bluuebunny/crossref_metadata_2025_split huggingface dataset:
(218) EFFECT OF MICROSURGICAL VARICOCELECTOMY ON SEX HORMONES LEVELS
Authors: Tenorio Lira Neto F , Miranda E 
Published: December 2024

Abstract

Introduction
Varicocele is defined as abnormal dilation of the internal spermatic veins due to incompetent venous valves, leading to venous reflux. This condition is found in 15% of all men, and its prevalence increases to 40% in men with primary infertility and to 80% in men with secondary infertility. Furthermore, clinical studies have demonstrated that this condition might impair Leydig cell function, and that varicocele repair can improve testosterone production.

Objective
To evaluate the effect of microsurgical varicocelectomy (MV) on serum sex hormone levels in infertile men with varicocele.

Methods
We reviewed a database of infertile men with palpable varicocele who underwent MV performed by a single surgeon and identified men who had preoperative and postoperative serum sex hormone data available. Total testosterone (TT), estradiol, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) were measured in real-time by a solid-phase chemiluminescent immunoassay, while free testosterone (FT) levels were calculated using the validated formula of Vermeulen. The testosterone/estradiol ratio was also calculated. Descriptive statistics, paired t-test, and Wilcoxon signed-rank test were used to compare the variables before and after MV. Significance was set at p &lt; 0.05. We performed a subanalysis including only participants with TT levels less than 300 ng/dL.

Results
Overall, we included 132 participants. When analyzing the entire cohort, there was a decrease in postoperative luteinizing hormone levels compared to baseline (4.8 vs. 5.2 mUI/mL, p &lt; 0.05), and no statistically significant differences were observed concerning the other sex hormone levels. However, in the 17 participants with preoperative TT levels less than 300 ng/dL, we found increases in TT levels (205 vs. 376 ng/dL, p &lt; 0.05) and estradiol levels (24.9 vs. 33.1 pg/mL, p &lt; 0.05) after MV. In this subgroup, the mean increase in testosterone was 125 ± 83 ng/dL compared to preoperative levels, whereas the median increase in estradiol was 4.6 (-1.0, 11) pg/mL. No other statistically significant differences were observed regarding preoperative and postoperative sex hormone levels. Seventy-six percent of the participants with preoperative TT levels less than 300 ng/dL achieved levels higher than 300 ng/dL postoperatively.

Conclusions
We demonstrated that microsurgical varicocelectomy increases total testosterone levels only in men with low baseline levels of this hormone. In this scenario, 76% of men achieved levels higher than 300 ng/dL postoperatively. We also found an increase in estradiol levels in these men. Moreover, luteinizing hormone increased after the procedure. However, the clinical relevance of such changes remains unclear.

Disclosure
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(235) IMPACT OF INTESTINAL OSTOMY ON THE SEXUAL QUALITY OF LIFE OF MEN AND WOMEN IN A BRAZILIAN HOSPITAL: A STUDY OF OCCURRENCE
Authors: Pfeifer B , Grossi F , Moy V 
Published: December 2024

Abstract

Introduction
Sexuality is an important contributor to quality of life, and there is a known high prevalence of sexual dysfunction in the general population. It is understood to be a complex phenomenon that involves, among other aspects, body image, which is affected in patients undergoing intestinal ostomy.

Objective
To assess the occurrence of sexual dysfunction in men and women with intestinal ostomy who underwent the procedure at a Brazilian hospital between 2010 and 2023.

Methods
Observational, descriptive study, type case series, retrospective. The validated questionnaires IIEF-5 and FSFI-6 were used to assess sexual dysfunction in men and women, respectively, via digital form, after agreeing to the informed consent form.

Results
Out of 55 patients, only 29 responded to the questionnaire, and only 19 were included. Of these 19 patients, 42% had sexual dysfunction, with 50% being women and 33.3% men. Due to the much lower than expected number of patients, it was decided not to perform inferential tests.

Conclusions
Sexual dysfunction was observed in 50% of women and 33.3% of men with ostomies, which resembles data from the general population. However, the scarcity of participants had a substantial impact on the results, suggesting the presence of stigma in exploring sexuality. This retrospective study highlights the need to educate healthcare professionals and patients on sexuality and serves as motivation for further prospective studies.

