bluuebunny/crossref_metadata_2025_split huggingface dataset:
(158) Comparison Implants for Penile Girth Enlargement: PPLA Shaft vs Silicone Implant
Authors: Knigavko O , Aguilar I 
Published: March 2024

Abstract

Introduction
Male dissatisfaction with the penis size is the most common manifestation of penile dysmorphophobia. Despite the diversity of penis enlargement methods a single safe technique that fully satisfies patients has not yet been developed.

Objective
The aim of this work is to compare the results of a combined operation on installation of a silicone implant or a porous polylactic acid (PPLA) scaffold impregnated with autologous stem cells with simultaneous ligamenotaxis to increase the length and circumference of the penis.

Methods
In 2017–2023 there were performed penis enlargement surgeries in 3 centers. In Ukraine and Poland 38 patients from were operated with implantation of a porous Max Pol PLLA scaffold, and in Mexico implantation of silicone implants Peniflex in 36 patients was performed. The results of penis enlargement were evaluated in the early (2 months) and long-term (36 months) periods.

Results
While implanting a silicone implant the majority of the patients - 31 (86.1%) are satisfied with the result, 27 (75%) patients mention an improvement in sexual life, 31 (86.1%) also mention an increase in their own self-sufficiency. At the same time, some patients mentioned the following complications: 2 (5.6%) patients mentioned displacement of the silicone matrix, 1 (2.8%) patient mentioned prolapse of the implant, 1 (2.8%) patient mentioned a decrease in erection (which did not improve after removal of the implant), in 1 (2.8%) case the silicone implant had to be removed due to the fact that the patient did not liked the appearance. While using a collagen-like matrix made of polymerized polylactic acid impregnated with autological stem cells in 38 patients, we have seen one significant complication - prolapse that caused the removal of the matrix (in men that had denied circumcision before implantation). However, 5 (13.2%) patients required additional polylactic acid gel injections between 6 and 36 months to optimize the shape or volume of the penis. 34 (89.5%) patients mentioned an improvement in the sexual function and sexual sensations of their partner, harmonization of relationships in a couple, and 36 (97.4%) men - an increase in a sense of self-sufficiency. In 3 years most of the patients 26 (68,4%) have been satisfied with particularly resolved implant but 13 (34.2) patients want to add some PLA gel as injection for penile girth recovery.

Conclusions
Thus, modern implants can improve the size and appearance of the penis, improve the quality of sexual life and the feeling of self-sufficiency in operated men. The use of silicone implants is simpler, it require only long drain 3–5 days. Most of operated patients were satisfied results of silicone implant. The use of a polymer matrix impregnated with autologuous stem cells requires a special biostem cell laboratory, more time for preoperative rehabilitation, but can be considered as more philological. Both methods can be considered as permanent and quite safe for penis enlargement.

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(163) Is There a Place for Immediate 3-Component Prosthesis Implantation Following Priapism?
Authors: Obaidat M , Kontogiannis S , Drettas P , Anastasios N 
Published: March 2024

Abstract

Introduction
One of the most difficult challenges in prosthetic urology is the insertion of penile implants into corpora scarred from an episode of priapism. In cases of scarred penile cavernosal bodies, surgery becomes challenging even for experienced surgeons, as it can be very difficult to dilate the corpora.

Objective
Usually, the initial insertion of a malleable device is used as a temporary measure, to maintain the penile length and simplify the subsequent insertion of an inflatable one. So our objective is to decrease the number of surgeries from 2 to 1.

