bluuebunny/crossref_metadata_2025_split huggingface dataset:
(052) Sexual Health and Clinical Sexology Specific Training Needs of Residents in Gynecology and Obstetrics
Authors: Kaabia O , Dimassi K 
Published: March 2024

Abstract

Introduction
Assuming that the Obstetrician and Gynecologist (ObGyn) is the natural and first interlocutor for sexual questions in women, particular attention should be paid to their specific training in sexual health and clinical sexology. However, it turns out that the latter is neglected with little attention given to the development or implementation of specific curricular programs within the gynecologists’ residency programs.

Objective
This study aims to: - Identify and analyze the specific needs of the ObGyn residents in terms of education and training in Sexual Health and Clinical Sexology. - Discuss the methods of integrating a specific sexology training into their residency program to be adapted to the needs thus identified.

Methods
It is a knowledge, attitudes, and practices cross-sectional online study that took place over 5 weeks starting May 1st, 2021. All the ObGyn residents registered at the National College of Gynecology and Obstetrics were contacted through the College’s social media groups. The online questionnaire was a 9-item Google form elaborated in concertation with the Frequency, Gravity Problem (FGP) grid leading to 33 questions.

Results
With a response rate of 34 %, 94 residents participated in the survey. The participants were representative of the local population of ObGyn residents with an equal proportion of participants from the 5 years of the program. According to 69% of the participants, complaints or sexual disorders are rarely encountered during the ObGyn residency program courses. This finding was not correlated with the participants' residency level (R= 0.258, p&gt; 0.05). The most frequently encountered sexual disorders during the clinical consultations were sexual disorders with pain (44.68%) and in particular vaginismus (75%). Regardless of the frequency of the disorders, the difficulties reported were primarily in the domain of knowledge (67.5%); then in the domain of know-how or practices (68%), and often in the domain of interpersonal skills (42.2%). Following the application of the rating system of the FGP grid, the main problems identified concerned sexual disorders with pain, in particular, vaginismus and then a decrease in female desire.

Conclusions
Following the analysis of these results and a review of the literature, we were able to propose the outline of a project to implement basic academic education and training in clinical sexology for the ObGyn residents.

Disclosure
No.
(057) Influence of Circadian Disruption on Erectile Function in Chronic Jet-Lagged Young Rats
Authors: Kataoka T , Hidaka J , Hotta Y , Furukawa-Hibi Y , Kimura K 
Published: March 2024

Abstract

Introduction
Sleep is crucial during the developing stage of one’s life and has been associated with physical activity. However, as the number of 24-hour stores such as convenience stores and supermarkets have increased, along with increased internet usage, people have developed the habit of staying up late, resulting in sleep deprivation due to disruption in the light-dark cycle. Jet lag is widely used in animal models for inducing irregular circadian rhythms. Chronic jet lagged model animals are known to develop a variety of disorders.

Objective
To investigate the influences of chronic jet lag on erectile function in rats in order to elucidate the effects of irregular circadian rhythms on future sexual function.

Methods
4-week-old rats underwent randomly assigned to remain either under the control light/dark cycle (Cont group) or under chronic light/dark shift schedule to simulate the conditions of chronic jet lag (CJL group). The shift-lag protocol consisted of 8 h light/dark phase advances repeated every 3 days for 4 weeks. Erectile function was examined at 1, 2, and 4 weeks post CJL treatment. After 4 weeks of CJL treatment, the rats were returned to control light/dark cycle for 4 and 8 weeks, as CJL(4w)+Rest(4w) group and CJL(4w)+Rest(8w) group, and erectile function was examined correspondingly. Erectile function was tested using intracavernous pharmacotherapy (ICP) measurements, and endothelial function was tested through an isometric tension study. Western blot analysis was used to assess the levels of endothelial nitric oxide (eNOS) and phosphorylated eNOS (p-eNOS). Additionally, mRNA expressions of clock genes (Bmal1 and Cry 1) and growth factors (TGF-β1 and ICAM-1) were tested using real-time PCR.

