bluuebunny/crossref_metadata_2025_split huggingface dataset:
(037) ULTRASOUND EVALUATION OUTCOMES OF THE CORPUS CAVERNOSUM IN THE GLANS: A CROSS-SECTION STUDY
Authors: Cavalcanti Filho M , Monteiro L , Fernandes G , Lemos C 
Published: December 2024

Abstract

Introduction
The penile Doppler ultrasound is a versatile diagnostic tool that allows for a detailed assessment of penile anatomy and hemodynamic variables. The ability to measure the length of the cavernous body that extends into the glans adds an additional dimension to the evaluation, potentially improving the clinical management of men with sexual dysfunction.

Objective
Our objective was to estimate the length of the corpus cavernosum extending into the gland using penile Doppler ultrasound.

Methods
A cross-sectional study was conducted using a penile Doppler ultrasound examination, performed by an experienced urologist, with a high-frequency linear transducer, in a standardized manner as described by Carneiro et al., 2020. To measure the shape of the corpus cavernosum in the intraglandular section, the transducer was placed in the longitudinal coronal groove topography as shown in the attached image 1. All statistical and graphical analyzes presented in this study were performed using RStudio.

Results
From January to April 2024, a total of 170 men were subjected to Doppler ultrasound examinations. The clinical data for the sample revealed an average age of 57.89 years, an average weight of 85.88 kg, an average height of 1.76 m, and an average Body Mass Index (BMI) of 27.61. The reasons for the exams were based on the medical diagnosis of Erectile Dysfunction, Peyronie’s Disease, or both. The clinical data were stratified based on the reason for the examination, and the results of the hypothesis tests demonstrated no differences between the groups. Findings for the corpus cavernosum in the glans revealed a range of values from a minimum of 0.53 cm to a maximum of 2.04 cm, with a mean measurement of 1.40 cm. The first quartile was observed at 1.10 cm, the median at 1.40 cm, and the third quartile at 1.70 cm. Upon scrutiny of the boxplot (image 2), the lack of marked outliers suggests that the entirety of the data adheres to an acceptable range. When evaluating the association with the chi-square test between cavernous length in the glans between three groups (Erectile Dysfunction, Peyronie’s Disease or both) there was no significant difference between the groups (p = 0.768). Pertaining to the dimensions of the penis, the average measurement of the stretched penis was found to be 13.04 cm, while the erect penis exhibited an average length of 12.48 cm.

Conclusions
In this pilot study, it could be suggested that Doppler ultrasonography may be a method for measuring the corpus cavernosum in the glans, and subsequently, for computing the average of this measurement. This approach might be worth considering in future studies.

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(041) PREVALENCE OF FEMALE SEXUAL DYSFUNCTION (FSD) IN THE FIRST FEMALE SEXUALITY CLINIC IN CHINA BY USING THE DR. EROS FSD SCALE
Authors: Jannini E , Yu Z , Li Z , Sun F , Colonnello E , Sansone A 
Published: December 2024

Abstract

Introduction
Female sexual dysfunctions (FSDs) represent a common issue among the general population. However, in many cultures and societies, such as China, FSD still needs to be addressed in the urological setting, so far more focused on Andrology. However, FSDs can be easily investigated in clinical practice, and for research purposes using validated psychometric tools, including the Female Sexual Function Index (FSFI), the most commonly used diagnostic instrument, also validated in Mandarin. While the scientific interest in this field is growing, several issues remain unaddressed by the FSFI, such as orgasmic intensity or satisfaction associated with the frequency of sex. The Dr. Eros FSD scale aims to fill this gap.

Objective
We aimed to explore FSDs in the general population in order to address the unmet expectations and needs of Chinese women in China.

Methods
In our Clinic, the first established in China aiming to treat FSDs, we developed a modified version of the FSFI, which also focuses on sex frequency, sexual urges, satisfaction related to orgasm and sexual activity, and vaginal discomfort during sexual activity. These 5 questions were added to the 19 items of the FSFI, for 24 questions. The two questions on sex frequency and sexual urges were added to the desire domain of the FSFI, whereas the following three were included in the Orgasm, Satisfaction, and Pain domains, respectively.