Methods
In this case, we dilated the corpora cavernosa initially with Metzenbaum scissors thoroughly and carefully. We placed the tip of the scissors at the outer side of each cavernous body (away from the urethra) and advanced it to the tip of the corpus cavernosum. Then, we used the cavernotomes

Results
Till now the prostheses are functional. We do believe that in certain cases, with the right choice of the patient, the implant of the IPP after priapism is a viable solution

Conclusions
Cavernotomes are a good option for dilating the fibrotic corpora. And it is safe

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(187) Efficiency and Safety of Combining Long-Acting and Short-Acting PDE5 Inhibitors
Authors: Jamali M , Chmitah T , Bahri A , Louardi N , Alami M , Ameur A 
Published: March 2024

Abstract

Introduction
Erectile dysfunction is a condition that affects many men worldwide, significantly impacting their quality of life. PDE5 inhibitors (PDE5i) are commonly prescribed medications for treating this condition, but some patients do not adequately respond to these treatments

Objective
This study aims to evaluate the efficacy and safety of a combination of long-acting and short-acting PDE5 inhibitors in non-responding patients

Methods
The study was conducted on 40 men with erectile dysfunction refractory to PDE5 inhibitors. Participants were evaluated using questionnaires, clinical examinations, and paraclinical tests. All patients received a combination treatment of daily 5 mg tadalafil and 100 mg sildenafil on-demand, one hour before sexual intercourse. Patients were followed up for 12 weeks, and the results were assessed using questionnaires and recording of side effects.

Results
The average age of the participants was 47.4 years. The main etiologies of erectile dysfunction were vascular, psychogenic, age-related, or neurological. After 6 weeks of treatment, a statistically significant improvement was observed in erectile function scores (SHIM) and erectile rigidity scores (EHS). This improvement was maintained until the 12th week, although not significantly. Side effects were generally minor and well-tolerated.

Conclusions
The combination of long-acting and short-acting PDE5 inhibitors proved to be effective and safe in non-responding patients to PDE5 inhibitors. This therapeutic approach offers a promising alternative before resorting to other more invasive options, such as prostaglandins or penile prosthesis. The combined use of these two types of inhibitors improves erectile function while minimizing undesirable side effects. Further studies could explore the addition of vacuum devices, shockwave therapy, or platelet-rich plasma injections to optimize outcomes. Overall, this study provides valuable insights for urologists in the treatment of non-responding patients to a single type of PDE5 inhibitor, opening up new therapeutic perspectives.

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(216) Benefit of Closed Wound Drainage System with Negative Pressure in Penile Enhancement Surgery
Authors: Jang S 
Published: March 2024

Abstract

Introduction
Many patients have had penile enhancement surgery and the surgeon try to reduce postoperative complications including hemorrage, infection, wound dehiscence etc. we want to evaluate the benefits of closed wound drainage system with negative pressure in penile enhancement surgery.

Objective
we want to evaluate the benefits of closed wound drainage system with negative pressure in penile enhancement surgery.

Methods
We have experienced 500 penile enhancement surgery. We adopted a pre-pubic minimal incision and dissected penile shaft and pre-pubic space. Inserted graft materials were Allograft dermal grafts which were fixed at the Buck's fascia. And we dissected fundi-form ligaments and sutured transversely pre-pubic dead space with PDS 2.0. In group 1, silastic drain were inserted in 250cases in order to drain postoperative bleeding and prevent inflammation. In group 2, the remain 250 cases adopted closed wound drainage system with negative pressure.

Results
In group 1, the wound infecton rate was 2.9% and no dermal graft infection was showed. In group 2, the wound infection rate was 0.6% and no dermal graft infection was appeared. Group 1 using closed wound drainage system with negative pressure is more effective than group 2 using silastic drain in order to reduce wound infection rate.

Conclusions
In penile augmentation surgery using Allogenic dermis, Using closed wound drainage system with negative pressure is safer than using silastic drain as postoperative drainage system.

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(221) Anatomical Transcriptome Atlas of the Male Mouse Reproductive System During Aging
Authors: Huang Y , Li X , Yao J , Liu W , Lu M , Xie Y 
Published: March 2024

Abstract

Introduction
The elderly males undergo degenerative fertility and testicular endocrine function that jeopardize the reproductive health and well-being. However, the mechanisms underlying reproductive aging are unclear.

