bluuebunny/crossref_metadata_2025_split huggingface dataset:
(079) IMPLEMENTATION OF A HYBRID VIRTUAL/IN-PERSON SEXUAL HEALTH CLINIC IN A HIGH- VOLUME CANCER CENTRE
Authors: Matthew A , Incze T , Stragapede E , Guirguis S , Peres D , Kemerer B , Elterman D 
Published: December 2024

Abstract

Introduction
Sexual health concerns are some of the most prevalent and challenging side effects of cancer treatment. A hybrid virtual and in-person Sexual Health Clinic (SHC) was recently established within a high-volume Cancer Centre to provide patients with comprehensive sexual health assessment and intervention. Previous research has highlighted the importance of implementation in the achievement of successful outcomes. As part of a robust program evaluation, implementation research methods were used to support the integration of the SHC.

Objective
The objective of this study was to employ a systematic framework to guide the implementation of an innovative hybrid virtual and in-person SHC within an oncology setting.

Methods
The study setting was a high-volume oncology Centre situated in a large urban setting. Participants were purposefully sampled to ensure involvement of relevant stakeholders, including healthcare providers (HCPs) and patient participants representing each identified cancer site (eg, prostate, testicular, bladder, kidney, cervical, ovarian and head & neck cancers). The Quality Implementation (QI) Framework was used to guide the knowledge translation and implementation strategy. The procedure involved conducting 30-minute, semi-structured interviews with patients, clinic personnel, and oncologists. The interviews were transcribed and analyzed using Framework Analysis methodology. The goal of the interviews was to determine ideal SHC implementation methods directly from the perspectives of both patients and HCPs.

Results
In total, 20 semi-structured interviews were conducted (6 patients and 14 HCPs) transcribed and analysed. After employing the Framework Analysis Method, 3 main themes and 10 subthemes were determined. The 3 main themes and associated sub themes include: 1) Recognized Need (Current Gap in Care, Common Concerns Across Populations, and Unique Needs by Population); 2) Confinements of Current Care (Mutual Avoidance/Silence, Concern of Providing Inadequate Care, and Lack of Time); and 3) Strategic Implementation (Need for a Unique Space and Team, Need for Flexibility, Need for Patient Awareness, and Multiple and Ongoing Engagement into Patient Workflow).

Conclusions
This study successfully identified the barriers and facilitators to implementing a hybrid in-person/virtual SHC within a high-volume urban oncology Centre. These findings offer practical insights into integrating sexual health programming into patient workflows, enhancing patient accessibility and engagement.

Disclosure
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(091) THE PREDICTIVE EFFECT OF ALEXITHYMIA IN RELATION TO IMPULSIVITY IN INDIVIDUALS WITH AND WITHOUT COMPULSIVE SEXUAL BEHAVIOR DISORDER
Authors: Do Espírito Santo Gonçalves P , De Tubino Scanavino M 
Published: December 2024

Abstract

Introduction
There is a consensus among researchers on the main characteristics of compulsive sexual behavior disorder (CSBD): impaired control of behavior; clinical suffering; continuity of sexual behavior despite significant impairment in important areas in the person’s life. Previous studies already show the connection between alexithymia and CSBD, as well as impulsivity and CSBD.

Objective
This study investigated the predictive effect of alexithymia in relation to impulsivity in individuals with and without CSBD.

Methods
Cross-sectional, observational and exploratory study, with a sample of 451 participants. Of these, 324 (71.8%) individuals with CSBD and 127 (28.1%) controls. They completed the Barratt Impulsivity Scale (BIS-11) and Toronto Alexithymia Scale (TAS - 26) questionnaires. Exclusion criteria were participants who met diagnostic criteria for paraphilic disorders (DSM-5685), gender dysphoria (DSM-5451), schizophrenia spectrum and other psychotic disorders (DSM-5 87), current hypomanic or manic episode of mood disorder (DSM-5123), neurocognitive disorders (DSM-5591) and other mental disorders (DSM-5707).