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(239) STUDY OF THE THERAPEUTIC POTENTIAL OF NANOFORMULATION CONTAINING ACMELLA OLERACEA (L.) EXTRACT FOR THE TREATMENT OF MEN WITH PREMATURE EJACULATION
Authors: Lira Batista L , Afonso Teixeira T , Rocha Lopes G , Santos Almeida HK , Prado Dantas HV , Garcia De Azevedo ME , Tenório Da Silva F , Dias Rocha K , Tavares Carvalho JC 
Published: December 2024

Abstract

Introduction
Acmella oleracea, also known as the toothache plant, is a plant species popular in the Amazon region for treating sexual dysfunctions. Its unique sensory properties have gained attention, producing a tingling sensation.

Objective
We evaluated the clinical action of a nanoformulation containing ethanolic extract of A. oleracea inflorescences in men with premature ejaculation. Significant constituents in the extracts were identified based on gas chromatographic analysis.

Methods
During the study, participants were given a spray preparation that contained A. oleracea extract and were instructed to use it locally on the penis for five minutes before sexual intercourse for 12 weeks. Patient couples were required to record the mean intravaginal latency time to ejaculation (IELT). We also assessed participants using the HAMA scale, which scored respondents according to their level of anxiety.

Results
During spray treatment, the A. oleracea nanoformulation increased participants’ IELT values (293 s) compared to baseline values (193 s), confirming the clinical action in men with premature ejaculation. Participants demonstrated good tolerance to the spray and had no systemic side effects or incidence of local effects. In terms of pathological anxiety, three of the participants were classified as moderate, three as mild and one as severe and, in relation to the IIEF-5, three were normal, three were mild and one was moderate.

Conclusions
A. oleracea can be considered a potential therapeutic alternative with benefits for male patients with premature ejaculation. This formulation promotes penile desensitization, attributed to spilanthol in an extract derived from A. oleracea inflorescences. However, as this study involved few participants, further multicenter studies must confirm the observations.

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(255) MASTURBATORY HABIT IN MEN WITH SEXUAL DYSFUNCTION IN BRAZIL – AN OVERVIEW OF FREQUENCY, SOCIAL AND RELIGIOUS FACTORS
Authors: Vasconcelos Sanvido L , A Rosseti C , Bessa Jr. J , C Nahas W , V Coimbra I , Gabriel Fraga L , Z S Pato E , Hallak J , C G Nascimento B 
Published: December 2024

Abstract

Introduction
Masturbation is a very common form of sexual manifestation. Despite this, there is great heterogeneity of masturbatory habits in the population, with possible social and cultural influences. Our objective was to evaluate masturbation habits (presence, frequency and predictors) in men seeking care for sexual dysfunctions (SD) in Brazil.

Objective
Report on the social profile, masturbatory habits, and frequency among a group of 354 men with Sexual Dysfunction (SD) attending a sexual medicine clinic at a leading teaching hospital in Brazil.

Methods
We retrospectively evaluated a database of prospective documentation of patients seeking treatment for SD in Brazil. All underwent a structured consultation, with social and demographic data obtained, such as age, education, religion, and income. Personal factors such as the presence of a partner, complaint of erectile dysfunction (ED), penile curvature (PC) and libido (0-10 scale) were also questioned. Finally, self-reported frequency of masturbatory sexual activity (monthly rate) were documented.

Results
356 patients were analyzed, the average age of this population was 63.11 ± 12.55 years, 79.6% had a partner, with mean age of 53.5 ± 11,6 and 3,1% of the population identified as homosexual. The family income of 42% of the men was between R$2000.00 – R$4000.00 and only 46% of them completed high school. In this population, 86.6% declared themselves religious, 53,8% as catholics and 23.51% as evangelical, whereas 9.6% declared no religion. Overall, 67.4% of patients reported masturbating at least once a month, with an average frequency of 6,19 ± 5.97 times/month. Evangelical men had a mean 3,09 times/month while men without religion had a mean of 5,12 times/month. of Men married had a mean of 3,46 times/month, while single men had a mean of 4,94 times/month and divorced presented a mean of 6 times/month. Libido mean rate was 8.14 ± 2.08.

Conclusions
Our data shows that the masturbatory habit in men with sexual dysfunction in Brazil is a habit, impacted by religious and social aspects. In general, men without a partner are more likely to masturbate, and men evangelicals have a significantly lower rate of masturbation.

