bluuebunny/crossref_metadata_2025_split huggingface dataset:
(171) Tunical Incision and Grafting for Severe Peyronie’s Disease Using Human Fascia Lata: Surgical Technique
Authors: Kalidoss S , Barreto Guimaraes P , Nusbaum D , Raheem O , Kocjancic E 
Published: March 2024

Abstract

Introduction
Management of Peyronie’s disease is challenging for patients and can present with deformed penile angulation, pain, and reduction in erectile function. This video demonstrates the usage of cadaveric fascia lata grafting to rectify severe ventral penile curvature symptomatic of advanced Peyronie’s disease.

Objective
We outline a surgical technique to use fascia lata allografting for the correction of excessive ventral penile curvature caused by Peyronie’s disease if non-surgical treatments are insufficient.

Methods
A 65 year-old African-American male patient with severe Peyronie’s disease and a history of hypertension presented with a ventral penile curvature of 110 degrees at the proximal third of the shaft. Consequently, he was unable to engage in penetrative sexual intercourse. An artificial hydraulic erection confirmed the curvature, and the areas of fibrotic plaque were palpated. A degloving incision was made proximal to the glans, and a 6 cm segment of Buck’s fascia was elevated ventrally. The neurovascular bundle and urethra were separated from the corporae. A second hydraulic erection was induced, exposing a 6 cm by 3.5 cm rectangular tunical defect which was marked for excision. Bovie electrocautery was utilized to excise the fibrotic section of tunica albuginea. A rectangular section of Biosure human cadaveric fascia lata graft was soaked in saline solution and trimmed to 6 cm by 4 cm. The graft was sutured to the excised region of the tunica albuginea with 4–0 Maxon in a watertight fashion with a running stitch. A final hydraulic erection confirmed the mitigation of the penile curvature, and Buck’s fascia and the shaft skin were re-approximated to the subcoronal skin with 3–0 Vycril suture.

Results
This grafting procedure resulted in a near complete resolution of the ventral penile curvature with no complications. The patient was admitted overnight for observation and discharged POD 1 with a 3-layer dressing and mesh underwear. The postoperative penile length increased to 17.5cm from 16cm preoperatively as a result of the grafting and mitigation of the penile curvature.

Conclusions
Fascia lata allografts are robust and easily obtainable, which is ideal for the corporal reconstruction of fibrotic tunica albuginea in patients with Peyronie’s disease. This procedure demonstrates the utility of cadaveric fascia lata as an alternative surgical grafting material for the surgical correction of penile curvature associated with severe Peyronie’s disease.

Disclosure
No.
(205) The Psychological, Sexual, and Financial Impact of Infertility on Couples: An Urological Approach
Authors: Jamali M , El Rhaz A , Oukouhou H , Nabil L , Alami M , Ameur A 
Published: March 2024

Abstract

Introduction
Infertility is a public health issue with socioeconomic and demographic impact. Understanding the psychological, sexual, and financial repercussions on couples is crucial for comprehensive treatment.

Objective
Infertility can evoke complex emotions and disrupt the couple's sexual relationship. The aim of this study is to examine the psychological, sexual, and financial aspects of this condition on infertile couples.

Methods
A retrospective study was conducted on 50 couples undergoing infertility treatment at a military hospital. Data, including medical records, questionnaires, and follow-up information, were collected.

Results
1. Psychological Impact: Infertility represents a failure of the parental project, leading to negative emotions. Women are more likely to report the psychological impact and seek help. Family pressure and potential divorce due to societal expectations were observed. 2. Sexual Impact: Infertility can significantly affect sexual life, causing decreased satisfaction, stress, and anxiety. Communication and emotional intimacy may suffer. Contrary to literature, men reported more sexual disorders due to socio-cultural factors and female partners' discomfort discussing sexuality. 3. Financial Impact: Infertility treatments incur substantial costs, adding to emotional and physical burdens. Financial implications vary by country, and lack of national funding policies lead to debt or abandonment of conception plans. In the study, half of the couples spent over $1000.

Conclusions
Infertility has a significant psychological, sexual, and financial impact on couples. A comprehensive approach involving healthcare practitioners and policymakers is necessary for significant improvement in the well-being of infertile couples.