Objective
This study aims to investigate the phenotypes and transcriptomes of seven regions of the male mouse reproductive tract: the testis, efferent ductules, initial segment, caput, corpus and cauda epididymidis, and vas deferens, in adult (3 months) and aged (21 months) mice.

Methods
Quantitative PCR, immunohistochemistry, immunofluorescent staining, and enzyme-linked immunosorbent assay were performed for the analysis of gene expression in mice, human tissues, and semen samples. Aged male mice showed both systematic and reproductive changes, and remarkable histological changes were detected in the testis and proximal epididymis. Transcriptomes of the male reproductive tract were mapped, and a series of region-specific genes were identified and validated in mouse and/or human tissues, including Protamine 1 (Prm2), ADAM metallopeptidase domain 28 (Adam28), Ribonuclease A family member 13 (Rnase13), WAP four-disulfide core domain 13 (Wfdc13), and Wfdc9. Meanwhile, age-related transcriptome changes of different regions of the male reproductive tract were characterized.

Results
Notably, increased immune response was functionally related to the male reproductive aging, especially the T cell activation. An immune response-associated factor, phospholipase A2 group IID (Pla2g2d), was identified as a potential biomarker for reproductive aging in mice. And the PLA2G2D level in human seminal plasma surged at approximately 35 years of age. Furthermore, we highlighted Protein tyrosine phosphatase receptor type C (Ptprc), Lymphocyte protein tyrosine kinase (Lck), Microtubule associated protein tau (Mapt), and Interferon induced protein with tetratricopeptide repeats 3 (Ifit3) as critical molecules in the aging of initial segment, caput, caput, and cauda epididymidis, respectively.

Conclusions
This study provides an RNA-seq resource for the male reproductive system during aging in mice, and is expected to improve our understanding of male reproductive aging and infertility.

Disclosure
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(239) Postoperative Outcomes and Risk Factors in Patients Receiving Partial vs Total Penectomy for Penile Malignancy
Authors: Raheem O , Liu A , Kalidoss S , Khalil M 
Published: March 2024

Abstract

Introduction
Partial penectomies (PP) and total penectomies (TP) are both performed for penile cancer in the United States. Compared to TP, PP is performed more frequently to preserve functional urinary outcomes. To date TP and PP outcomes have not been compared, in this study we compared clinical characteristics and post-operative outcomes between TP and PP conducted between 2006–2016.

Objective
We conducted a retrospective review of penile cancer patients from National Surgical Quality Improvement Program (NSQIP) database for the years 2010–2016 using international classification of diseases clinical modification (ICD-CM) ninth revision codes. A total of 260 patients, 67 TP and 193 PP patients, were included.

Methods
We conducted a retrospective review of penile cancer patients from National Surgical Quality Improvement Program (NSQIP) database for the years 2010–2016 using international classification of diseases clinical modification (ICD-CM) ninth revision codes. A total of 260 patients, 67 TP and 193 PP patients, were included.

Results
Partial penectomy patients were less likely to be transferred patients (7.3% vs 20.9%, p=0.002), less likely to be suffering from diabetes (25.9% vs 40.3%, p=0.026), and were more likely to have preoperative laboratory values within normal limits. TP was associated with increased preoperative white blood cell count x109, preoperative white blood cell count &gt; 7.5x109 (p&lt;0.001), preoperative hematocrit (p&lt;0.001). PP patients were, in contrast, shown to have higher pre-operative creatinine levels (p=.037) and lower platelet levels than TP patients (p=.045). PP patients had shorter operation times (78.8 vs 145.5 min, p&lt;0.001). PP patients also had decreased levels of inpatient stay length (1.67 vs 4.31, p&lt;0.001), any 30-day post-surgery complication (7% vs 31%, p&lt;0.001), deep incisional surgical site infection (0.5% vs 6% p=0.017), wound disruption (0.5% vs 6.0%p=0.017), intraoperative or postoperative transfusion (1.6% vs 7.5%, p=0.029), and sepsis (0.5% vs 7.5%, p=0.005), when compared to patients who underwent TP. TP patients displayed a significantly greater number of concurrent surgical procedures (p&lt;0.001), when compared to PP patients. There was no information on urinary, sexual, and erectile outcomes in the database.