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(267) IMPACT ON THE SEXUALITY OF COUPLES WITH INFERTILITY
Authors: Valente S , Santini F , Zeitler E , Vazquez L , Ortiz J 
Published: December 2024

Abstract

Introduction
The World Health Organization (WHO) defines infertility as the inability to conceive a pregnancy after one year of regular vaginal intercourse without the use of contraceptive methods. It is a stress factor for those seeking parenthood. It affects between 10-15% of the world’s population. In bibliographic reviews, sexual dysfunctions as a cause of infertility are little investigated in both gender.

Objective
To analyze the sexual function of couples who consult the University Institute of Fertility and Human Reproduction for the first time and identify if couples have disorders in their sexual function that cause infertility.

Methods
People between 18 and 44 years old who consulted the Institute, who were heterosexual couples without fertility treatments in the last six months and in the last year had sought pregnancy in a traditional way, were studied. They were given the Golombok Rust Inventory of Sexual Satisfaction Questionnaire (GRISS), self-administered to both, with 5 ratings (Never, Almost never, Occasionally, Usually, Always) and 9 different scales: infrequency, no communication, dissatisfaction, avoidance, no sensuality, erectile dysfunction, premature ejaculation, vaginismus, anorgasmia.

Results
We studied 170 individuals, 85 couples. Age average: men 34.4 women 35.6. Educational level 55% completed secondary school. 21,18% had impotence, 32,94% premature eyaculation, 62,35% vaginismus, 1,18 anorgasmia. Female sexual dysfunction 61,18 and male sexual dysfunction 44,71%.Infrequency in sexual relations 30,5%. Couple sexual dysfunction with inability to conceive 33%.

Conclusions
The tendency for dyadic sexual dysfunction is high, at 33%, but the incidence of vaginismus is higher, which rises to more than 60%, identifying that many of the couples who consult for infertility have as their primary etiology a sexual dysfunction, which could be solved with sexual therapy if identified. It is of radical importance that professionals who work in infertility services or are related to women’s and men’s health give space and relevance to the sexual behavior of couples, guaranteeing sexual psycholearning, increasing the quality of life, trying to provide behaviors adapted to sexuality, and thus, avoid iatrogenesis and/or negligence at the time of conception.

Disclosure
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(290) SURGICAL TREATMENT OF PEYRONIE’S DISEASE WITH AUTOLOGOUS BUCCAL MUCOSA GRAFT IN COMPLEX CURVATURES
Authors: Martinucci De Oliveira L , Favero Ambar R , Claudio Rocha A , Panhoca R , Augusto Seabra Rios L , Aparecido França W , Francisco Atílio Gorga C , Berna Bertero E 
Published: December 2024

Abstract

Introduction
Peyronie’s disease (PD) affects a considerable proportion of middle-aged men, characterized by the development of fibrotic plaques in the tunica albuginea and corpus cavernosum of the penis. It is a benign pathology that affects 3.2% of men aged 40-70 years, and its etiology is multifactorial and mainly related to traumatic events, which trigger penile deformities, pain and sexual dysfunction. Surgical treatment is indicated in advanced chronic cases of the disease, and in cases of complex PD (curvature &gt;60°), one of the recommended surgical approaches is corporoplasty with autologous buccal mucosa graft (BMG).

Objective
To evaluate the surgical efficacy of penile corporoplasty with autologous BMG for treatment of PD with complex curvatures (&gt; 60°).

Methods
We retrospectively evaluated patients with PD in stable phase with &gt;60° curvatures (proven in pharmaco-induction erection test), naïve to penile surgeries, who were treated by plaque incision and BMG between 2022 and 2024 in a tertiary hospital. Exclusion criteria were PD lasting less than 12 months or in an active inflammatory phase, history of penile trauma, severe erectile dysfunction and congenital penile curvature. All patients signed informed consent forms.