Results
The Dr. Eros FSD scale was administered to 14 896 women (age: 36.2 ± 8.1 years, range 18-18) admitted to the outpatient service of our Clinic, from March 2020 to May 2024. Mean ± SD for the 6 domains were as follows: Desire, 12.9 ± 3.2; Arousal, 12.8 ± 5.4; Lubrication, 15.6 ± 5.9; Orgasm, 13.2 ± 5.7; Satisfaction, 13.8 ± 4.4; Pain, 14.0 ± 5.06. Since a lower score is suggestive of increased severity of SDs, the most severe female sexual complaints in China are seemingly hypoactive sexual desire disorder and poor overall satisfaction, in an age-dependent manner. Regression analysis showed a significant effect of aging on all six domains (p &lt; 0.001 for all, fig. 1) when stratifying the population by age (age &lt; 45, N = 12 666; age 45-55, N = 1924, age ≥ 55, N = 306).

Conclusions
The new Clinic, dealing with all FSDs, from HSSD to hypolubrication, from anorgasmia to vaginismus, from dyspareunia to couple’s problems, is the unique institution systematically addressing female sexual health in China. Our experimental data demonstrate that this is a major unmet need in this part of the world. The prevalence and severity of SDs among Chinese women are clinically relevant issues for healthcare, which should urgently be addressed with the instruments of modern Sexual Medicine, possibly involving both Western and traditional Chinese medicine (TCM) in a holistic perspective.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Mia Clinic.
(049) THE RITE OF TASFIH IN TUNISIA
Authors: Kaabia O , Gharbi I , Smaali H , Guefrech O , Maya Bahri Y 
Published: December 2024

Abstract

Introduction
Tasfih is a magical practice exercised by an old woman on girls before puberty, in some North African countries to prevent any pre-marital vaginal penetration. In doing so, it is believed that the hymen becomes unbreachable. It is a taboo practice that is frequently reported as a cause of vaginismus.

Objective
The primary aim of this study is to assess the prevalence of the rite of Tasfih among young Tunisian women. The secondary objective is to evaluate the epidemiological profile of this rite’s victims.

Methods
This is a cross-sectional study including Tunisian women aged between 18 and 45. The study was conducted through an online self-administered questionnaire to provide a nuanced analysis of the topic through the collection of both quantitative and qualitative data from the participants. It was conducted over a 5-week period, by sharing the questionnaire on social media platforms.

Results
This study included 1207 women. The prevalence of the rite of Tasfih was 8.62%. The mean age among the victims of the rite of Tasfih was 28.66 +/−6.04 years. Among the women who self-reported Tasfih, 71% went to university, 94% came from a conservative family, 22% had rural origins, and 26% were unemployed at the time of the study. A history of physical abuse was reported in 30% and sexual harassment in 63%. Regarding their medical history, 26% were smokers, 12.5% had a mental health history, 41% reported a history of vaginismus and 38% had at least one child.

Conclusions
The prevalence of the magic rite of Tasfih among young adult Tunisian women is 8.62%. It is associated with a conservative family but is not limited to rural origins. Participants who self-reported Tasfih also reported high rates of vaginismus, physical abuse, and sexual harassment.

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(052) APPLICATION AND VALIDATION IN SPANISH OF THE “VULVAR PAIN SCREENING QUESTIONNAIRE” IN WOMEN WITH CHRONIC VULVAR PAIN
Authors: Valente S , Gomez Cherey F , Bolognessi V , Soloa P , Maldonado V , Ortiz J 
Published: December 2024

Abstract

Introduction
Persistent vulvar pain without a clearly identifiable cause has a prevalence of 8-21%. However, many patients have difficulty obtaining a diagnosis. It is known that multiple factors participate in the painful process. In order to speed up treatment arrival, it is essential to have an effective tool to be able to evaluate and make a diagnosis by health professionals. The VPA-Q Questionnaire (Vulvar Pain Assessment Questionnaire) was developed in Canada to contribute to the evaluation and diagnosis of chronic vulvar pain, considering an altered subscale, an average value ≥2.

Objective
This study sought to adapt and validate the VPA-Q to a population of Argentine women.

Methods
The translation and cross-cultural adaptation was carried out according to the Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-Reported Outcomes (PRO) Measures guidelines. Once approved, validation was carried out in Argentina in a cohort of patients. 184 women were recruited and completed the FSFI (Female Sexual Function Index) questionnaire. 65 women presented the altered pain domain and were included in the study to complete the VPAQ-full (63 items). Statistical analysis: Epidemiological analysis of population variables was performed, internal consistency with Cronbach’s alpha in each subscale, a value &gt;0.8 and p &lt; 0.05 were considered significant.