Results
The ICP/MAP ratio was significantly lower in the CJL group (0.35 ± 0.05) at 4 weeks than in the control group (0.66 ± 0.05) (P &lt; 0.05). CJL group exhibited significantly lower testosterone levels, Bmal1, Cry 1, TGF-β1, and ICAM-1 expression, and p-eNOS and cGMP levels. The ICP/MAP ratio in the CJL(4w)+Rest(4w) group (0.47 ± 0.06) was lower than that in the control group (P &lt; 0.01) whereas the ratio in the CJL(4w)+Rest(8w) group (0.81 ± 0.03) was similar to that in the control group (P &gt; 0.05).

Conclusions
In this study, chronic jet lagged (4 weeks) rats exhibited a decreased ICP/MAP ratio, reduced testosterone level, and decreased p-eNOS expression, indicating the development of erectile dysfunction (ED). Upon 8 weeks of normal light/dark shift schedule, erectile function was recovered. This study suggests that irregular circadian rhythms induced by repeated jet lag, especially in childhood, may affect the production of sex hormones and erectile function in the future. Therefore, it is necessary for children to follow a regular circadian rhythm and healthy lifestyle.

Disclosure
No.
(066) A Low Androgen State Impairs Erectile Function by Suppressing EPAC1 in Rat Corpus Cavernosum Penis
Authors: Rui J , Xi L , Hao L , Xiangjun K , Wen-Ju X , Rui J 
Published: March 2024

Abstract

Introduction
The relationship among exchange proteins activated by cAMP 1(EPAC1), androgen and erectile function is still unknown.

Objective
To explore whether EPAC1 expresses in penile corpus cavernosum of rats and how EPAC1 affects erectile function under low androgenic conditions.

Methods
Thirty 8-week-old healthy male rats were randomly divided into six groups (n=5): sham operation (sham), castrated, castrated + testosterone replacement (castrated + T), sham + EPAC1 over-expression lentivirus (sham + EPAC1), castrated + empty lentivirus vector (castrated + empty vector), and castrated + EPAC1. Four weeks after the operation, the lentivirus vectors carrying the EPAC1 gene were injected into the corpus cavernosum penis tissues of the sham + EPAC1 and castrated + EPAC1 groups (1×108TU/ml, 20 μl per rat). A week after injection, the ratio of maximum intracavernous pressure to mean arterial pressure (ICPmax/MAP) and the levels of serum testosterone (T), nitric oxide (NO), the active form of ras homolog gene family, member A (RhoA-GTP), protein kinase B (AKT), phospho-AKT (p-AKT), endothelial nitric oxide synthase (eNOS), phospho-eNOS (p-eNOS), p-AKT/AKT, p-eNOS/eNOS and EPAC1 levels were measured.

Results
EPAC1 is primarily located in the cytoplasm of endothelial cells and smooth muscle cells in the rat corpus cavernosum penis. In comparison to the sham group, the T, ICPmax/MAP and NO levels of the castrated group were notably reduced (p &lt; 0.01). Meanwhile, the RhoA-GTP concentration in the castrated + EPAC1 group was reduced in comparison with the castrated + empty vector group (p &lt; 0.01). Compared with the castrated + empty vector group, the p-AKT/AKT, EPAC1 and p-eNOS/eNOS levels in the castrated + EPAC1 group were significantly increased (p &lt; 0.05).

Conclusions
Androgen deficiency can suppress EPAC1 expression in the penile corpus cavernosum of rats, while the up-regulation of which can improve the erectile function of castrated rats.

Disclosure
Yes, this is sponsored by industry/sponsor: This study was supported by the Research Foundation of the Department of Human Resources and Social Security of Sichuan Province of Returned Scholars grant 2019-76.
Clarification: No industry support in study design or execution.
(090) Depression Among Infertile Women: Prevalence and Risk Factors
Authors: Thi Huyen Trang N , Pham Thi My H , Nguyen Thi Thu T , Nguyen Thanh K , Pham Van H 
Published: March 2024

Abstract

Introduction
Infertility is a significant issue that affects many couples worldwide. Depression is one of the most common psychiatric disorders among infertile patients.

Objective
This study aims to determine the prevalence of depression and its determinant factors among infertile patients in the Andrology and Fertility Hospital of Hanoi based on the PHQ-9.

Methods
The study was conducted among 360 infertile patients who visited the Andrology and Fertility Hospital of Hanoi between August 2022 and January 2023. Depression was measured using the Patient Health Questionnaire-9 (PHQ-9). The relationships between depression and demographic/fertility characteristics were explored using univariate and multiple logistic regression with an odds ratio (OR) and 95% confidence interval (CI).

