bluuebunny/crossref_metadata_2025_split huggingface dataset:
(043) Gender-Affirming Bilateral Orchiectomy Prior to Vaginoplasty versus with Vaginoplasty: A Comparison of Preoperative Goals and Postoperative Satisfaction
Authors: Stelmar J , Zaliznyak M , Mallavarapu S , Sandhu S , Smith S , Garcia M 
Published: March 2024

Abstract

Introduction
Gender-affirming bilateral orchiectomy (GA-BO), defined here as either a standalone procedure and/or precursor to vaginoplasty, is associated with a decrease in gender-affirming hormone therapy (GAHT) dosages. In comparison to bilateral orchiectomy at time of gender-affirming vaginoplasty (GA-V), GA-BO is associated with shorter waitlist times, procedure duration, and outpatient recovery. While objective benefits of GA-BO have been described, there is limited qualitative data that assesses the preoperative goals and postoperative satisfaction of patients who elect GA-BO. We aim to assess the decision-guiding factors that led patients to select GA-BO, and to compare measures of patient satisfaction between GA-BO and GA-V patients.

Objective
To assess the decision-guiding factors that led patients to select gender-affirming bilateral orchiectomy before vaginoplasty versus with vaginoplasty, and to compare measures of patient satisfaction between groups.

Methods
A retrospective chart review identified 170 patients who underwent GA-BO (n=106; 64%) or GA-V (n=64; 36%) between 4/2017 and 12/2020 at our institution. Patients were emailed a link to an anonymous, online questionnaire (QualtricsTM).

Results
136/170 (80%) patients completed the questionnaire: 86/136 (63%) respondents were GA-BO patients and 50/136 GA-V (37%). 78/86 (91%) of GA-BO respondents had either subsequently undergone vaginoplasty, or, planned to do so in the future. For patients who later underwent vaginoplasty, the mean reported time interval between GA-BO and vaginoplasty was 15 months [Range: 1–34 months]. Respondents prioritized the following expectations in their decision to undergo GA-BO: potential to decrease GAHT medications and dosages (reported as important by 67%), low rates of complications (56.5%), short recovery time (51.6%), and low postoperative pain (46.2%). GA-BO and GA-V patients reported high postoperative improvement in various indices of gender dysphoria and body image, with only 1/4 indices of gender dysphoria differing significantly between the two groups (Figure 1). Unsurprisingly, GA-V patients reported a significantly greater improvement in 3/3 body image indices.

Conclusions
GA-BO is a low-risk procedure that provides a more immediate option to decrease gender dysphoria and improve QOL. All patients who were assigned male at birth and are interested in genital gender-affirming surgery should be made aware of the advantages of GA-BO and offered GA-BO alongside GA-V.

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(054) Novel Use of Clitoral Pulse Sensor During Arousal
Authors: Pearlman A , Winter A , Jameson C , Numbers J , Mcmonigal A , Justin E , Hotaling J 
Published: March 2024

Abstract

Introduction
Penile erection is well understood in men and has been extensively studied. The Erectile Hardness Score is a commonly used tool to quantify the strength of an erection. No such measurement tool exists for women. This study builds on the work done by Mechelmans et al exploring Clitoral Pulse Amplitude (CPA) as a marker for physical arousal in women. CPA has been shown to be related to clitoral blood volume, erection, and engorgement of the clitoris. This erection in the clitoris is homologous to penile erection.

Objective
To test a new clitoral pulse sensor for correlation with subjective arousal for proof of concept. To test the comfort and usability of such a device configured with an internal (vaginal) portion and a clitoral portion.

Methods
In the study, 20 healthy female participants wore the device while watching a control (non-arousing) video and during progressively more sexually arousing activities. They were allowed to choose their own materials to watch, read, or listen to for arousal, and a masturbation phase was included for additional information. Participants also reported their subjective arousal after each phase. After the test, participants were also surveyed about the comfort and usability of the device.