Results
In the univariate linear regression which dependent variable is impulsivity, and the independent variables are the four factors of the TAS - 26: TAS Factor 1 – Difficulty identifying and describing feelings and distinguishing feelings from bodily sensations; TAS Factor 2 – difficulty in daydreaming (fantasizing); TAS Factor 3 – Focus on external events rather than internal experiences; TAS Total score. The variables that presented a p value of up to 0.20 and were subsequently included in the multivariate regression model: presenting CSBD (β = 15.41; p-value = &lt;0.001); TAS Factor 1 (β = 0.84; p-value = &lt;0.001); TAS Factor 2 (β = -1.14; p-value = 0.0001); TAS Factor 3 (β = 1.87; p-value = &lt;0.001); TAS Factor 4 (β = 0.67; p-value = 0.096) and TAS Total Score (β = 0.63; p-value = &lt;0.001). The following variables with independent associative effects were observed, namely: TAS Factor 1 (β = 1.36; p-value = &lt;0.001), TAS Factor 3 (β = 1.85; p-value = &lt;0.001) and TAS Total score (β = −0.92; p-value = 0.008).

Conclusions
The study confirmed that alexithymia is associated with impulsivity, the more alexithymic the person is, the more impulsive behavior they will present.

Disclosure
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(106) SURGICAL OUTCOMES OF PLICATION TECHNIQUES IN SEVERE PEYRONIE’S DISEASE
Authors: Zandoná P , Pedrenho R , De Bessa J , Barbosa C , Goes P , Valente Coimbra I , Pato E , Nahas W , Hallak J , Nascimento B 
Published: December 2024

Abstract

Introduction
Surgical techniques for Peyronie’s Disease (PD) exhibit varying profiles of advantages and disadvantages concerning outcomes such as shortening, postoperative erectile dysfunction, risks, and satisfaction.

Objective
The objective of this project is to present the surgical outcomes of plication techniques in patients with severe PD.

Methods
This observational cohort study was conducted at a tertiary hospital involving Peyronie’s Disease patients. Following comprehensive discussion on technical alternatives, patients who underwent penile plication techniques were retrospectively analyzed pre-, intra-, and postoperatively. Penile length was measured from the pubic symphysis to the tip of the glans, with stretched flaccid penis (SFPL). Curvatures were assessed using a goniometer. Perception and discomfort regarding shortening and residual curvature, as well as penetration capability, were evaluated through interviews conducted by a team member other than the surgeon. Improvement in sexual life post-treatment and satisfaction rates were assessed by direct questions, including a 0-10 scale.

Results
A total of 48 plication procedures were performed between November, 2017 and December, 2022, with preoperative and intraoperative objective data available for all procedures. Complete follow-up data were available for 20 patients, with an average follow-up period of 20.4 months. Overall, the mean age was 61.9 years (SD 10.3). The mean intraoperative curvature was 54.15 degrees (SD 15.58), decreasing to 10.54 degrees (SD 5.87) following plication. During follow-up, 55% (11/20) of patients reported perceiving some residual curvature, causing discomfort only for 18% (2/11) of them. Penetration capability post-surgery was 95% (19/20), with the only exception being related to rigidity issues. Mean erectile function (0-10 scale) was 7.36 (SD 1.46) preoperatively and 7.26 (SD 2.25) postoperatively. Mean stretched flaccid penis lenght was 13.8 (SD 1.51) preoperatively and 13.71 (SD 1.3) after plications. 75% the patients reported noticing penile shortening, although only 26% of them referred being bothered with it. Average sexual frequency increased from 2.78 (SD 3.43) times per month preoperatively to 6.78 (SD 5.4) postoperatively. All patients (100%) reported improvement post-surgery and expressed willingness to undergo the procedure again. The mean satisfaction score (0-10) was 8.8 (SD 1.47).

Conclusions
In this sample of patients with severe PD, our results demonstrate that plication techniques, chosen after comprehensive technical discussions, yield satisfactory objective, functional, and subjective outcomes.

Disclosure
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(115) THE IMPACT OF VACUUM ERECTION DEVICES USE ON PENILE DOPPLER ULTRASOUND READINGS AND INTRACORPOREAL INJECTION DOSAGE INPATIENTS FOLLOWING PELVIC SURGERIES
Authors: Khalaf Alla K , Mahdi M , Majzoub A , Jacob J , Slovacek H , Wang R 
Published: December 2024

Abstract

Introduction
Vacuum erection devices (VEDs) are believed by many to play an integral role during penile rehabilitation following pelvic surgery through enhancing penile blood flow, length preservation and assisting in achieving penile erection.

Objective
Our aim is to investigate the influence of VEDs usage on penile doppler ultrasound (PDU) readings and the dose adjustments of ICI therapy in men following pelvic surgery.