Conclusions
PP is associated with fewer post-operative complications, shorter surgeries, shorter hospital stays, and fewer concurrent surgical procedures. Total penectomy is associated with a greater proportion of patients suffering from comorbid conditions, suggesting that TP patients are at higher risk for post-surgical complications and longer hospital stays. There is a gap in reported data pertaining to post-operative sexual function and erectile outcomes for PP at a national level.

Disclosure
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(260) Effects of Surface Delay Agents on Penile Sensibility in Premature Ejaculation
Authors: Zheng L , Wei L , Jiang T 
Published: March 2024

Abstract

Introduction
The penis is an important sensory organ during sexual intercourse, transforming the sensations experienced from intercourse into neural impulses and transmitting them to the central nervous system. Our previous research has found that the sensitivity of the penis varies due to histological and neuroanatomical differences between the penile shaft and glans. We have identified hypersensitivity zones within the penis, classifying them into three subtypes，namely, glans penis, penile shaft, and whole-penis hypersensitivity. However, it remains unknown whether there are differences in sensitivity after the application of surface anesthetics to these subtypes.

Objective
As the hypersensitivity of the penis is not uniform throughout, with specific sensitive zones, this study aims to investigate whether there are differences in sensitivity after surface delay agents are applied to the hypersensitive and hyposensitive areas. This will aid in the precise use of surface delay agents and reduce their side effects.

Methods
Based on the neurophysiological results, 290 patients with primary premature ejaculation were categorized into the group with single glans penis hypersensitivity, the group with single penile shaft hypersensitivity, the group with the whole penis hypersensitivity, and the group with the whole penis being hyposensitivity. Differences in sensory thresholds, latencies, and amplitudes between the hypersensitive and hyposensitive areas of the penis were compared between patients before and after the use of delaying agents on the surface of the penis.

Results
The surface delay agent can indiscriminately increase the sensory threshold of both the hypersensitive and hyposensitive areas of the penis (P&lt;0.001), but it only prolongs the latency of the hypersensitive area (P&lt;0.001), without affecting the latency of the hyposensitive area of the penis.

Conclusions
The effects of the surface delay agent on the hypersensitive and hyposensitive areas of the penis are different. The delay agent only extends the latency of the hypersensitive area, suggesting that there may be differences in receptors, sensory cells, and synaptic transmission of sensory nerve fibers between the hypersensitive and hyposensitive areas of the penis.

Disclosure
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(271) Assessment of Varicocele Bilaterality in Infertile Men
Authors: Almekaty K , Elsharkawy A , Zahran M , Ragab M , Rashed A , Soliman M , Salem K , Ghaith A 
Published: March 2024

Abstract

Introduction
Varicocele is the most common correctable cause of male factor infertility. It has always been a debatable subject as regard how it affects fertility and the best way to treat. However, there is a wide consensus nowadays that varicocelectomy improve male fertility potentials. Proper assessment of the disease bilaterality is crucial not to miss one side and not to jeopardize treatment outcome.

Objective
The primary outcome measure was to assess disease bilaterality and the secondary outcome measure was to report on improvement in semen 3 and 6 months post varicocelectomy and pregnancy rate 1 year post surgery.

Methods
This prospective study was conducted between January 2019 and January 2022. Infertile males with varicoceles underwent microsurgical subinguinal varicocelectomy by expert uroandrologists. Patients who were referred as unilateral varicoceles had their CDUS repeated for assessment of missed concomitant contralateral varicocele. Then, patients who were diagnosed with bilateral varicoceles underwent bilateral subinguinal ligation straight away. Those who were referred with unilateral varicocele had their palpable sides operated on first; then the contralateral side was also explored using an intraoperative Doppler device and the maximal vein diameter was measured. Patients came for follow for at least 6 months after surgery to evaluate any complications and assess improvement in semen parameters. Gynecologists also reported on normal pregnancy rate 1 year after surgery.