Results
The main outcome measures are CPA, subjective sexual arousal, and usability feedback ratings. The pulse sensor successfully detected CPA and results show that most participants had increasing levels of subjective arousal correlating with increasing CPA. Statistical correlation between CPA and arousal was positive but low, which could be attributed to differences of sensor calibration and/or device placement by participants. Overall, this positive relationship indicates that a commercially available pulse sensor could be integrated into a future device to measure physical arousal in women, a metric which was previously not widely available. Furthermore, participants reported high satisfaction with the comfort and usability of the device. These insights give us confidence that this device shape will be comfortable and usable in further iterations. Eventually, we hope to commercialize a similar device which would give women greater insights into their sexual health and provide valuable information to their doctors.

Conclusions
This study showed a positive relationship between CPA and subjective sexual arousal, opening possibilities for future measurement devices. Participants felt the device was very comfortable and easy to use, suggesting this form factor with vaginal (internal) and clitoral (external) portions is a viable configuration for further development. We anticipate improving both the pulse sensing system and device usability as the device is further commercialized.

Disclosure
Yes, this is sponsored by industry/sponsor: FirmTech.
Clarification: Industry initiated, executed and funded study.
Any of the authors act as a consultant, employee or shareholder of an industry for: FirmTech.
(056) The Association Between Disgust Sensitivity, Sexual Desire, Relationship Satisfaction in Finland
Authors: Al Haj Baqir B , Jern P 
Published: March 2024

Abstract

Introduction
Disgust is a basic emotion directed towards certain objects to avoid harm (Angyal, 1941), mainly pathogens. Research, however, has proposed a heterogeneity of disgust beyond pathogen avoidance to generate the functional model, which proposed the functionally distinct domains of disgust: moral, pathogen, and sexual. This model proposes that sexual disgust is an avoidance of sexual contact with unfit partners that may yield unfit offspring (Tybur & de Vries, 2013), this may be due to other anxiety related disorders (Davey, 2011 and Troop et al., 2002)

Objective
This study focuses on the association between disgust sensitivity with sexual desire, and relationships satisfaction. Hypothesis: elevated levels of disgust sensitivity are negatively associated with sexual desire and relationship satisfaction.

Methods
Invitation letters were sent out to the registered Finnish population in the Finnish Central Population Registry to participate in a(n) (online) survey, 9,319 individuals responded to the invitation and completed the survey and agreed to participate in the research. The tools used in this study were Perceived Relationship Quality Component (PRQC), Sexual Desire Inventory (SDI), and the Three-Disgust Domain Scale (TDDS).

Results
The results indicate that the sexual desire and sexual disgust sensitivity, are negatively correlated, the relationship satisfaction correlations are positive except the men pathogen disgust which is a negative correlation between pathogen disgust sensitivity and relationship satisfaction. The correlation between the study variables indicated that among men and women sexual disgust is negatively correlated with sexual desire, and the correlation of relationship satisfaction and sexual disgust was positively correlated.

Conclusions
The results show the negative association of sexual disgust with sexual desire, but there is a positive relationship between sexual disgust and relationship satisfaction.

Disclosure
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(059) Effects of a Red-Light–Controllable Nitric Oxide Donor, NORD-1, on Diabetes Mellitus-Induced Erectile Dysfunction in Rats
Authors: Hotta Y , Oyama K , Mori T , Kataoka T , Furukawa-Hibi Y , Kimura K 
Published: March 2024

Abstract

Introduction
Diabetes mellitus (DM) often causes erectile dysfunction (ED). Phosphodiesterase-5 inhibitor has limited effects on diabetes mellitus-induced erectile dysfunction (DMED). One contributing factor to this reduced effect is the decreased production of nitric oxide owing to neuropathy and endothelial impairment. To address this issue, we developed a red-light–controllable nitric oxide donor, NORD-1, that successfully enhanced erectile function in intact and cavernous nerve injury model rats.