Results
The average age was 53.1 (± 11.2) years, 90.8% were Argentine, 66.2% were married, 81.5% were menopausal. The predominant associated symptom was vaginal dryness (83.1%). 33.8% never looked at their vulva. 44.6% had pain for 2-5 years. 66.2% presented pain during sexual activity, 40% did not tolerate the entry of any object into the vulva. The reliability analyzes of the subscales were: Pain Severity (mean: 2.72; Cronbach’s α: 0.94), Emotional Response (mean: 1.78; Cronbach’s α: 0.96), Cognitive Response (mean: 1.17; Cronbach’s α: 0.89), Interference in life (mean: 1.04; Cronbach’s α: 0.95), Interference in sexual life (mean: 2.02; Cronbach’s α: 0.9), Interference in self-stimulation (mean: 1.03; Cronbach’s α: 0.86).

Conclusions
Exploratory and confirmatory factor analyzes demonstrated that the adapted version of the VPAQ-full, into Spanish, satisfactorily meets the validation requirements. Measuring and understanding vulvar pain and its impact on sexual, emotional and cognitive health is key to evaluating the sexual health and quality of life of women and their relationships.

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(053) SOCIOSEXUAL SKILLS INVENTORY: CONFIRMATORY FACTOR ANALYSIS INTRODUCTION
Authors: Soares Alves Mendes V , Benevides Soares A 
Published: December 2024

Abstract

Introduction
Casual sexual relationships can be a way to achieve sexual pleasure without the need to establish bonds or succumb to pressures typical of a romantic relationship. However, despite the erotic satisfaction obtained, Casual Sex (CS) is associated with sexual risks such as sexually transmitted infections, abuse, harassment, unwanted pregnancy, and regret. In this regard, the scientific literature explicates that Social Skills (SS) are associated with promoting sexual health and preventing problems such as those aforementioned. Thus, the acquisition of SS can function as protection in CS contexts, contributing to self-protection and better performance. Consequently, in a previous study, the Sociosexual Skills Inventory (SSSI) was developed, a psychological assessment instrument that identifies SS in the context of seeking CS. The instrument has two factors that reveal direct and indirect approaches.

Objective
To confirm the internal structure and seek new validity indicators for the SSSI.

Methods
374 young adults aged 18 to 29 (M = 23.37 and SD = 2.79) participated. The SSSI, the Love Styles Inventory (LSI), and the Condom Use Self-Efficacy Scale (CUSES) were administered. Confirmatory Factor Analysis (CFA) was conducted using JASP 0.16.2 software, and correlation analyses between the instruments were performed. All participants signed the Informed Consent Form, and the project was approved by the Research Ethics Committee.

Results
Two different models were tested through CFA, one with 18 items (as per the original instrument) (χ2: 269.204; df: 134; χ2/df: 2.01; TFI: 0.966; TLI: 0.961; RMSEA: 0.052) and the other with the suppression of items 8 and 10 (factor loadings of 0.34 and 0.17 respectively), with 16 items (χ2: 194.567; df: 103; χ2/df: 1.89; TFI: 0.976; TLI: 0.971; RMSEA: 0.049). The second was considered more suitable for excluding two items with loadings below 0.40, presenting better fit indices, and being theoretically more coherent. The final 16-item model maintained the two-factor structure: 1) Direct Sociosexual Skills (DSSS) (α = 0.81; ω = 0.82) and 2) Indirect Sociosexual Skills (ISSS) (α = 0.78; ω = 0.79). Regarding Pearson Correlation analysis, DSSS correlated with the Skill (0.18) and Assertiveness (0.20) dimensions of CUSES and with the Direct (0.65) and Subtle (0.53) styles of LSI; whereas ISSS correlated with Skill (0.15), STI (-0.12), and Assertiveness (0.23) dimensions of CUSES and Direct (0.52) and Subtle (0.65) Love Styles.

Conclusions
It was possible to verify that the SSSI remains with the internal factorial structure almost unchanged and with more validity indicators. Thus, it is noted that the instrument can be used by psychologists and researchers to evaluate the repertoire of SS for approaches in favor of CS, as well as possible behavioral problems that may contribute to sexual risks and the approach style employed in these contexts.