Disclosure
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(207) Premature Ejaculation and Varicocele, are they Associated? Systematic Review
Authors: Mahdi M , Khalafalla K , Arafa M , Elbardisi H , Majzoub A 
Published: March 2024

Abstract

Introduction
Premature ejaculation (PE) is one of the most common sexual disorders that negatively impacts couple’s satisfaction. Varicocele on the other hand is a highly prevalent condition affecting men population. A higher incidence of PE is observed among patients with varicocele, which incited several authors to evaluate the possible correlation between varicocele and PE. Others went beyond that to investigate whether varicocele repair can lead to an improvement in PE.

Objective
To systematically review the literature for all the studies exploring the relationship between PE and varicocele.

Methods
A systemic review was performed utilizing (PRISMA) statement. The PubMed, Google scholar and Scopus databases were used to look for articles published up to June 2023 using the appropriate keywords. Articles reporting an association between the presence of varicocele and PE and exploring changes in ejaculation latency time after varicocele correction were included. Data including study design, sample size, varicocele details, PE diagnostic method, outcome measured and tools used to measure it were collected. The Newcastle-Ottawa scale was used for assessing the quality of the included studies.

Results
A total of eight studies were identified, two of them were retrospective and six were prospective. Intravaginal ejaculation latency time (IELT) was used as a diagnostic tool for PE in 5 studies, Premature Ejaculation Diagnostic Tool (PEDT) in 1 study, Chinese Index of Sexual Function for Premature Ejaculation-5 (CIPE-5) scores in 1 study, and subjective assessment in 2 studies. Two studies looked for the prevalence of PE among patients with and without varicocele. Both studies showed a significantly higher frequency of PE among varicocele patients. Whereas six studies evaluated the improvement in ejaculatory function after varicocelectomy; five of them revealed a statistically significant improvement. Quality check: only one study was of strong quality while the remaining 7 studies were of fair quality.

Conclusions
Limited evidence suggests the presence of positive relation between varicocele and PE. The small number of studies and patients, lack of enough prospective clinical trials, short term follow up, heterogenous study design and absence or diversity in the diagnostic tools used prevent our ability to build strong evidence. For the purpose of supporting the relation and validate it, further prospective studies on a larger number of patients with long-term follow up are needed to reach a solid verdict.

Disclosure
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(208) Enhancing Opportunities for Sexuality Assessment During Initial Mental Health Assessments: Barriers and Enablers for Psychiatric Registrars
Authors: Gunawan J , Fox C , Ramanathan V 
Published: March 2024

Abstract

Introduction
Assessments of sexuality and sexual wellbeing is recommended as “best practice” in psychiatric assessments, however, education opportunities on sexuality and sexual wellbeing do not feature prominently in the training curriculum of psychiatric trainees in Australia.

Objective
To explore the training experiences of psychiatric trainees and identify barriers and enablers to enhance human sexuality assessments within mental health assessments.

Methods
Qualitative inquiry was adopted to allow for exploration of the issues. Semi-structured interviews of psychiatric trainees based at a metropolitan hospital and health service were conducted and analysed with a thematic analysis approach.

Results
Seven emergent themes were identified: barriers and enablers, skills and competence, inadequate training within the psychiatry training program, the belief that human sexuality is important to psychiatry, and training needs.

Conclusions
Psychiatric trainees believe that human sexuality and sexual wellbeing are an important part of mental health assessments. Despite this belief, participants reported a lack of direct training in sexual history taking, treatment of sexual issues, and sexual wellbeing, leading to an overall lack of confidence in assessing patients’ sexuality within mental health assessments. Psychiatrists of all levels of training require specific, regular education regarding human sexuality to ensure sound knowledge and consistent patient care.

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(249) Association of Single Nucleotide Polymorphisms (rs2301365 & Rs737008) in PRM1 Gene and Male Infertility: A Meta-Analysis
Authors: Ejaz H , Arshad A , Irfan M , Ismail S B , Hussain N H N 
Published: March 2024

Abstract

Introduction
In the sperm nucleus, protamine is a major DNA-binding protein that replaces histone. It is a basic arginine-rich protein responsible for DNA compaction. Protamin I (PRM1) is one of the important genes that produces protamine. Mutations and polymorphisms in PRM1 may increase the odds of male infertility.