Objective
In this study, we investigated whether NORD-1 and red-light irradiation could improve DMED in rats.

Methods
Seven-week-old Sprague–Dawley male rats were used. Rats in the DM and sham groups were intravenously administered streptozotocin 50 mg/kg and saline, respectively. One week after treatment, the blood glucose levels of rats in the DM group were found to be over 250 mg/dL. Five weeks after the treatment, we performed a functional study using the measurements of intracavernous pressure (ICP) under the stimulation of the cavernous nerve. The study was performed before and after NORD-1 treatment, both with and without light irradiation. Additionally, we performed an isometric tension study using corpus cavernosum from rats treated with either NORD-1 or a control compound, SiR650.

Results
The ICP/MAP ratio of the DM group was significantly lower than that of the sham group before and after NORD-1 treatment without light irradiation (both P&lt;0.05). However, after NORD-1 treatment with light irradiation, the ICP/MAP ratios of the Sham and DM groups were substantially enhanced compared with that before and after NORD-1 treatment without light irradiation (all P&lt;0.05). The ICP/MAP ratio of the DM group was similar to that of the Sham group under the normal condition before NORD-1 treatment by light irradiation. Moreover, systemic blood pressure was not affected by NORD-1 and light irradiation. In the isometric tension study, rat corpus cavernosum from rats treated with SiR650 showed no changes under red light in both the Sham and DM groups. However, the corpus cavernosum from rats treated with NORD-1 was strongly relaxed by red light in both groups.

Conclusions
NORD-1 and red-light irradiation could improve DMED in STZ-induced DM rats without lowering blood pressure.

Disclosure
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(076) Hyaluronic Acid Injection of Penis for Management of Premature Ejaculation: A Systematic Review with Single-Arm Meta-Analysis
Authors: Atmoko W , Savira M 
Published: March 2024

Abstract

Introduction
Premature ejaculation (PE) is the most prevalent male sexual dysfunction globally. Pharmacological treatments as the primary mainstay for PE therapy have drawbacks in systemic effect and possible recurrence after drug cessation. In the last few years, there has been a progressive use of hyaluronic acid (HA) injection in Andrology, including its use to prolong ejaculation latency time by increasing penile glans sensitivity. However, no meta-analysis on its efficacy and safety exists.

Objective
The study aimed to conduct a comprehensive systematic review and single-arm meta-analysis to identify the efficacy and safety of HA injection in the penis for treating PE.

Methods
A systematic search on PubMed, Scopus, and Embase databases were searched from inception to May 31, 2023, according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement. Risk of bias of included study were carried out based on Cochrane ROB2 and ROBINS-I tools. Intravaginal ejaculatory latency time (IELT) was considered the primary outcome, whereas satisfaction and complication rate were the secondary outcomes. Pooled rate and mean difference with matching 95% confidence level intervals (CIs) in the random effect model were applied in analysis using STATA 18.0 and RevMan 5.4. To ensure the impact of each study, a leave-one-out sensitivity analysis was performed.

Results
Of the 60 studies identified, three clinical trials and six observational studies with low and moderate risk of bias met the inclusion criteria. A total of 616 participants were eligible for meta-analysis. The results found that HA injection, with different techniques, can significantly increase IELT by 239.78 (95% CI 147.14 – 332.43), 202.76 (95% CI 121.86 – 283.66), 164.62 (95% CI 112.19 – 217.06), and 189.01 (95% CI 71.74 – 306.28) seconds at 1, 3, 6, and ≥12 months follow-up. Despite significant heterogeneity among the studies, the sensitivity analysis results were unaffected by the removal of any of the articles. As for safety, the most commonly reported complications were pain, ecchymosis, and papule formation with pooled incidence of 19% (95% CI: 15% – 24%), 8% (95% CI: 5% – 13%), and 5% (95% CI: 3% – 8%), respectively. The majority of adverse events were mild, temporary, and self-limited, although a single case of skin necrosis and vascular emboli had been reported. In addition, patients and their partners also reported increased satisfaction after HA injection.

