2019, with 2703 having semen analysis data available for review. Overall demographics demonstrated a mean age of 41, partner age 33, median time since vasectomy of 7 years, 92% first-time cases, and distribution of repair as noted: VV/VV (79%), VV/EV (12%), EV/EV (6%), VV/x (1%), EV/x (&lt;1%), x/x (0%). Of men who had 0 sperm at varying time points, the percentages of those who experienced a return of sperm are noted as follows: 0 sperm at &lt;2 months (52% experienced a return at some point, n = 349 used in calculation), 0 at 2-4 months (38% return, n = 210), 0 at 5-7 months (17% return, n = 206), 0 at 8-10 months (20% return, n = 133), 0 at 11-18 months (9% return, n = 107). The data are limited by the fact that relatively few men continued to send in semen analysis samples beyond 12 months (n = 403 with at least one result &gt;12 months and n = 101 with results &gt;24 months).

Conclusions
Men who experience azoospermia post-vasectomy reversal may experience a return of sperm over time, with the likelihood for return declining based on the duration of persistence of 0 sperm.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: PathRight Medical.
(095) THE USE OF EJACULATED VS TESTICULAR SPERM IN MEN WITH EITHER CRYPTOZOOSPERMIA OR NON-OBSTRUCTIVE AZOOSPERMIA
Authors: Oppenheimer A , Huang J , Rhodes Q , Nodler J , Stocks B , Lipshultz L 
Published: December 2024

Abstract

Introduction
Although use of ejaculated sperm for Intracytoplasmic Sperm Injection (ICSI) in men with cryptozoopsermia obviates conventional testicular sperm extraction (cTESE) or micro testicular sperm extraction (mTESE), there exists an ongoing debate as to whether testicular sperm produce better ICSI outcomes.

Objective
To better understand this issue, we identified all men presenting to single reproductive urologist’s practice and a single IVF center with cryptozoopsermia (CZ) or non-obstructive azoospermia (NOA) and analyzed ICSI outcomes. Our study represents the largest single-surgeon analysis conducted in the US.

Methods
All men presenting to a single reproductive urologist’s practice with CZ or NOA and who subsequently underwent ICSI were identified during 2012 to 2023. Per our practice pattern, men with NOA first underwent Testicular Core Extraction (TCE); those with sperm underwent office cTESE and those without sperm underwent operative mTESE. Three groups undergoing ICSI cycles were then identified: Cryptozoospermic men in which ejaculated sperm was used (n = 30), cTESE in which extracted sperm were used after a positive TCE (n = 33), and mTESE in which operatively extracted sperm was used after a negative TCE (n = 7). Fertilization and embryo rates per number of eggs inseminated were compared between groups using GraphPad Prism Software. P &lt; 0.05 deemed significance using One-way ANOVA.

Results
Fertilization rates were highest within the cTESE group (81%) v. the ejaculated group (74%) v. the mTESE group (40%) (p = 0.02). As expected, embryo rates were overall lower than fertilization rates; however, the same pattern emerged albeit non-significantly: cTESE 36%, ejaculated 31%, and mTESE 10% (p = 0.2). Following our practice pattern, men undergoing operative mTESE after negative TCE had significantly poorer ICSI outcomes (p = 0.0004).

Conclusions
Advances in ICSI technology have resulted in successful birth outcomes from the ejaculate of male partners with CZ. As such, many male partners go directly to IVF and never undergo appropriate workup and treatment by a reproductive urologist. Testicular sperm harbor less DNA damage, ejaculatory contaminate, and diminished exposure to reactive oxygen species. Per our data, the use of testicular sperm is associated with improved ICSI outcomes. Furthermore, we demonstrate that men requiring operative mTESE after negative TCE have a lesser chance of successful ICSI results.

Disclosure
No.
(104) THE IMPORTANCE OF ERECTILE FUNCTION IN FOSTERING INTIMACY IN HETEROSEXUAL RELATIONSHIPS FROM THE FEMALE PERSPECTIVE
Authors: Nham E , Vigil H , Flannigan R , Brotto L , Witherspoon L 
Published: December 2024

Abstract

Introduction
Heterosexual men with erectile dysfunction (ED) commonly site fear of losing intimate partners due to lack of sexual performance and pursue invasive treatments to maintain erections. Female views on the significance of erectile function in healthy relationships remains under-explored, however. This study examines female perspectives on the importance of erections in relationships.