Results
A total of 7 patients were included in the study, with a mean age of 58 (± 8) years. In the preoperative period, the mean curvature observed was 75°, the mean plaque size was 1.8 cm, and the mean penile length was 12 cm. 5 patients (71.4%) had dorsal curvature and 2 patients (28.6%) had dorsolateral curvature. At the 6-month follow-up after surgery, the mean penile curvature was 32.1° as in 85.7% of the sample had satisfactory residual curvature (&lt; 45°) and the mean penile length was 10.6 cm. None of the patients had erectile dysfunction in the late postoperative period. Regarding the degree of postoperative satisfaction, we found that 85.7% of the patients were satisfied or very satisfied with the final result.

Conclusions
The buccal mucosa is a highly promising biological material for the replacement of penile plaque, demonstrating a remarkable capacity for adaptation and revascularization. This material provides good clinical results, both anatomical and functional, and maintains stable elasticity. The method described is simple to apply and may be recommended in the surgical treatment of Peyronie’s disease. Despite its limitations, our study contributes significantly to the current knowledge on the safety and efficacy of BMG in the treatment of PD. Our findings were consistent with those of previous studies, showing that penile corporoplasty using BMG results in excellent structural and functional outcomes and high levels of patient satisfaction.

Disclosure
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(291) PREVALENCE OF ERECTILE DYSFUNCTION AFTER TREATMENT FOR ISCHAEMIC PRIAPISM IN AN UROLOGICAL REFERRAL CENTER
Authors: Cambui Castro Lima G , Miolaro De Mello LG , Moreira Fonseca W , Pucharelli Resuto D , Rodrigues Beal P , Martini Perini G , Hagerman M , Gaspar Peão JC , Nardozza Junior A , Brandão Vasco M , Lima Lemos CI , Barbosa Garofo Stabile Moura D , Fonseca Ribeiro JV 
Published: December 2024

Abstract

Introduction
Ischaemic priapism is an urologic emergency characterized by an acute compartment syndrome of the penis. Its treatment is time-sensitive, with success rates directly correlated to the timing between onset of symptoms and urological intervention. The development of erectile dysfunction (ED) after an episode of priapism is an undesirable clinical outcome. Prolonged erection can lead to tissue damage on the corpora cavernosa due to sustained hypoxia and acidosis. Such damage can result in fibrosis of the erectile tissue, impairing an individual’s capacity to initiate and maintain an adequate erection. Studies indicate that the duration of priapism is linked to the severity of erectile dysfunction. Though ED is the most relevant complication associated with the treatment of ischaemic priapism, its prevalence is not well-reported in the current literature.

Objective
To evaluate the prevalence of ED in patients who underwent treatment for ischaemic priapism.

Methods
Retrospective cohort of patients diagnosed with ischaemic priapism in an urological referral center between 2016 and 2024, with subsequent analysis of the prevalence of ED in periodic outpatient consults after urological intervention. Statistical analysis was done with data systematically collected via Excel and proportions were calculated in a single sample using binomial testing. Results showed a statistical power of 93%.

Results
Data was collected from forty-two patients treated in an urological referral center for ischaemic priapism between 2016 and 2024. Timing between onset of symptoms and initial treatment ranged from 5 to 240 hours (median 54 hours). Patient age ranged from 8 to 69 years (mean 35,4 years). 52,4% of patients underwent cavernous aspiration, with or without sympathomimetics. 21,4% of patients underwent Winter’s shunt. 19% of patients underwent Al-Ghorab’s procedure. 4,8% of patients underwent corporal snake maneuver for distal shunting. 2,4% of patients underwent Ebbehoj’s shunt. Thirty-four patients were evaluated for erectile function during post-procedure follow-up, of wich 73,5% reported ED.

Conclusions
Patients who underwent urological intervention for the treatment of ischaemic priapism presented with a high rate of ED during post-procedure follow-up.

Disclosure
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(293) EFFICACY OF ALPHA LIPOIC ACID SUPPLEMENTATION IN SPERM PARAMETERS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED TRIALS
Authors: Zang Pires I , Oberto Da Silva Gobbo M , Yuji Ura Sudo R , Louize Milbradt T , Marquardt Filho N , Teodósio Da Ros C 
Published: December 2024

Abstract

Introduction
Male factors contribute to 30 to 50% of infertility in couples. Treatment options for male infertility are limited, thus antioxidant supplementation for idiopathic male infertility is currently being studied. Alpha lipoic acid (ALA) has a high antioxidant capacity and the potential to penetrate tissues, cells and organelles, including mitochondria, due to its water and lipo solubility properties. The recent inclusion of randomized trials in the literature has required a new systematic review and meta-analysis to evaluate the efficacy of alpha lipoic acid in sperm parameters changes.

