bluuebunny/crossref_metadata_2025_split huggingface dataset:
(074) The Sensitivity Difference Between the Glans Penis and Penile Shaft in Primary Premature Ejaculation
Authors: Zheng L , Wei L , Jiang T 
Published: March 2024

Abstract

Introduction
The penis is a vital organ of perception that transmits perceived signals to ejaculation-related centers. The penis consists of the glans penis and penile shaft, which differ considerably in both histology and innervation.

Objective
This paper aims to investigate whether the glans penis or the penile shaft is the main source of sensory signals from the penis and whether penile hypersensitivity affects the whole organ or only part of it.

Methods
The thresholds, latencies, and amplitudes of somatosensory evoked potentials (SSEPs) were recorded in 290 individuals with primary premature ejaculation using the glans penis and penile shaft as the sensory areas.

Results
The thresholds, latencies, and amplitudes of SSEPs from the glans penis and penile shaft in patients were significantly different (all P &lt; 0.0001). The latency of the glans penis or penile shaft was shorter than average (indicating hypersensitivity) in 141 (48.6%) cases, of which 50 (35.5%) cases were sensitive in both the glans penis and penile shaft, 14 (9.9%) cases were sensitive in the glans penis only, and 77 (54.6%) cases were sensitive in the penile shaft only (P &lt; 0.0001).

Conclusions
There are statistical differences in the signals perceived through the glans penis and the penile shaft. Penile hypersensitivity does not necessarily mean that the whole penis is hypersensitive. We classify penile hypersensitivity into three categories, namely, glans penis, penile shaft, and whole-penis hypersensitivity, and we propose the new concept of penile hypersensitive zone.

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(097) 3 Year Follow Up After Modified Grid Incision and Sealing with Collagen Fleece for Treatment of Peyronie’s Disease
Authors: Moon D G , Ahn S T , Lee W K , Cho S B 
Published: March 2024

Abstract

Introduction
Previously, we introduced a less invasive modified technique by multiple grid incisions of Peyronie’s plaque.

Objective
To assess the efficacy of technique in 32 patients with 3 year follow-up.

Methods
From 2018, 32 patients with stable Peyronie’s disease were included with 3 major steps of surgery; 1) dissection of neurovascular bundle/urethra according to plaque location, 2) multiple deep grid incisions of plaque for complete correction of curvature/deformity, 3) sealing with TachoSil®. Prospectively, the stretched penile length (SPL), totally straightness, penile sono, erectile function at preoperative, and 6, 12, 24, 36 months postoperatively under approval of Institutional Review Board.

Results
Mean age was 59.2 years (46–72). Mean curvature was 53.5 (40–80) degree, 8 with hinge and 7 with hourglass deformity. IPP was inserted in 4 and 1 at postoperative 30 months for poor erectile function. Mean follow-up was 35.4 months (12–57). Daily massage softened the hard thickening of penis gradually from 3 months until 3 year. On follow-up sonography, subcutaneous thickening gradually decreased to near normal at 1–3 year and tunical breakage by grid incision reunited at postoperative 10–12 months. 2 patients immediately recurred dorsal curvature but most patients achieved totally straightness. Most patients gained preoperative length after 1.6 year. 96% of patients satisfied in GAQ at 2 year. Minor skin problem was occurred in two of IPP. Subcutaneous bulging hematoma was occurred in 3 patients but subsided in two within 3 months. One patients need revision surgery. In postoperative erectile function of 23 patients without IPP, spontaneous hard erection was recovered in 5 and the rest are satisfied with PED5 inhibitors.

Conclusions
Our prospective progress reports with technical modification of various plaque incisions shows that one can achieve a sufficient surgical effect without making defect of tunica albuginea but need long term follow up for 3 years at best.

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(117) Is Platelet-Rich Plasma Effective and Safe for Managing Erectile Dysfunction? A Meta-Analysis of Before-After Data from Clinical Studies
Authors: Savira M , Atmoko W 
Published: March 2024

Abstract

Introduction
Erectile dysfunction (ED) is common health issues among men with increasing prevalence along with age. With the advancement of technology, the aim of therapy for ED is start to shift in reversing the pathology and not only relieving the symptoms. Platelet-rich plasma (PRP) are one of the regenerative modalities that has gained popularity in many medical disciplines. Many studies have been conducted that favour PRP in improving erectile function. However, no relevant meta-analysis of PRP have been performed to date.