Methods
We conducted a retrospective review of our institution’s database to identify patients experiencing erectile dysfunction as a result of pelvic surgery. The study involved individuals from a single institution who visited the Sexual Medicine clinic, underwent PDU, utilized Trimix ICI, and had a follow-up for a minimum of one year. Our investigation comprised data gathered from 127 patients meeting these outlined criteria between 2020 and 2022. Patients were categorized into two groups: Group 1 comprising individuals using VED with ICI for a duration of at least 1 year (minimum of at least 3 times per week) & Group 2 without VED. Student T-test was used to compare various numerical variables between both groups.

Results
In general, out of the 127 patients included, 20.3% were diabetic, 50.8% were hypertensive, 18% had radiation therapy & 14% had Androgen deprivation therapy. B blocker intake was reported in 18% of patients. With regards to surgery type, 46.1% underwent bilateral nerve sparing prostatectomy, 35.9% underwent partial nerve sparing while 4.7% had a non-nerve sparing technique. Cystoprostatectomy was observed in 5.5% while the remaining 7.8% had other pelvic surgeries. Results of the patient demographic and clinical parameters along with the PDU readings between both groups are reported in Table 1. Notably, no statistically significant differences were observed between both groups in terms of age, HbA1c, Testosterone levels, PDU readings, or in relation to the alterations in the ICI Trimix dosage.

Conclusions
Our initial analysis indicates that the use of VED in the rehabilitation of patients following pelvic surgery does not influence erectile function status measured by PDU readings or Trimix ICI requirements in the post-operative period. While counseling patients aboutVED usage in conjunction with Trimix injections lacks substantial supporting evidence, theoretically, it might play a role. Additional studies are necessary to definitively ascertain its significance, moving from its current indeterminate status.

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(120) TUNICA ALBUGINEA FLAP IN FEMINIZING SEX REASSIGNMENT: A NEW VARIATION OF THE PENILE SKIN INVERSION TECHNIQUE
Authors: Rocha RI , Silva THCD , Paiva OG , Cintra Junior W 
Published: December 2024

Abstract

Introduction
Feminizing sex reassignment has been shown to be an effective method for treating gender dysphoria, and inversion of the penile skin is the most common method for creating a neovagina.

Objective
The present study proposes a new variation of the original technique, using a tunica albuginea tissue flap that is fixed to the ischium, providing support and containment for the local tissues.

Methods
A cavity is created between the rectum and the bladder, where the inverted penile skin will be positioned to line the neovagina. After the penis is removed and the corpora cavernosa exposed, a rectangular band of the tunica albuginea tissue is attached to the pubis. This flap is fixed with slight traction bilaterally to the ischium, on the lateral walls of the cavity created in the space anterior to the rectum. The urethra and neoclitoris are exteriorized through the midline of the flap.

Results
The use of the tunica albuginea of the corpora cavernosa allows for better containment of the urethral bulb, provides support for the urethral meatus, and improves the aesthetic appearance of the vulva by deepening the groove between the labia majora.

Conclusions
The vulva created is aesthetically similar to that of a cisgender woman and the vaginal canal, after undergoing a postoperative dilatation regimen, will be able to accommodate penetration.

Disclosure
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(126) RELEASE OF 6-NITRODOPAMINE AND 6-CYANODOPAMINE FROM HUMAN CORPUS CAVERNOSUM, CORPUS SPONGIOSUM, TUNICA ALBUGINEA AND THE BULBOSPONGIOSUS MUSCLE
Authors: De Miranda Cará A , Lorenzon F , Caliano Mathias-netto F , Placco Araujo Glina F , Glina S , Paiva O , Fregonesi A , Cintra Júnior W , Itocazo Rocha R , De Nucci G 
Published: December 2024

Abstract

Introduction
The novel catecholamine, 6-nitrodopamine (6-ND), promotes relaxation of rabbit corpus cavernosum, acting as selective dopamine D2-receptor antagonist, indicating that the modulation of corpus cavernosum smooth muscle tone may primarily depend on the balance of dopamine and 6-ND release and synthesis. 6-Cyanodopamine (6-Cya) is a novel catecholamine that is released from rabbit isolated heart and found in the circulation of patients with chronic kidney disease.

Objective
To investigate the release of new endogenous catecholamines from penile human tissues.

Methods
Human penile tissues were obtained from 13 patients (mean age: 45 years old) who had undergone male-to-female gender reassignment surgery. All the patients had used androgen blockers and estrogen treatment for at least two years before the surgery. The release of 6-nitrodopamine and 6-cyanodopamine in Krebs–Henseleit’s solution was quantified by liquid chromatography coupled to tandem mass spectrometry (LC–MS/MS). The method was applied to investigate the basal release of these novel catecholamines from human corpus cavernosum (CC), corpus spongiosum (CS), tunica albuginea (TA) and the bulbospongiosus muscle (BSM). To assess the NO involvement in the synthesis and the neural source of this molecules, the tissues were incubated for 30 minutes with NO synthase inhibitor N(ω)-nitro-L-arginine methyl ester (L-NAME-100 μM) and the voltage-gated sodium channel blocker tetodrotoxin (TTX-1 μM), respectively.