Objective
The present meta-analysis investigated the association of single nucleotide polymorphisms (SNPs) (rs2301365 & rs737008) in the PRM1 gene and male infertility.

Methods
The original research articles, published till July 2023 in the English language, on the association of rs2301365 and rs737008 in the PRM1 gene and male infertility, were retrieved from Science Direct, PubMed, NCBI and Google Scholar.

Results
A total of 129 studies were retrieved by searching in the different databases, after the removal of duplicates, meta-analysis, and abstracts, 14 were finally selected. In 11 case-control studies, the association of the rs2301365 (-190C &gt;A) polymorphism was presented as the meta-analysis of different models, Allelic model (C vs. A), Dominant model (CC + CA vs. AA), Recessive model (CC vs. CA + AA), Additive model (CC vs. AA), Heterozygous model (AC vs. AA). Allelic, additive, dominant and heterozygous models reported that the -190C&gt;A (rs2301365) increased the odds of male infertility. The ethnic subgroup analysis showed the same pattern of association for the Caucasian infertile men. However, none of these overall and subgroup analyses based on ethnicity showed an association between rs2301365 (-190C &gt;A) and infertility in Asian men. For rs737008 (139C &gt; A) in the meta-analysis of 14 studies, none of these overall and subgroup analyses based on ethnicity showed an association with male infertility. Trial sequential analysis (TSA) for the allelic model of rs2301365 (-190C &gt;A) showed the required sample size was 2252 at 90% power and 5% type-I error, whereas the cumulative z-curve crossed the trial sequential monitoring boundaries of harm. However, the sample size was greater than required therefore further studies will not likely change results. For rs737008 (139C &gt; A), TSA recommended more studies to be conducted.

Conclusions
The PRM1 rs2301365 (-190C &gt;A) was associated with male infertility in overall analysis and Caucasian men. Further studies on this SNP may not change results. However, rs737008 (139C &gt; A) was not associated with male infertility. However, further studies are recommended.

Disclosure
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(252) Has the COVID-19 Pandemic Impacted Penile Implant Public Interest in the US?
Authors: Hammad M A M , Nakamura H , Miller J , Azad B , Yafi F A 
Published: March 2024

Abstract

Introduction
The COVID-19 pandemic has significantly impacted various aspects of society, including healthcare-seeking behaviors. Online search trends have become valuable indicators of public health concerns and interests.

Objective
This study focuses on the search trends for penile implants to understand how these trends have changed in different metro/county income levels pre- and post-COVID-19.

Methods
Data on Google search trends for penile implant procedures were collected for specific metropolitan areas before and after the COVID-19 pandemic. The metropolitan areas with the highest search intents were further analyzed. Average household income and per capita income, based off 2021 US Census Bureau, were calculated for the top five metropolitan hot spots (household income, per capita income before and after the pandemic) then visualized in a linear model.

Results
Between 2016 and 2023, pre- and post- COVID-19, the interest in penile implants has been steadily increasing on average in the US (figure 1). Within these interest groups, a handful of counties account for the most searches that result in the following surges, and are associated with specific socioeconomic backgrounds and events. Before COVID-19, the average household income of counties most interested in penile implants was $53,215.80 (39th percentile) and the per capita median income was $34,626.80 (37th percentile). Post-COVID-19, both of these averages decreased over time to $50, 945.17 (37th percentile) and $31, 435.17, respectively (34th percentile) (figure 2).

Conclusions
This study demonstrates significant increases in Google search trends for penile implant procedures after the COVID-19 pandemic. Before the pandemic, higher-income regions demonstrated more interest in penile implant searches, potentially linked to affluence and investment in men’s health, compared to more interest in lower income regions post-pandemic.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Advisory board and speaker for Coloplast; consultant for Cynosure; advisory board and speaker for Halozyme; intellectual property with Masimo; advisory board for Promescent; consultant for Sprout; advisory board for Xialla.
(267) Penile Length and Circumference in Vietnamese Men
Authors: Ho Huu P , Nguyen Anh T , Le Thi Thu H , Nguyen Thi Huyen T 
Published: March 2024

Abstract

Introduction
Penile size has long been an important fixation in men's lives. Establishing what the normal size of the penis is very important to have a yardstick for men, which is a challenge and depends on the culture, race, and form of measurement applied.