Results
A total of 329 cases completed the study. A hundred cases (30.4%) were initially referred as unilateral varicoceles and 229 (69.6%) as bilateral varicoceles. After reassessment of the study population, bilaterality of varicocele was found to be as high as 98.5% (324/329). This is statistically significantly higher than initial US (P&lt;0.001). Repeat CDUS strongly correlated with the intraoperative measured varicocele diameter [r=0.9, P&lt;0.001]. Moreover, sperm parameters showed significant improvement 3 and 6 months post varicocelectomy. Normal pregnancy after 1 year of surgery occurred in 118 cases (35.9%).

Conclusions
Varicocele bilaterality is underreported. Thorough assessment by expert radiologists and andrologists is of paramount importance not to miss significant pathology or hazard treatment outcome.

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(281) Low-Intensity Shockwave Therapy Combined with Tadalafil 5mg Daily has Better Efficacy for Mild and Moderate Erectile Dysfunction: The Preliminary Results of a Multicenter Clinical Study in China
Authors: Lu M , Huang Y , Chen Y , Yuan S 
Published: March 2024

Abstract

Introduction
Most clinical studies have demonstrated that low-intensity extracorporeal shockwave therapy (Li-ESWT) can improved erectile function in patients with erectile dysfunction (ED). The EAU guideline recommended to use Li-ESWT for mild vasculogenic ED patients. However, the therapeutic advantages of Li-ESWT combined with phosphodiesterase type 5 inhibitors (PDE5i) have not been explored clearly in clinical practice for mild and moderate ED patients.

Objective
To compare the therapeutic effects of Li-ESWT and Li-ESWT combined with PDE5i in mild and moderate ED patients with 8≤IIEF-5≤16 from a multicenter clinical study in China.

Methods
Patients with ED which IIEF-5 score is less than 22 and aged 18–60 years old were enrolled from three clinical centers from Jun. 2019 to Mar. 2023. The demographic data, International Index of Erectile Function-5 (IIEF-5), erectile hardness score (EHS) and self-reported symptom questions were collected. Patients were treated by a linear low-energy shock waves generator (Renova). Low-intensity shock wave (energy density of 0.09mJ/mm2) treatments were applied (once a week, 4 weeks in total, 5000 shocks each time). Patients in Li-ESWT combined with PDE5i group took 5mg of tadalafil once a day for one continuous month during ESWT. Comparative analyses of pre- and post-treatment and intergroup were used for statistics.

Results
In total, 42 ED cases (37.43±11.86 years) in Li-ESWT group and 116 cases (37.41±10.14 years) in combined group were enrolled for analysis. The IIEF-5 score and EHS in both groups were significantly improved after 1 month treatment (p&lt;0.01). Compared with Li-ESWT group, patients in combined group significantly had higher self-reported efficiency (61.2% vs. 47.6%, p=0.013), IIEF-5 scores (15.34±7.15 vs. 13.96±7.71, p=0.039) and EHS (2.85±0.82 vs. 2.69±0.89, p=0.050). In the mild and moderate ED (with 8≤IIEF-5≤16) sub-group, 30 ED cases (36.81±10.99 years) in Li-ESWT group and 96 cases (36.80±10.69 years) in combined group were enrolled for analysis. The combined regimen showed better therapeutic advantages, including effective parameters IIEF-5(14.50±6.74 vs. 12.87±8.54, p=0.040), EHS (2.85±0.75 vs. 2.81±0.67, p=0.046) and self-reported efficiency (64.2% vs. 54.1%, p=0.001).

Conclusions
Li-ESWT can effectively improve erectile function in this multicenter clinical study in China, and the combination of Li-ESWT with daily use PDE5i had a better therapeutic effect on Chinese ED patients, especially on mild and moderate ED. Long-term follow-up with large sample study need to be developed for exploring the optimal therapeutic regimen.

Disclosure
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