Objective
A single-arm meta-analysis were conducted to evaluate the outcome of PRP for the treatment of ED based on the data before and after the procedures.

Methods
We systematically searched PubMed, Embase, Scopus in June 2023 to find the relevant articles based on the Preferred Reporting Items for Systematic Review and Meta-analysis statement. All randomized controlled trials (RCTs), observational, and case control studies in English with 10 or more subjects and a minimum of 1 month follow-up after PRP treatment reporting International Index of Erectile Function-Erectile Function (IIEF-EF) score were included. Pooled analysis on outcomes that were reported in at least 2 studies were performed using RevMan 5.4 and STATA18 with 95% confidence intervals (CIs). We also conduct heterogeneity test and a leave-one-out sensitivity analysis.

Results
A total of three RCTs, three observational studies and one case-control study, comprising 236 patients, were included from 183 studies identified. The pooled analysis showed that PRP injection significantly increased the IIEF-EF score by 3.87 (95% CI: 2.92, 4.83, p&lt;0.00001), 3.01 (95% CI: 2.27, 3.74, p&lt;0.0001), 3.29 (95% CI: 2.26, 4.32, p&lt;0.00001), at 1, 3, and 6, months follow-up. Subgroup analysis of IIEF-EF based on the use of PDE5i in the protocol or during follow-up period also found the same finding result. The proportion of patient who met MCID after 6 months of follow of was 70% (95% CI: 59%, 80%). In term of penile hemodynamic, a significant improvement was found in peak systolic velocity and end diastolic velocity at the end-point of follow-up. On contrary, there was no significant improvement were found for IIEF score of intercourse satisfaction and overall satisfaction domain. The most common complication reported were transient subcutaneous bruising. Two cases reported a formation of painless plaque but no other major adverse events were reported. Consistent result was found after a leave-one-out sensitivity analysis.

Conclusions
PRP is a promising restorative modality for ED with improvement in IIEF-EF score and penile hemodynamic. However, further studies and human trials are required to confirm the efficacy and durability of this novel treatment as well as to find out the best protocol of administration.

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(123) Postoperative Changes of Serum Total Testosterone Levels in Patients with Prostate Cancer After Robot-Assisted Radical Prostatectomy
Authors: Horiguchi Y , Hagiwara K , Shimizu T , Kawano Y , Sakamoto N , Tsukuda F , Koga S 
Published: March 2024

Abstract

Introduction
Although a relationship between prostate cancer and serum total testosterone (TT) has been studied, previous evidences were contradictory. Although a relationship between prostate cancer and serum total testosterone (TT) in terms of cancer biology as well as sexual function has been studied, previous evidences were contradictory and not organized very well.

Objective
We investigated the changes in TT levels after robot-assisted radical prostatectomy (RARP) for prostate cancer as a prospective surveillance.

Methods
From July 2015 to January 2022, 290 patients out of 1,343 prostate biopsies performed in our hospital underwent RARP with a diagnosis of localized prostate cancer. TT measurements were performed at 6:00 early morning on admission to all patients for biopsy. Of these, we studied 76 patients whose TT values have been measured during postoperative follow-up. TT values were measured 1 month after RARP, every 3 months until 36 months thereafter, and every 6 to 12 months thereafter for up to 72 months postoperatively.

Results
The median and quartile of age, serum PSA and TT (pre-TT) values at biopsy of the 76 patients were 69 years (64–72 years), 7.47 ng/mL (5.65–12.74 ng/mL) and 4.03 ng/mL (2.96–4.83 ng/mL), respectively. There was no significant correlation between age and pre-TT values (p = 0.21). RARP was performed an average of 2.9 months after biopsy. The median follow-up period was 43 months (31–60 months). PSA recurrence was observed in 18 patients (23.7%), with 3- and 5-year PSA non-recurrence rates of 77.4% and 74.9%, respectively. There was no significant difference in pre-TT values between patients with or without PSA recurrence (p = 0.107). Analysis of TT values at each observation period after RARP showed relative increase by an average of 23.4% (after 1 month) to 41.6% (after 36 months) when compared with pre-TT values. Further analysis of dividing 76 patients into 2 groups by a pre-TT value of 3.00 ng/mL showed that only in the low pre-TT group (pre-TT &lt; 3.00 ng/mL: 21 cases, 27.6%), the rate of increase in TT values over pre-TT was significantly higher than that in the normal pre-TT group (pre-TT ≥ 3.00 ng/mL: 55 cases, 72.4%) at each observation period up to 72 months after RARP except 33 and 54 months