Results
6-ND was detected in HCC using liquid chromatography–tandem mass spectrometry. Incubation with L-NAME significantly reduced 6-ND levels (0.6 ± 0.2 vs. 0.4 ± 0.4 ng/mL; n = 8), whereas incubation with TTX did not affect 6-ND release (n = 6). The 6-ND was also detected in the CS (2.1 ± 1 ng/mL; n = 8), TA (0.4 ± 0.2 ng/mL; n = 4), and BSM (0.6 ± 0.5 ng/mL; n = 4), and its release was not affected by pre-incubation with TTX, indicating that the source of this molecule is not neurogenic. 6-Cyanodopamine was detected in the CC (0.4 ± 0.2 ng/mL; n = 8), TA (0.4 ± 0.2 ng/mL; n = 4) and BSM (0.3 ± 0.3 ng/mL; n = 4). In the CS, 6-Cya was not detected. Similar to 6-ND, the release of 6-Cya was not affected by pre-incubation with TTX. Furthermore, tissues pre-incubated with L-NAME showed no difference in the levels of 6-Cya compared to basal levels.

Conclusions
The results indicate that 6-nitrodopamine and 6-cyanodopamine are the predominant catecholamines detected in the basal release from human corpus cavernosum, corpus spongiosum, tunica albuginea and bulbospongiosus muscle. Whether 6-cyanodopamine modulates HCC tonus remains to be investigated.

Disclosure
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(127) PREVENTIVE EFFECTS OF PTERORHACHIS ZENKERI HARM (MELIACEAE) IN TESTOSTERONE PROPIONATE-INDUCED BENIGN PROSTATIC HYPERTROPHY IN WISTAR RAT
Authors: Watcho P , Bonsou Fozin GR 
Published: December 2024

Abstract

Introduction
Benign prostatic hypertrophy (BPH) is an androgen-dependent and age-related disease which significantly affects the patient’s life. BPH can lead to a number of symptoms for patients commonly referred to as lower urinary tract symptoms including obstructive and irritative disorders as well as complications such as renal failure and sexual disorders. In addition, medical health care remains problematic due to therapeutic limits such as the cost, the accessibility and the side effects.

Objective
The aim of the present study was to assess the preventive effects of the aqueous (62 mg/kg) and methanolic (10 mg/kg) extracts from Pterorhachis zenkeri (P. zenkeri) on testosterone propionate-induced benign prostatic hypertrophy in rats.

Methods
Adult Wistar rats were randomly partitioned into groups of 5 rats each and treated with one of the following: distilled water (10 ml/kg)/soja oil (1 ml/kg), testosterone (10 mg/kg), aqueous extract (62 mg/kg), methanolic extract (10 mg/kg), testosterone plus bicalutamide (5 mg/kg) plus aqueous extract (62 mg/kg), testosterone plus bicalutamide plus methanol extract (10 mg/kg) during 2 or 4 weeks. At the end of the treatment periods, body and prostate related weights, biochemical, histological, histo-morphometrical and oxidative stress parameters were comparatively measured.

Results
Testosterone propionate induced a significant (p &lt; 0.001) increase in the size and relative weight of ventral prostate, plasmatic level of prostate specific antigen (PSA), length of prostate epithelial cells and prostate structural damages. Additionally, the levels of prostatic dihydrotestosterone and, plasmatic nitrogen monoxide and malondialdehyde were increased whereas the activity of superoxide dismutase was decreased. Administration or co-administrations of P. zenkeri extracts with bicalutamide time-dependently prevented the above-mentioned damages through its anti-androgenic and anti-oxidant properties.

Conclusions
The bioactive compounds present in P. zenkeri extracts could justify the reported findings. Present results therefore suggest that P. zenkeri could be a good candidate in the management of BPH.

Disclosure
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(130) ASSOCIATION BETWEEN CARDIOVASCULAR DISEASE AND RISK OF FEMALE SEXUAL DYSFUNCTION: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Dilixiati D , Ruotong C , Yishen M , Yuting L , Dilimulati D , Azhati B , Rexiati M 
Published: December 2024

Abstract

Introduction
Female sexual dysfunction (FSD) is a considerably underestimated condition. It has been repeatedly reported that patients with cardiovascular diseases (CVD) may suffer from an increased risk of FSD. However, there is still a lack of comprehensive and systematic evaluation of various CVD and FSD.