Disclosure
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(055) MANAGING PROXIMAL CORPORAL PERFORATION DURING PENILE IMPLANT SURGERY USING RE-DILATATION ONLY: DEMONSTRATING A CASE OF INFRAPUBLIC APPROACH
Authors: Slovacek H , Mahdi M , Albakr A , Wang R 
Published: December 2024

Abstract

Introduction
Many options have been described for the surgical management of proximal corporal perforation during penile implant surgery with the intent to prevent the risk of cylinder migration and device failure. These methods include the historical formal corporal repair, windsock technique using non-absorbable grafts, absorbable mesh plugs/patch, and fixation of the rear tip extender or shod material covering implant tubing by sutures.

Objective
We aim to demonstrate by video our simple technique in the management of proximal corporal perforation using only re dilatation into the normal proper tract without the need of corporal repair or cylinder fixation.

Methods
We are demonstrating by video and graphs a case of 69-year-old gentleman undergoing penile implant procedure using infra pubic approach. The patient presented for the surgery after he failed the medical treatment for erectile dysfunction. He was known to have controlled diabetes and a past surgical history of bilateral hernia repair and Robotic assisted radical prostatectomy. We prefer the infra pubic approach for patient with bilateral hernia repair as infra pubic incision allows inserting the reservoir under direct vision into the sub muscular space. During the procedure, while trying to overcome the right corporal fibrosis, proximal perforation occurred. The perforation seemed to be on the medial side of the corpora. It was managed by re dilatation of the proximal corpora into a new tract starting from the corporotomy site away from the initial tract, following a more lateral direction up to the most proximal part of the corpora at the pubic bone. Sequential dilatation using up to size 13 Brooks dilator was done. Following that, the cylinders were inserted and confirmed to be in the proper position after full inflation.

Results
The patient recovered well and was able to use the device after 6 weeks. During the follow up period up to 6 months there was no reported cylinder migration or other device related complications. We have used the demonstrated technique in many patients, with favorable outcome.

Conclusions
Managing proximal corporal perforation during penile implant surgery using re dilatation of a new proper tract is an effective technique. It is less time and cost consuming than the reported methods. Further studies are needed to support the efficacy of using this technique.

Disclosure
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(058) CAVERNOSAL BANDING: A NEW PROCEDURE TO ADDRESS SIGNIFICANT WEAKENING OF ALBUGINEA IN COMPLEX PENILE PROSTHESIS SURGERY: A PROOF-OF-CONCEPT CASE WITH A FOLLOW-UP OF 2 YEARS
Authors: Pescatori E , Loreto A 
Published: December 2024

Abstract

Introduction
In cases of penile prosthesis redo-surgery the finding of albuginea weakening may represent a challenging issue to deal with.

Objective
We present an original technique to address weakening of albuginea in patients with inflatable penile prostheses.

Methods
A 52 y.o. white male with four former implant surgeries (penoscrotal) reported that upon activation no erection developed, while the scrotum enlarged. In the latest surgery initial weakening of albuginea was reinforced with absorbable collagen fibrin sealant patches. MRI disclosed bilateral cylinders herniation at the site of former corporotomies. Surgical procedure. Penoscrotal approach: in the herniation area there was bilaterally a wide albuginea defect. In the involved area we circumferentially isolated the albuginea dorsally from Buck’s fascia, inclusive of the neurovascular bundle, and ventrally from urethra. We developed some tissue planes to cover the albuginea defect. The old device was removed and replaced with a new AMS 700CX. We measured: circumference of isolated corpora in tumescence state (12 cm), and distance between the limits of the two isolated circumferences -proximal and distal- (5 cm). A 12x5 cm rectangle of bovine pericardium was fashioned. CAVERNOSAL BANDING was achieved transferring the fashioned rectangle patch around the isolated albuginea of the two corpora cavernosa. The two short sides were sutured together and to the ventral albuginea, beneath the urethra, and anchoring stitches fixed the patch to the albuginea, to keep it flat (figure). Patient had to daily cycle the device for three months, not exceeding the tumescence status, to allow a sound remodelling process of the graft.

Results
At 3 months: MRI: normal appearance of the inflated cylinders, without bulging; IIEF score = 24; QoLSPP scores: 25 - functional domain, 15 - social domain, 19 - relational domain, 18 - personal domain. At 2 years from surgery patient is having regular sexual intercourse without any clinical evidence of bulging, with high satisfaction.

Conclusions
The outcomes of this first case suggest that CAVERNOSAL BANDING with bovine pericardium is a working solution for challenging cases of albuginea weakening/loss in patients with penile prosthesis.