Conclusions
The transition of postoperative TT values in the patients who underwent RARP continued to show a significant increase at each observation period only in the group with low TT values preoperatively, suggesting that biochemical hypogonadism may have been presumably caused by prostate cancer-bearing conditions preoperatively in these patients with low TT values.

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(128) Penile Replantation in Patient with Klingsor Syndrome; Case Report and Review of Literature
Authors: EL-Bahnasawy M , Elgazzar K , Alzahrani T , Aljohani M 
Published: March 2024

Abstract

Introduction
Penile amputation has multiple etiologies including self-mutilation, work-related accidents, circumcision, assault motivated by jealousy, rage and feelings of betrayal and animal attacks. By far self –mutilation due to underlying psychiatric disorders (Klingsor Syndrome) are the commonest cause. Re-implantation is the gold standard for management, however it may always not be possible to achieve because of significant local ischemia, tissue damage and prolonged duration post trauma.

Objective
We are reporting our experience with one case of Klingsor Syndrome and its stepwise management.

Methods
A 31 years old male Schizophrenic patient self-mutilated his penile shaft due to fixed illusion (get rid of devil in his penis). He also attempted to remove his entire scrotum. His father brought his son with the amputated penile part put in ice. Immediate application of wet saline towel to penile stump and putting of amputated penile part into cold iced saline. Anti-tetanic serum was given together with i.v. antibiotics. Urology team, Plastic microsurgery team together with Psychiatry treating consultant all were emergently called at once. Amputated penile shaft was prepared by the microsurgeon to identify the dorsal artery, vein and nerves and marked by micro-bulldogs. Urology team started by fixation of s.p. cath and preparing, cleaning penile stump. End-to end anastomosis of the urethra was done. Next, the corporal bodies, were reattached using interrupted sutures. Dorsal vein and artery were re-anastomosed microsurgically

Results
Few days post-operatively skin necrosis started inspite of positive needle brick to the glans indicating healthy underlying glans. Second stage debridement of necrotic skin with later skin grafting resulted in cosmetically and functionally excellent penis regarding erectile and voiding functions

Conclusions
Penile amputation is a rare surgical emergency mostly found in the literature as isolated case reports. Klingsor syndrome is well known etiology for this type of penile injury and warrants psychiatric control. A multidisciplinary approach involving a urologist, micro-vascular surgeons as well as a psychiatrist ensures good outcome. Microvascular re-implantation remains the treatment of choice with the highest probability of adequate cosmetic as well as functional outcomes

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(168) Combining Varicocelectomy and Penile Venous Stripping for Patients with Varicocele and Erectile Dysfunction on an Ambulatory Basis
Authors: Hsu G , Chueh J , Chiang I , Fang C 
Published: March 2024

Abstract

Introduction
Varicocelectomy is a well-established procedure for varicocele testis over one century. It has recently been advanced to minimally invasive surgery types such as laparoscopic or Da Vinci varicocelectomy. Should we question why the approach is beyond the shortest-cut route? Despite penile venous surgery is still cautious in treating patients with erection dysfunction (ED), an anatomy-based penile venous stripping has been conducted for decades, however. It is common to encounter patients with two disease entities. Could the shortest-cut approach be available?

Objective
We sought to report a novel approach for this purpose on an ambulatory basis.