Objective
We aimed to elucidate the association between CVD and FSD through a comprehensive literature review and meta-analysis.

Methods
The PubMed, Scopus, Embase, and Cochrane Library databases were systematically searched from inception to February 28, 2023. We identified all relevant studies reporting the risk of FSD in subjects with or without CVD. The associations between CVD and the risk of FSD were assessed by calculating pooled ORs (cross-sectional studies) and RRs (longitudinal studies) with 95% CIs. We employed random-effects models to account for potential heterogeneity, and the quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS). Fifty-four articles with 148 946 individuals were included in our meta-analysis.

Results
Compared with control subjects, subjects with CVD had a 1.51-fold increased risk of FSD (OR 1.51 95% CI, 1.34-1.69, P &lt; .001, heterogeneity I2 = 91.4%, P &lt; .001). Subgroup analyses indicated that the association between CVD and FSD remained significant in longitudinal studies (RR 1.50 95% CI, 1.21-1.86, P &lt; .001, heterogeneity I2 = 86.7%, P &lt; .001). Particularly, hypertension (OR 1.41 95% CI, 1.23-1.62, P &lt; .001, heterogeneity I2 = 82.7%, P &lt; .001), stroke (OR 1.81 95% CI, 1.54-2.12, P &lt; .001, heterogeneity I2 = 0%, P &lt; .423), and myocardial infarction (OR 2.07 95% CI, 1.60-2.67, P &lt; .001 heterogeneity I2 = 82.4%, P &lt; .001) were significantly associated with FSD. Meta-regression revealed that the primary sources of heterogeneity in FSD are attributable to adjustments for covariates, study design, and study population.

Conclusions
Our meta-analysis indicated that patients with CVD suffer from a greater risk of developing FSD. Meanwhile, we validated these findings in longitudinal queues. Notably, conditions such as hypertension, stroke, and myocardial infarction demonstrated a significant association with the incidence of FSD.

Disclosure
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(150) SATISFACTION AFTER PENILE PROSTHESIS IMPLANT IN PATIENT WITH PSYCHOGENIC ERECTILE DYSFUNCTION
Authors: De Rocco M , Silva Garreton A 
Published: December 2024

Abstract

Introduction
The penile prosthesis implant is a therapeutic tool widely used today for the treatment of erectile dysfunction refractory to treatment with oral, intraurethral, vacuum and/or intracavernous therapies. On some occasions we can find patients whose erectile dysfunction has a mainly psychogenic cause, making these patients a therapeutic challenge when deciding whether they are potential candidates for a penile prosthesis.

Objective
Describe our population of patients with erectile dysfunction of psychogenic cause to determine the satisfaction obtained with the implantation of a penile prosthesis, and compare them with patients who undergo penile implant for erectile dysfunction of organic cause.

Methods
The medical records were reviewed and did a follow up to complete an ad hoc questionnaire to describe the characteristics of the population with erectile dysfunction due to psychogenic causes, which included the questions GAQ-1 (Did your erections improve?), GAQ-2 (Are you more confident to initiate sexual relationship?), SEP-2 (Were you able to penetrate your partner?) and SEP-4 (Did you experience a satisfactory sexual relationship?) among others. Moreover, the QolSPP questionnaire (Quality of Life and Sexuality with Penile Prosthesis) was applied for the comparison between patients with erectile dysfunction of psychogenic cause and those patients with organic cause.

Results
The group of psychogenic patients answered affirmatively the GAQ-1 question in 96% of the cases, in 92% the GAQ-2 question, in 92% the SEP-2 question, and in 95% the SEP-4 question. In addition, 96% of them responded that they were satisfied with the penile prosthesis and the average satisfaction score was 8.71/10 points (5-10 points). The QolSPP questionnaire showed statistically significant differences between both groups in favor of the psychogenic group (N = 25) compared to the organic group (N = 36) in 8 of the 16 question domains, most of them related to the satisfaction and well-being with the prosthesis. Complications occurred in 16% of patients in the psychogenic group and in 2.8% in the organic group.

Conclusions
The results show a significant satisfaction with the use of a penile prosthesis in patients with erectile dysfunction due to psychogenic causes. However, we have observed a particular tendency to present greater complications in this group of patients.

Disclosure
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