Results
The mean total PHQ-9 score was 4.47 (SD = 4.14). Using a cut-off value of 10, the prevalence of depression was 11.7%. Depression was significantly associated with being age over 35 years old (OR = 2.24, 95% CI =1.05 – 4.76), having an income per month of less than 10 million VND (OR=2.01; 95%CI (1.01 – 4.72), husbands feeling pressured to have children (OR = 2.26, 95%CI = 1.08 – 4.72), feeling uncomfortable when others find out about infertility (OR=2.78, 95%CI = 1.36 – 5.67), not receiving support from the workplace (OR=2.55, 95%CI = 1.25 – 5.20) and believing they can be happy without children (OR=4.41, 95%CI = 1.37 – 14.18).

Conclusions
The high prevalence of depression among infertile patients in this study highlights the need for healthcare providers to screen and provide psychological support to this population. The finding that female aged above 35, low income, with husbands pressuring them to have kids, feeling uncomfortable when others know about their infertility, and lacking support from their workplace was found to be significant risk factors for depression are significant determinants of depression among infertile patients suggests that interventions should be targeted toward these groups.

Disclosure
No.
(094) Evaluation of Female Sexuality After Vaginal Hysterectomy in a Cohort of Tunisian Women
Authors: Souayeh N , Bettaieb H , Rouis H , Mbarki C , Hsayaoui N 
Published: March 2024

Abstract

Introduction
Researchers indicate that hysterectomy might adversely affect pelvic anatomy and therefore female sexuality. However, only a few studies focused on evaluating female sexuality after vaginal hysterectomy.

Objective
This study aimed to evaluate female sexual function after a vaginal hysterectomy.

Methods
This was a monocentric prospective study conducted in the gynecology-obstetrics department of Ben Arous regional hospital over a period of 5 years [January 2016-December 2020]. We included all patients who underwent vaginal hysterectomy. Selected women received a preoperative evaluation of their sexual function using the Female sexual function index (FSFI). They were invited for two follow-ups at 12 and 24 months after surgery. The main outcomes measured were frequency of sexual intercourse, dyspareunia, orgasm, vaginal dryness, sexual desire, and FSFI scores.

Results
A total number of 109 women underwent vaginal hysterectomy over the study period. The mean age was 41 years ranging from 31 to 69 years. Only 79 patients completed the required follow-ups in order to evaluate their satisfaction and the impact of surgery on their sexuality. The percentage of women engaging in sexual intercourse increased significantly from 70.8% before vaginal hysterectomy (VH) to 77.21% and 75.9% at 12 and 24 months after respectively. The rate of dyspareunia dropped significantly from 40.5% before surgery to 5% and 3.8 % at 12 and 14 months after VH. The rate of women experiencing orgasm increased significantly from 63.2% before VH to 72.1% and 70.8 % after 12 and 24 months. Low sexual desire also decreased significantly from 10.1% before VH to 6.3% and 5% respectively at 12 and 24 months. The percentage of women experiencing satisfactory vaginal lubrication increased from 36.7% to 46.8% and 45.5%. Average FSFI significantly increased from 24.58 prior to the surgery to 26.82 and 27.55 at the 12 months and 24 months follow-ups respectively.

Conclusions
Female sexual function is a major cause of women's concern for scheduled hysterectomy. Our results showed a significant improvement in female sexual function after a vaginal hysterectomy. Therefore, the vaginal route for hysterectomy should be encouraged among middle-aged women as a minimally invasive technique that does not affect female sexual function or feminine shape.

Disclosure
No.
(098) Does Early Implantation of Penile Prosthesis for Ischemic Priapism Associated with Decreased Complication Rate? A Systematic Review of Literature
Authors: Savira M , Atmoko W 
Published: March 2024

Abstract

Introduction
Ischemic priapism (IP) is a prolonged undesired erection that accounts for &gt;95% of all priapism episodes. Like compartment syndrome, it is characterized by diminished corporal blood flow and can lead to corporal fibrosis, penile shortening, and refractory erectile dysfunction. Penile prosthesis (PP) implantation is the treatment option in IP to treat the priapic episode and to preserve erectile function. However, no standardization exists regarding the optimal timing of PP implantation surgery.