Disclosure
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(060) THE NO-TOUCH TECHNIQUE FOR PENILE PROSTHESIS IMPLANTATION
Authors: Feghali J , Meilika K , Eid J 
Published: December 2024

Abstract

Introduction
The No-Touch Technique, a surgical approach to penile prosthesis implantation, was developed by Dr. J. Francois Eid in 2005. Its primary goal is to reduce the risk of bacterial contamination of the prosthesis during penile implant surgery.

Objective
This video presents the step-by-step details of the technique, showcasing the precision and care taken to ensure proper isolation of the device from the patient’s skin.

Methods
The video, filmed with a special high-definition camera, guides viewers through the entire process of the “No-Touch Technique” for a three-piece penile implant. It begins with the preparation of the surgical field, followed by detailed procedural steps. These steps include the use of a sterile fluoroscopy transparent drape, which prevents direct skin contact with the implant, as well as the use of gloves and instruments. The technique allows for surgical manipulation of the penis and scrotum while maintaining isolation. Additionally, the method emphasizes minimal dissection, small corporotomies, and hemostatic closure of the tunica albuginea combined with intracorporal injection of a hemostatic agent. These maneuvers are critical in preventing infection and render the placement of a drain unnecessary.

Results
Data collected since 2006, based on nearly 5000 consecutive implants, validates the effectiveness of the No-Touch Technique that was shown in this detailed video. The infection rate remains remarkably low at 0.7%, supporting the theory that isolation from skin significantly reduces the risk of postoperative infections.

Conclusions
Through this visual presentation, the “No-Touch Technique” is demystified, providing a clear and comprehensive understanding of this best practice in penile prosthesis surgery. The video serves as an invaluable resource for urologists and surgical teams worldwide, promoting a safer surgical environment and improved patient outcomes.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Dr J. Francois Eid (consultant for Coloplast, Boston, Rigicon).
(063) THE MODIFIED SLIDING TECHNIQUE WITHOUT CAVERNOUS DILATATION: A NOVEL METHOD OF TUMESCENCE PRESERVATION
Authors: Vinay J , Fleck D , Saez N , Vega A , Abad J , Urzua R 
Published: December 2024

Abstract

Introduction
Erectile dysfunction (ED) and penile shortening (PS) share multiple risk factors. Normal aging, Peyronie’s disease, pelvic surgery and priapism are some of the conditions often associated with both ED and PS. Furthermore, penile prosthesis placement has the shortcoming of not preserving the original penile length and tumescence.

Objective
The objective of this video is to present a novel adaptation of the modified sliding technique (MoST) with the aim of preserving penile tumescence during sexual arousal.

Methods
We present the case of a 69 year old patient that presented severe organic ED and PS (from 14 to 11 cm) during the last 5 years. Currently, he is not able to penetrate or have sexual intercourse. He was refractory to multiple phosphodiesterase 5 inhibitors, rejecting intra-urethral/intra-cavernous alprostadil. He underwent penile prosthesis placement with length preservation using MoST, with a novel method of penile tumescence preservation.

Results
We performed a malleable penile implant placement with length preservation using MoST. Initial penile length was 11 cm. After an initial circumcision, the penis was degloved. 2 longitudinal para-urethral incisions were made into Buck’s fascia, followed by mobilization of the neurovascular bundle (dorsal) and corpus spongiosum (ventral). 2 longitudinal incisions were made in the tunica albuginea, along with a proximal semicircular incision dorsally and a distal semicircular incision ventrally. Then, traction was applied to the shaft, creating 2 tunical defects secondary to the sliding of the tunica albuginea. Without dilating the corpus cavernosum, a malleable implant was placed, after measuring with a Furlow inserter. Dorsal and ventral tunical defects were then covered by Buck’s fascia and corpus spongiosum, respectively. The penis was then re-gloved, and wrapped in adhesive dressing, using the ´mummy wrap´ technique. Final measurement of penile length was 14 cm.

Conclusions
Multiple medical conditions linked to ED are associated with important PS. MoST is an effective and safe option to treat both severe/refractory ED and PS. Traditional penile implant placement techniques do not preserve the original penile length, which can be bothersome for several patients. MoST not only can preserve penile length. If it is performed without cavernous dilation, it can preserve penile tumescence during sexual arousal, giving a more satisfactory and physiological experience to patients.

Disclosure
No.