Conclusions
HA injection in the penile can effectively prolong the ejaculation time by at least a year with tolerable adverse events. Nevertheless, the optimal injection technique, ideal patient candidate, and long-term outcome still need to be determined through additional well-designed trials.

Disclosure
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(084) Frequency of Bleeding at First Vaginal Intercourse and Stereotypes Surrounding it: A Pilot Survey of 6370 Russian-Speaking Women
Authors: Nazaralieva A , Niurkina S , Bocharova M 
Published: March 2024

Abstract

Introduction
Despite the fact not all women experience bleeding at first vaginal intercourse (BFVI), in some cultures failure to prove virginity on the wedding night (sheets/garments covered with blood) may have serious consequences for a woman (bullying, domestic violence, shame and even honor killings). Low awareness of the true frequency of BFVI and of individual variation of the anatomy of the hymen may lead to inaccurate conclusions in cases of sexual assault or “virginity testing” (VT) at schools and/or in clinical settings, which can have a drastic impact on the mental health of young women. In cultures where defloration is sacralized, young women tend to choose anal sex instead of vaginal, which bears further risks including higher hazard of HIV; women also tend to seek hymenoplasty often performed in secrecy (in many cases it cannot guarantee bleeding at following intercourse, as intended).

Objective
To evaluate the frequency of stereotypes surrounding BFVI among Russian-speaking women

Methods
An anonymous survey was completed by 6370 Russian-speaking women across different countries who have had at least one vaginal intercourse. We aimed to reach women from varying religious, socioeconomic and educational backgrounds. The survey included questions on whether women experienced BFVI and if not, whether it had any negative consequences; and list of questions regarding their feelings about virginity, hymen reconstruction and sex in general. The questionnaire was distributed by the authors and biomedical bloggers, via social media (Instagram, Facebook, and Telegram). Preliminary results are presented.

Results
Median age was 31 (15–70); 59% were married; 73.6% reported being raised in secular families. 21.2% - in religious families, and 2.1% - in strictly religious. 43,2% respondents denied having any BFVI; 42,3% confirmed BFVI; while 5,3% reported bleeding on following sexual encounters but not on first intercourse. A minority (3,6%) did not remember whether any bleeding was present. Among those who didn’t have BFVI, 75 (2,2%) reported long-lasting conflicts with partners, 166 (5%) reported withdrawal of their partners, 115 (3,5%)– mistrust, 88 (2,7%)– constant blaming, 37 (1,1 %) – emotional abuse, 2 (0,1%) – physical violence. Two hundred twenty-three (3.5%) women experienced VT at school, 76 (1.2%) referred themselves for VT, and 25 (0.4%) did so at the demand of their own family.

Conclusions
Traditions demonstrating BFVI associate with negative emotions and affect marital relationships as well as sexual health of women. Medical professionals should be aware of the frequency of BFVI; anatomy and gynecology books should reflect corresponding scientific findings. Myths about virginity should be addressed via media and opinion leaders to prevent gender based violence.

Disclosure
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(105) Arab Patient and Partner Satisfaction Following Malleable Penile Prosthesis Implantation in North Africa and the Middle East
Authors: Ragheb A , Osmonov D , Abdallah M , Abdelbary A , Emadeldin M , Elmarakby A 
Published: March 2024

Abstract

Introduction
Due to the sensitivity of the topic of penile implants for the treatment of refractory erectile dysfunction (ED) in the Middle East and North Africa region, a scarce body of related research is available.

Objective
We aimed at investigating the levels of patient and partner satisfaction after malleable penile prosthesis implantation among the Arab population and its dynamics during and after the first 6 months of surgery.