Objective
The present review aims to systematically analyse the literature comparing early and delayed PP implantation in patients with IP.

Methods
A systematic search on PubMed, Scopus, and EMBASE databases were searched from inception to July 1st, 2023 and followed by hand searching. All the steps were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. We assess the quality of evidence and the risk of bias in each included study.

Results
Three retrospective cohort studies comprising 199 subjects were included in this systematic review. All studies have different definitions of the timing of early PP implantation, ranging from within one week to ≤6 months from the onset of priapism. Despite different types of PP used, all studies agreed that early PP implantation results in lower intraoperative complications, such as corporeal perforation and urethral injury, greater preservation of penile length and girth, and a lower rate of prosthetic revision. On the other hand, the delayed insertion was linked to a longer surgical time because of challenges brought on by fibrotic tissue, with most of them also requiring a smaller cylinder. In regards to post-operative complication, the majority of studies demonstrated that delayed implantation would result in a higher rate of complication rate; however, one study demonstrated that early PP implantation had a higher likelihood of prosthesis erosion and infection, which was believed due to a higher rate of bacterial invasion during the earlier shunt surgeries.

Conclusions
The majority of current evidence favours early penile prosthesis insertion in term of lower complication rate for IP, especially the intraoperative complication, for IP, compared to the delayed implantation. Nevertheless, better quality evidence is still needed from RCT to determine the exact timing for early implantation, patient selection, and the best penile prosthesis types.

Disclosure
No.
(099) A Preliminary Investigation on the Incidence of Complications and Patient Contentment Following the Surgical Implantation of Inflatable Penile Prosthesis After Salvage Radical Prostatectomy
Authors: Khalaf Alla K , Mehr J , Wang R 
Published: March 2024

Abstract

Introduction
Erectile dysfunction (ED) is a common complication post salvage radical prostatectomy (RP). Yet, there is scant data in the literature on complication rates and patient satisfaction in those that undergo inflatable penile prosthesis (IPP) insertion post salvage radical prostatectomy (RP) following targeted radiotherapy for treatment of localized prostate cancer. It is understood that these patients have a higher rate of complications as they have experienced both radiation and prostatectomy adverse events which could alter their overall satisfaction after prosthetic surgeries.

Objective
Our aim is to conduct a preliminary analysis of IPP complication rates and satisfaction rates in patients that had 3-piece IPP implantation following salvage radical prostatectomy.

Methods
A retrospective chart review from our institutional database was done from 2018 to 2021. The inclusion criteria were patients that had an inserted 3-piece IPP and a history of salvage RP following radiation therapy. Only patients that participated Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire at least 6 months from implant date were included. Data on satisfaction, IPP infection rates, mechanical failure rates, and overall complications was also collected. Complications include hematoma, erosion, reservoir hernia.

Results
A total of 22 patients were included in the study. The median age (IQR) is 65 (64–67) years and the median time (IQR) from RP to IPP insertion is 23 (11–49) months. All patients were approached in a penoscrotal manner with submuscular placement of reservoir (Table 1). The satisfaction rate was high at 91.8% on follow up. Overall complications rate was observed in 2 patients. One patient had a mechanical pump failure at 37.9 months while another patient had signs and symptoms of scrotal wall infection at 15 months. Both devices were easily replaced with no post op complication and remained functional on further follow up.

Conclusions
In patients that underwent salvage prostatectomy IPP insertion, they reported high satisfaction rates and low complication rates despite the exposure to both prostate cancer treatments adverse events. Further research is needed to confirm the results obtained and to investigate the underlying causes for the observed outcomes. The scientific process is iterative, and the answers obtained from one study often lead to more questions and the need for additional investigations.

Disclosure
No.
(121) Acceptant and Commitment Therapy to Increase Compliance to Sexual Dysfunction Treatments in Men with Prostate Cancer: 6- and 12-Month Data from a Randomized Controlled Trial
Authors: Nelson C , Boukhalfa N , Pessin H , Schofield E , Mulhall J 
Published: March 2024

Abstract

Introduction
For many men with prostate cancer, difficulty with sexual dysfunction, in particular erectile dysfunction (ED), can trigger a psychological process which leads to avoidance of utilizing sexual dysfunction treatments.

Objective
This study tests a novel psychological intervention based on Acceptance and Commitment Therapy (ACT) concepts to help men utilize these treatments.