Objective
The objective of the study is to explore female perspectives on importance of erections in relationships and determine if female partners will pursue and/or maintain relationships with males with ED.

Methods
A survey-based study employed a virtual 35-item questionnaire adapted from the McCoy Female Sexuality Questionnaire. Participants included heterosexual females aged 18 years and older.

Results
From May to November 2024, 217 survey responses were received, 56 of which had &gt;50% incomplete entries leaving 161 for analysis. The average age of participants and their male partners was 33 (Standard Deviation, SD = 11) and 35 (SD = 10) years, respectively. A majority were either married or in long-term relationships (93/161). Only 89 of 161 female respondents considered penetrative intercourse important for their connection with their partners, citing narrative reasons such as partner satisfaction, stress relief, and viewing intercourse as an expression of love, attraction, intimacy, and vulnerability. Some females (47/161) felt that a lack of penetrative intercourse would negatively impact their relationships with narrative concerns around changes in relationship dynamics, male partner masculinity, his mental well-being, and female sexual gratification. Conversely, 33 of 161 females saw penetrative intercourse as non-essential, emphasizing other aspects of intimacy. Majority of females (79/161) indicated they would not end a relationship due to a partner’s erectile dysfunction (Fig. 1). When asked if they would start a relationship with a male with erectile dysfunction 56 of 161 of females said they were open to it, while 51 of 161 were not.

Conclusions
While penetrative intercourse holds significance as a means of intimacy for many heterosexual females, it is only one component of relationships and other aspects of intimacy are also highly valued. The outcomes of our study can help counsel men considering invasive treatments for erectile function and provide context on how women view erectile dysfunction and its significance on current and new relationships.

Disclosure
No.
Impulse control and its association with ejaculation time in men with premature ejaculation
Authors: Sağlam Tarık , Takım Uğur , Kavla Yasin , Demir Demirhan Örsan , Turan Şenol 
Published: December 2024

Abstract

Background
The relationship between impulse control and premature ejaculation (PE), the most common sexual dysfunction in men, is not yet well understood.

Aim
To assess the association between impulse control issues and the severity of PE in men with a lifelong diagnosis of this condition.

Methods
A cross-sectional observational study was designed to evaluate patients who presented to the clinic with complaints of PE between March 2023 and March 2024. The final study sample comprised 40 men with lifelong PE and 40 healthy control subjects.

Outcomes
Impulse control was evaluated with the UPPS Impulsive Behavior Scale and the Barratt Impulsivity Scale-11 (BIS-11), while depression and anxiety levels were measured using the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). The severity of PE was assessed using the Arabic Index of PE (AIPE).

Results
The mean AIPE score was 15.13 ± 3.33 in the PE group and 32.05 ± 2.06 in the control group (P ˂ 0.001). Compared to the control group, the PE group had significantly higher UPSS Impulsive Behavior Scale scores in all subscales (P ˂ 0.001 for planning, urgency, and lack of perseverance; P = 0. 001 for sensation seeking) and total scores (P ˂ 0.001). The BIS-11 scores were also significantly higher in the PE group compared to the control group for all subscales (P ˂ 0.001 for all). The patients in the PE group also had higher levels of anxiety and depression (P ˂ 0.001 for all).

Clinical Implications
A clinician’s quantitative assessment of ejaculation time and the severity of PE among men presenting to the clinic with complaints of PE may reveal accompanying comorbid conditions more effectively.

Strength and Limitations
The current study is a novel investigation that quantitatively evaluates PE in terms of intravaginal ejaculatory latency time and severity, aiming to identify comorbid conditions. As a limitation, the necessity for patients and their partners to measure the time to ejaculation limited the sample size, making it challenging to generalize the findings.

Conclusion
Our findings suggest that impulse control plays a significant role in lifelong PE. It is important for clinicians to assess impulse control and consider therapeutic interventions for men presenting with PE complaints, particularly in those classified as severe.