Methods
This was a prospective 6-month follow-up study of 120 patients undergoing malleable penile prosthesis implantation at our unit by a single surgeon. Three telephone encounters were conducted for each couple at 1 month, 3 months, and 6 months postoperative (PO). We utilized our validated Arabic version of the Modified Erectile Dysfunction Inventory of Treatment Satisfaction (AM-EDITS). During the 1st first encounter, we inquired about the general patient perioperative experience, starting from preoperative counseling till the first month after surgery. The 2nd and 3rd encounters focused on patient and partner satisfaction after implant utilization.

Results
The average ages of the men and their partners were 54.7±8.4 and 32.9±4.6 years, respectively. Levels of anxiety decreased in over 82% of the men in our study upon receiving proper preoperative counseling. Almost all of the patients were happy (96%) with their early PO days with over 50% of them exceeding their expectations. After 3 months, 82.5% of the men were satisfied, describing their erections to be 80% close to natural. Of the 92.5% satisfied partners at 3 months, nearly 80% were highly satisfied. Over 93% of them reported feeling sexually desirable by their husbands. As opposed to the significant rise in men’s overall satisfaction and AM-EDITS index by 11.6% and 5.2 ± 0.8% (P &lt; 0.001), respectively after 6 months PO, partners demonstrated a 12.4% and 5.9 ± 0.8 decline (P &lt; 0.001), respectively, compared to the 3 months follow up.

Conclusions
Malleable penile implants still represent a good quality-of-life treatment option for middle to low-income countries. Time has a positive effect on Arab men’s PO satisfaction as opposed to their partners’. The explanation behind these findings should be investigated in further studies. A proper understanding of the dynamics of patient and partner satisfaction over time may be useful for proper perioperative counseling of both parties to ensure their sustainable satisfaction.

Disclosure
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(120) E-Mergir: Preliminary Efficacy of a Digital Psychological Intervention Program for Improving Mental Health, Sexual Health, and Quality of Life of Prostate Cancer Survivors
Authors: Quinta-Gomes A L , Pieramico S , Rocha H , Carvalho J , Nobre P J 
Published: March 2024

Abstract

Introduction
Introduction: Prostate cancer is one of the most common cancers affecting men worldwide. The diagnosis of prostate cancer and associated treatments have a negative impact on people's physical, emotional, and sexual health, compromising their overall well-being and quality of life throughout the course of the disease. Despite the decreased levels of sexual functioning and sexual satisfaction associated with this type of cancer (Quinta-Gomes et al., 2019), patients' access to specialized healthcare and support is still limited. Given their flexibility and convenience, smartphone-based digital interventions can contribute to bridging this gap and constitute an important way to access specialized and personalized supportive care on emotional and sexual health for people with prostate cancer.

Objective
Objective: The present study aims to evaluate the preliminary efficacy of a digital psychological intervention program using smartphones aimed at improving the mental health, sexual health, and quality of life of prostate cancer survivors.

Methods
Methods: A randomized controlled pilot study is underway involving 30 prostate cancer survivors randomly assigned to an experimental group (with access to the program) and a waiting list control group (treatment as usual). The program was structured in five modules to be completed by the participants in a maximum period of 6 weeks while receiving support from a psychologist. The study was approved by an institutional Ethical Board. Acceptability, usability, feasibility, and preliminary efficacy (overall improvement in sexual and relational satisfaction, sexual pleasure, sexual distress, psychopathology, and quality of life) were defined as the main outcomes of this study. Participants' assessments will take place in two moments, before and after the implementation of the program.

Results
Expected results: It is expected that the program and the experimental design adopted will prove to be adequate and have good acceptability by the participants. Improvements in sexual and relational satisfaction, sexual pleasure, sexual distress, psychopathology, and quality of life are also expected for participants using the program compared to those in the waiting-list group.

Conclusions
Conclusions: As a future empirical-based digital psychological intervention program focused on patients' unmet sexual needs, E-mergir will significantly contribute to addressing the emotional and sexual health and quality of life of people with prostate cancer. Funding: Horizon Europe, NORTE-01-0145-FEDER-000057, CCDRN

Disclosure
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