Methods
This ongoing study recruited men with prostate cancer starting intracavernosal injection therapy (ICIT) for the treatment of ED. The recruitment goal is N=220. Subjects are randomized to ICIT + ACT (ACT), which focuses on reducing avoidance, or ICIT + Enhanced Monitoring and Education (EME), which includes enhanced follow-up. Both groups receive ICIT plus 3 sessions (30–45 min) and 10 booster sessions (10 min). The interventions are delivered over the course of a year. Subjects are assessed at entry and every 6 months (m) for two years. The primary outcomes are the number of penile injections/week (verified by syringe count), and compliance (defined as ≥2 injections/week). Secondary outcomes assess psychosexual variables. Preliminary 6m and 12m data is presented. Since these are preliminary analyses, effect sizes (d) are reported for secondary variables (d=0.2, small effect; d=0.5, medium effect; d=0.8, large effect).

Results
To date, 191 subjects have been randomized; 112 have completed the 6m assessment (ACT n=57, EME n=55) and 97 completed the 12m assessment (ACT n=48, EME n=49). Mean age at baseline was 60±7 years. At 6m and 12m, the ACT group utilized more injections/week vs. the EME group (6m: median 1.8 vs. 1.2, p=0.01; 12m: median 2.0 vs. 1.4, p=0.01) and were more compliant with ICI vs. the EME group (6m: 65% vs. 35%, p=0.01, RR=1.86; 12m: 79% vs. 41%, p=0.01, RR=1.93). At 6m and 12m, the ACT group reported greater: satisfaction with ED treatment (d=0.6) and overall sexual relationship (d=0.2). The ACT group also reported lower: sexual bother (d=0.2), prostate cancer treatment regret (d=0.3), negative psychological impact of cancer (d=0.3), and depressive symptoms (d=0.4).

Conclusions
Preliminary analysis suggests ACT significantly increases ICI use. Data also indicate that ACT helps increase men’s satisfaction with injections and sexual relationship, while reducing sexual bother, prostate cancer treatment regret, the psychological impact of cancer, and depressive symptoms.

Disclosure
No.
(138) Efficacy and Patient Satisfaction of Low-Intensity Shockwave Treatment for Erectile Dysfunction in a Retrospective Real-World Study in Japan
Authors: Md M , Kurosawa M , Tsujimura A , Morino J , Anno Y , Yoshiyama A , Kure A , Uesaka Y , Nozaki T , Kobayashi K , Horie S 
Published: March 2024

Abstract

Introduction
In Japan, the treatment options for erectile dysfunction (ED) are very restricted, if phosphodiesterase type 5 inhibitors (PDE5Is) are not effective. In this situation, low-intensity extracorporeal shockwave therapy (LiESWT) has gained increased attention as a new option for ED treatment in Japan.

Objective
To clarify the efficacy of low-intensity extracorporeal shockwave therapy for patients with erectile dysfunction, compare the efficacy between two types of lithotripters (ED1000 [focused type] and Renova [linear type]), and detect factors indicative of therapeutic gain with the treatment.

Methods
This retrospective study included 76 patients (52.8 +/- 11.7 years) treated by ED1000 (12 times over 9 weeks) and 484 patients (52.5 +/- 11.6 years) treated by Renova (4 times over 4 weeks). Age, sexual symptoms scores, and blood examinations were assessed. Efficacy was judged by improvement of the scores and patient satisfaction and compared between patients at 1 month after treatment with the lithotripters. Independent factors influencing efficacy by Renova were also assessed.

Results
Sexual symptom scores were improved significantly by both lithotripters, although the changes in the scores did not differ significantly between them. Efficacy rate as judged by patient satisfaction was 65.8% with the ED1000 and 71.1% with Renova, also without significant difference. Among several factors including age, sexual symptoms scores, endocrinological factors, metabolic factors, and the rate of phosphodiesterase type 5 inhibitor use, only age was found to be an independent factor influencing the efficacy of Renova.

Conclusions
We clearly showed the high efficacy of both lithotripters. Although the efficacy rate did not differ between them, we speculated that the fewer treatment sessions needed with the Renova versus the ED1000 would be a great advantage for patients. We also suggest that Renova should be recommended for patients younger than 70 years of age.

Disclosure
No.