Methods
From October 2013 to October 2020, 68 men aged from 28 to 68 years consulted us with erectile dysfunction and varicocele testis, at least grade II. Dual pharmaco-cavernosography and sonography are the primary tools for confirmation, respectively. The abridged five-item version of the International Index of Erectile Function (IIEF-5) erection hardness scales (EHS) was used to assess erection restoration. Acupuncture-assisted local anesthesia was routinely applied on an ambulatory basis. Neither electrocautery nor suction apparatus was used in the entire procedure. They underwent penile venous stripping (PVS) via circumferential approach and, subsequently, to the deeper portion of the erection-related veins via a pubic longitudinal method; later, bi-lateral varicocelectomy was conducted while the spermatic cord was hooked out. The PVS entails stripping one deep dorsal vein and two cavernosal veins after every specific emissary vein is microscopically ligated closest to the outer tunica, whereas the para-arterial veins are segmentally ligated. The visibility of the pampiniform plexus was enhanced by the squeezing method. Finally, the wound was meticulously repaired using a 6–0 nylon suture. Postoperative cavernosography was routinely made for comparison. Radiopacity was used to compare the penile crus, Corpora cavernosa, and femur cortex. Follow-up was made via INTERNET every six months, one year, and then yearly.

Results
The average follow-up period was 5.2±1.2 years, and the surgery time was 6.3±1. 5 hours, respectively. The blood loss is negligible. The radiopacity was unexceptionally enhanced postoperatively. There was a significant difference (P&lt;0.01) between the preoperative (9.9±2.6) vs. Postoperative IIEF-5 scores (20.6±2.4). The EHS improved on at least one scale. Overall, the post-ejaculation testicular aching was no more bothered in all 23 patients who sustained preoperatively in 6 months postoperatively.

Conclusions
This combination of physiologically penile venous stripping and bilateral varicocelectomy appears feasible for patients with erectile dysfunction and varicocele via a circumferential and pubic approach on an ambulatory basis.

Disclosure
No.
(169) Penile Fracture and Urethral Injury Repair
Authors: Megson M , Tagdiwala P , Pasyar A , Lee W G 
Published: March 2024

Abstract

Introduction
Penile fracture refers to the rupture of tunica albuginea of the penile corpora cavernosum which most often occur due to trauma during coitus or manual manipulation. This can be associated with either a partial or a complete urethral injury up to 39% of cases, usually those fractures crossing the septum. It is important to address both conditions to ensure sexual and voiding function is maintained.

Objective
The patient presented in this video is a 35-year-old gentleman who presented to the emergency department post-trauma related to sexual intercourse causing immediate detumescence and swelling.

Methods
This video describes the penile fracture repair performed using a midline ventral incision repair technique. Prior to surgery the patient is imaged, usually ultrasound, to allow location and marking of the suspected penile fracture. Due to the suspected urethral injury requiring a suprapubic catheter insertion at the presenting hospital, a flexible cystoscopy was performed initially. This showed the urethra was inaccessible at the level of the penile scrotal junction but within the penile urethra. A ventral midline incision along the penile raphe over the suspected fracture site is made. Dartos and Bucks Fascia were dissected to expose the tunica albuginea and allow identification of the fracture site. Further dissection was required to determine the lateral extents of the injury. Stay sutures can then be placed to allow easier closure of the injury. The tunica albuginea was then sutured with PDS sutures, care was taken to ensure these are buried sutures to ensure the patient is unable to palpate these. Subsequently, urethral injury was addressed by performing primary urethral anastomosis. A catheter was introduced through the urethra, a complete transection was seen and the ends were then dissected out to allow an end to end anastomosis to be performed. The anastomosis was checked for a leak with a table urethrogram using dilute betadine. Upon adequate closure of the urethra the ventral midline incision was closed.

Results
The procedure was successful and uneventful. He has a urethrogram 3 weeks post-op on which no evidence of a leak was shown. This patient went on to have good erectile function at 2 months post-operatively. However, he has a 30-degree ventral curvature which he finds bothersome. This is currently being treated conservatively with a vacuum device.

Conclusions
The BAUS consensus documents reports erectile dysfunction and penile curvature rates following surgery for penile fracture repair are reported to be 5% and 5% respectively. Conservative management results have a much higher rate of complication with 62% chance of erectile dysfunction and 35% chance of curvature.

Disclosure
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(200) Demographic, Clinical, and Socioeconomic Variables and Risk Assessment Perpetrators of Sexual Crimes in Poland
Authors: Kołomańska A 
Published: March 2024

Abstract

Introduction
The study of sexual recidivism has been attracting the attention of the mental health services and criminal justice system, as well as researchers. A significant problem for clinical judicial experts when issuing court opinions is assessing the risk of recidivism.

Objective
The aim of the study was to assess the demographic, clinical and socioeconomic variables of adult male sex offenders convicted of sexual crimes in Poland, as well as assessing their risk of recidivism.