Objective
To evaluate the size of the penis in flaccidity, erection, and stretch of Vietnamese men.

Methods
A total of 259 men who visited the Andrology and Fertility Hospital of Hanoi, VietNam were involved in the study between October 2022 and April 2023. Penile measurements (flaccid, erect length/circumference, stretched length) were predominantly taken by 1 investigator using a tape measure and the same measurement technique. All statistical analyses were completed using STATA 17.0. Statistical analysis was performed with the Spearman correlation as tested by the Kolmogorov–Smirnov test (p&lt;0.05).

Results
The mean age of 259 patients was 29,24 (range: 15–48). The mean penile lengths were: flaccid length 9.21 cm (SD 1.71 cm), flaccid circumference at the middle of the shaft 8.25 cm (SD 0.96 cm), erect length 13.22 (SD 1.46cm), erect circumference at the middle of the shaft 10.42 cm (SD 0.94 cm), and stretched length 12.47 cm (SD 1.61 cm). The mean testicular volume was 12.47 mL (SD 6.37 mL) and 12.65 (SD 4.03 mL) for the left and right testicles, respectively. Stretched length is most closely correlated with erect length with r=0.68. We also observed that the testicular volume, erect length was a significant inverse correlation with age, which ranged from r = -0.14 to -0.21.

Conclusions
The results of this study help to establish a reference range for male genital size in Vietnam, which should be helpful for urologists and andrologist in counseling patient

Disclosure
No.
(287) Influence of Severe Chronic Scrotal Pain on Men’s Sexual Activity: An Indication for Surgery?
Authors: Le Anh Tuan , Mai Ba Tien Dung , Vu Le Chuyen , Dang Quang Tuan 
Published: March 2024

Abstract

Introduction
Severe chronic scrotal pain significantly influences numerous aspects of a patient’s life and activities, particularly sexual activity.

Objectives
This study seeks to explore the clinical characteristics and the effects of chronic scrotal pain on male sexual activity, with a focus on patients with severe chronic scrotal pain who were candidates for microsurgical denervation of the spermatic cord.

Methods
This is an observational study that encompassed all patients with severe chronic scrotal pain who underwent microsurgical denervation of the spermatic cord at the Department of Andrology, Binh Dan Hospital, from January 1, 2022, to May 31, 2023, after other causes had been excluded.

Results
Thirty-one patients with chronic scrotal pain underwent surgery, with a mean age of 24.2 ± 4.3 years and a pain duration of 2.3 ± 1.6 years. Pain was located in the scrotum (41.3%), testis-epididymis (47.8%), spermatic cord (24.6%), and inguinal (15.1%), with postepididymitis (45.3%) being the predominant cause. The average Numerical Rating Scale (NRS) pain score before surgery was 6.8 ± 2.3. Thirteen out of thirty-one patients experienced severe pain (NRS = 7-10). The Quality of Life (QOL) scores were 6.75 ± 1.1 for patients with moderate pain and 4.6 ± 4.0 for those with severe pain. A smaller testicle size was observed in 43.5% of patients, and 51.6% had varicose veins on ultrasound, measuring 3.4 ± 1.2 mm. Sixteen out of thirty-one patients reported that scrotal pain impacted their sexual activity. Patients with higher pain scales (NRS 7-10) had significant effects on erectile function compared to those with moderate pain (P &lt; 0.05). Decreased libido was reported in 34.1%, and lowered testosterone levels in 37.5% of the patient group. Sexual activity induced pain in 60.9% of cases, and the incidence of erectile dysfunction was significantly higher in the high pain scale group (P = 0.02). No significant statistical difference was observed between the duration of intercourse and the severity of scrotal pain.

Conclusion
Chronic scrotal pain, predominantly observed in young patients, has substantial impacts on the quality of life and sexual performance. Therefore, a meticulous consideration of sexual factors is imperative in male patients with chronic scrotal pain. Surgical indications for chronic scrotal pain treatment may be deemed necessary for sexual disorders associated with scrotal pain.