Objective
We aimed to perform a systematic review and meta-analysis of the currently available randomized trials comparing the effects of ALA supplementation versus placebo on sperm function in infertile male patients.

Methods
Pubmed, Embase, Cochrane Library, and ClinicalTrials.gov databases were searched from inception to June 2024. A random-effects model was employed to compute mean differences and risk ratios for continuous and binary endpoints. Heterogeneity was evaluated through the prediction interval. All statistical analysis was conducted using R software 4.4.1. The certainty of evidence was evaluated with the GRADE approach. Results were reported following the PRISMA statement guidelines. PROSPERO identification: CRD42024564932.

Results
Five randomized trials comprising 250 patients with a mean age of 28 to 40 years were included in this analysis. Over a mean follow-up time of 3 months, ALA was associated with a reduced proportion of abnormal sperm morphology (MD −0.89; 95% CI −1.48 to −0.29; p = 0.003), increased total motility (MD 13.49; 95% CI 3.52 to 23.46; p = 0.008), and increased sperm progressive motility (MD 12.43; 95% CI 2.89 to 21.97; p = 0.01). Additionally, ALA was associated with a higher pregnancy rate in two individual studies reporting the outcome, however, no significance was found in our pooled analysis (RR 2.28; 95% CI 0.66 to 7.85; p = 0.1). Finally, ALA did not change ejaculation volume (MD 0.14; 95% CI −0.54 to 0.83; p = 0.6), sperm concentration (MD 11.99; 95% CI −0.67 to 24.66; p = 0.06), live sperm (MD 4.42; 95% CI −3.17 to 12.02; p = 0.2), or total antioxidant capacity (MD 0.43; 95% CI −0.02 to 0.87; p = 0.06). No adverse events were reported.

Conclusions
In this meta-analysis of 5 studies, ALA was associated with a favorable change in sperm function. However, there were no effects on the pregnancy rates. This could be explained by the small sample size and short follow-up time. Therefore, more prospective randomized controlled trials are needed, especially including pregnancy rates and longer follow-up.

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(309) CASE REPORT: SEXUAL COGNITIVE THERAPY FOR PATIENTS DIAGNOSED WITH ERECTILE DYSFUNCTION ASSOCIATED WITH OBSESSIVE COMPULSIVE DISORDER
Authors: Soares Alves Mendes V 
Published: December 2024

Abstract

Introduction
Erectile Dysfunction (ED) and Obsessive Compulsive Disorder (OCD) can significantly impair an individual’s quality of life, affecting sexual functioning and mental health. Understanding the interplay between these conditions is essential for developing effective therapeutic interventions.

Objective
To report the efficacy of Sexual Cognitive Therapy in treating a patient with comorbid ED and OCD.

Methods
Case Presentation: A 20-year-old cisgender heterosexual male presented with difficulties in achieving and maintaining an erection, feelings of failure in sexual and academic domains, and anxious symptoms. The patient had a family history of OCD and generalized anxiety disorder. Initial diagnostic hypotheses included erectile dysfunction and anxious symptoms, later confirmed as OCD and ED. Intervention: The intervention comprised cognitive-behavioral techniques and specific sexual therapy strategies, including psychoeducation on sexual myths and the sexual response cycle, cognitive restructuring, mindful sex practices, and sensory focus exercises. The therapy aimed to identify and modify dysfunctional thoughts, beliefs, and behaviors contributing to sexual problems.

Results
Results: The patient exhibited significant improvement in cognitive flexibility, a reduction in OCD and ED symptoms, and increased confidence in sexual performance. He transitioned from reliance on medication (Viagra) to successful sexual activity without it. The intervention effectively addressed underlying cognitive distortions and sexual myths, contributing to overall symptom reduction and partial remission of OCD.

Conclusions
Conclusions: This case report demonstrates that Sexual Cognitive Therapy can effectively manage the complex relationship between ED and OCD. The patient’s progress highlights the potential of a tailored, integrative therapeutic approach for treating comorbid sexual and mental health disorders. Further studies are warranted to validate these findings and refine therapeutic strategies for similar cases.

Disclosure
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