Methods
The participants of the study consisted of 30 sexual offenders (66% preferential and 34% non-preferential) serving prison sentences in a dozen Polish prisons. A retrospective file review was completed for 30 medical and medicolegal files. Medical records included documentation such as psychiatric notes, psychological assessments, medicolegal assessments, and medical consultation notes. The analysis took variables including age, sex, marital status, and education. The risk of recidivism was estimated based on the participants’ files, using semi-structured interviews, and calculated using the Sex Offender Treatment Intervention and Progress Scale (SOTIPS) (McGrath, et al., 2013).

Results
Data analysis was done with Statistical Package for Social Sciences (SPSS). Participants of this study were mostly single (67%) males (100%), with an average age of 43 years (range = 24–63 years). Only 3% had completed higher education. Table 1 for a summary of the study results. Clinically, more than half of the sex offenders had a personality disorder (67%) diagnosis, with 66% of the sample diagnosed with sexual preference disorders. The Pearson correlation analysis was used to analyze the relationships between sexual preference disorders and age (r = 0,36; p &lt; 0,05). The correlation also analysis showed that marital status was positively related to age (r = 0,34; p &lt; 0,05). SOTIPS score was positively correlated with sexual preference disorders (r = 0,30; p &lt; 0,05). A positive correlation, although very weak, was found between the score on the SOTIPS scale and age (r = 0,22; p &lt; 0,05).

Conclusions
The results of the study showed that, sexual offenders are heterogeneous in terms of age. Most sex offenders (67%) have never been married before. The study also found a high proportion (64%) of sex offenders who reoffend. The larger proportion of sex offenders has sexual preference disorders. Therefore, one can conclude that sex offenders should be subject to preferential offender therapy.

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(225) Female Sexual Function During the Last Trimester of Pregnancy
Authors: Kaabia O , Toumi E 
Published: March 2024

Abstract

Introduction
Since antiquity and until today, sexuality remains a taboo and complex subject, often little discussed either in private circles or with healthcare professionals. Although advertising and the media sometimes use it to attract attention, sexuality is still synonymous with the unknown, raising several interrogations. These concerns are accentuated during the onset of pregnancy and all the physical, psychological, and environmental upheavals associated with this physiological state.

Objective
This study aims to assess the changes in female sexual function during the third trimester of pregnancy

Methods
It is a cross-sectional online study that took place over 5 weeks starting March 1st, 2023. All low-risk singleton third-trimester pregnant and newly delivered women enrolled in the public and private prenatal care centers of the region were contacted through the institutions’ social media groups to be recruited. The online questionnaire was a 4-item Google form elaborated in concertation with the literature and included the validated translated version of the Female Sexual Function Index (FSFI).

Results
The study included 81 married participants (8% response rate). The median age of the participants was 30,4± 6,9 years and 65,4% of them were employed when pregnant. The mean pregnancy rate per participant was 2,7± 1,9 and 90% of the pregnancies were spontaneous. When questioned about their sexual life during the 3rd trimester of pregnancy, 68% of the participants report being uncomfortable when the subject of sexuality is on the table. Most of the respondents (78%) were unsatisfied with their couple's sexuality during pregnancy. A low sexual desire was reported in 84,0%, dyspareunia in 55,6% with a decrease in lubrification in 16,0%, and orgasm disorders in 17,3%. Secondary vaginismus was described by 12,3%. Partners initiated sexual intercourse according to 72,8% of the respondent. Sexual intercourses were mutually initiated in 27,2%. Pregnant women reported a change in their sexual life during the 3rd trimester in 96,3%: the 7th month of pregnancy is associated with less frequent (70,5%) and shorter (69,2%) penetrative intercourses with lower female sexual desire (48,7%). The 8th and 9th months are associated with lower sexual desire (80,8%; 94,9%), lower sexual pleasure (75,6%; 92,3%), and less frequent orgasms (67,9%; 82,1%) and penetrative intercourses (85,9%; 93,6%).

Conclusions
Our results suggest that the third trimester in singleton low-risk pregnancies is associated with severe impairment of the female sexual function in relation to less frequent and shorter penetrative intercourses, lower desire, and pleasure associated with a general sexual unsatisfaction.

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