Disclosure
No.
(291) The Effect of Administration and Discontinuation of Finasteride in Male Rats
Authors: Lee D , Choi Y 
Published: March 2024

Abstract

Introduction
It has been suggested that 5AR (5-alpha reductase) inhibitors may have negative effects on psychosexual activity, but there is still debate.

Objective
We aimed to observe the effect of 5AR type 2 inhibition on brain tissue by using finasteride.

Methods
14 weeks old, eight male rats were assigned to each group (group 1 as the control group, group 2 as the finasteride group, and group 3 as the finasteride withdrawal group). Each rat was isolated and acclimatized in a single cage, then mated for 2 days. Rats in group 2 and 3 were administrated with finasteride for 4 weeks, then rats in group 2 were sacrificed whereas rats in group 3 were sacrificed 4 weeks thereafter. Before sacrifice, they were exposed to female bedding at least for 2 days. RT-PCR, western blot, and immunohistochemistry were performed for brain tissue evaluation where the target genes/proteins were 5AR (type 2) and c-Fos.

Results
Dihydrotestosterone (ng/dl) and dihydrotestosterone to testosterone ratio (%) plunged after 1 month administration of finasteride (group 2), and they were ameliorated after discontinuation of the drug (group 3) (Figure 1). These results were parallel to those from the western blot and immunohistochemistry (Figure 2 and 3). On the contraty, RT-PCR showed elevation of each gene (5AR and c-Fos) expression (Figure 2).

Conclusions
Finasteride exerted an influence on brain tissue including hippocampus and ventromedial preoptic area via 5AR-2 inhibition, resulting in decrease of c-Fos protein activation. However, the negative impact of finasteride on rat brain in regard with c-Fos activation may fall away in a month cessation of the drug.

Disclosure
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“A Poem Is a Gesture toward Home”: Formal Plurality and Black/Queer Critical Hope in Jericho Brown’s Duplex Form
Authors: Hoelzer Kaitlin 
Published: March 2024

Abstract
Jericho Brown’s The Tradition (2019), which won the Pulitzer Prize for poetry, includes four duplexes, a poetic form of Brown’s own invention that combines the sonnet and the blues. Made of fourteen lines separated into seven couplets, the duplex is a complex structure comprised of sets of indents and repeated lines. Brown’s use of disparate source forms to create a new form altogether challenges the supremacy of a singular, white American literary tradition, putting it into conversation with other traditions in order to critique its historically racist and heterosexist boundaries. As he does so, Brown works not to abolish “the tradition” or canon but to expand it beyond reductive ideas of who and what is allowed into this historically exclusive space. The complexity of Brown’s formal project mirrors the nuanced and critical hope the duplex form expresses and evokes in readers; in contrast to queer theory’s focus on negativity, Brown’s duplexes align with the work of José Muñoz and Mari Ruti, who assert that hope is equally as important as negativity. The duplex form holds the positive and negative together in both form and content, and seeks to expand emotional experience and the canon, ultimately attempting to change the way readers feel and act.
“He Hopes They Have Disappeared”: Necro-elasticity and the Tyranny of the Present in Helena María Viramontes’s “The Cariboo Cafe”
Authors: Avila Edward 
Published: March 2024

Abstract
This essay investigates the ways in which Helena María Viramontes’s “The Cariboo Cafe” (1985) depicts the necropolitical order of power in Central America and the United States during the decades-long civil wars (late 1970s to early 1990s) marked by racial violence and brutality committed by US-backed dictatorial regimes and police enforcement in both Central American and the United States. “The Cariboo Cafe” offers critical insights into the dialectical operations of the bio-necropolitical order of power in which the exposure to harm, injury, and death (that is, precarity) of racialized segments of the population serve to foster and secure the lives of those considered politically and, thus, ontologically relevant. The spatial and temporal dimensions of the story offer key insights into the specific ways in which necro-elasticity constitutes both spatial and temporal dispossession. Such dispossession, especially in its temporal configuration, points to the flattening of historical consciousness, what I refer to as “non-contextualization,” that ultimately underwrites the ideological conditions of possibility for the emergence and reproduction of individual and collective innocence and, thus, impunity.