bluuebunny/crossref_metadata_2025_split huggingface dataset:
(042) Bilateral Orchiectomy as a Standalone Gender-Affirming Procedure: Does it Compromise Skin Grafts Available for Later Vaginoplasty?
Authors: Stelmar J , Zaliznyak M , Mallavarapu S , Sandhu S , Smith S , Garcia M 
Published: March 2024

Abstract

Introduction
Penile inversion vaginoplasty is the gold-standard gender-affirming surgical technique for creating a neovaginal canal. While bilateral simple orchiectomy (BSO) is usually completed at the same time as vaginoplasty, long wait times associated with vaginoplasty have highlighted pre-vaginoplasty BSO as a more immediate opportunity to mitigate gender dysphoria, decrease estrogen dosages, and completely eliminate antiandrogen hormone therapy. The impact of standalone BSO on later vaginoplasty is defined by a single study that associated BSO with a decrease in scrotal skin and a need for extragenital skin grafts-findings that have fueled hesitation around pre-vaginoplasty BSO.

Objective
To provide a detailed comparison of pre- and intraoperative skin graft measurements and postoperative neovaginal depth between patients who underwent BSO prior to versus concurrent with vaginoplasty.

Methods
All consecutive patients who underwent penile inversion vaginoplasty at a single institution were identified in a retrospective chart review. Demographic characteristics and the following measurements of vaginoplasty skin grafts were collected and compared between groups: preoperative stretched penile length (measured from base to 1cm proximal to the glans ridge on gentle stretch), preoperative stretched scrotal skin length (measured on gentle stretch in two parts: from the penoscrotal junction to mid scrotum, then from midscrotum to mid perineum), and intraoperative scrotal skin tube length (defined as the amount of scrotal skin that could be harvested and tubularized on a metal dilator (Figure 1A)).

Results
57 patients completed penile inversion vaginoplasty between August 2017 and May 2023: 17(30%) completed pre-vaginoplasty BSO and 40(70%) BSO concurrent with vaginoplasty (mean age ± SD = 36.6 ± 12.6y and 37.4 ± 12.8y, p&gt;0.05). Notably, there was no significant difference in length of preoperative scrotal skin or intraoperative tubularized scrotal skin grafts (Figure 1B). While pre-vaginoplasty BSO patients had less neovaginal depth (p&lt;0.05), they also had significantly less preoperative penile skin (p&lt;0.01).

Conclusions
Contrary to the singular study in the literature, we found no between-group differences in scrotal skin measurements. Furthermore, zero patients required extragenital skin grafts to achieve mean neovaginal depth of 14.4±1.0cm, which approximates the average depth among studies reporting routine use of extragenital skin. Less neovaginal depth amongst BSO patients is expected, as this group had less penile skin available to line the canal. Findings from this study may help address patient and provider fears that BSO decreases scrotal skin available for later vaginoplasty, thereby lessening the decision-making burden of balancing the pros and cons of early BSO.

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(048) Women's Knowledge about Female Masturbation
Authors: Kaabia O , Mkaouer L 
Published: March 2024

Abstract

Introduction
The scarcity of in-depth studies on female masturbation testifies to the lack of attention paid to this crucial subject and to the cultural hurdles to talking about such a subject. This absence of evidence prevents healthcare practitioners from understanding women's experiences, needs, and challenges regarding their sexuality and sexual autonomy. It is therefore imperative to fill this knowledge gap with research studies that look at the cultural, social, and religious specificities specific to female masturbation.

Objective
The main objective of this study is to assess the knowledge of women regarding female masturbation taking into consideration their cultural, social, and religious backgrounds.

Methods
We present a cross-sectional study based on an online 15-item questionnaire posted once per week, 5 weeks in a row from March 14, 2023. The online self-administered questionnaire was presented in the local written dialect. The questionnaire was divided into a sociodemographic section, a general knowledge assessment of genitalia and the sexual female function, and a section about the misconceptions and knowledge about female masturbation. All participants were self-designated female participants over the age of 18, recruited from sports centers' Facebook and Instagram pages.

Results
The study included 213 participants, 82% of who have attended high education institutions, and 70% were single. The mean age was 25 [18, 45]. Internet was the participants' primary informational source in 64%. Friends were the second source of information with 15%. With regard to the participants' knowledge, the results of the study reveal a diversity of levels of knowledge within our population. Some participants demonstrated a limited or incorrect understanding of female masturbation, often influenced by cultural, and religious beliefs or preconceived ideas. This inaccurate knowledge contributes to the spread of negative stereotypes and judgments about practice.

Conclusions
It is important to recognize that female masturbation often remains a difficult subject to discuss and is surrounded by social taboos. In light of our findings, it is clear that additional efforts are needed to promote better understanding and acceptance of female masturbation through comprehensive sexuality education programs.

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(051) Urodynamic Profiles of Young Aged Women with Genital Pain Disorder
Authors: Yoon H , Kim M 
Published: March 2024

Abstract

Introduction
It is not uncommon in young female patients with genital pain disorder, they also complain urethral discomfort or unusual sensitivity, bothering symptoms on their urethra and genital area with LUTS. Although urodynamic studies or pressure flow studies are one of very optional studies of diagnostic steps, pressure flow studies provide detailed information of patient bladder-urethral synergistic function that may contribute proper function of the pelvic floor and related organs. However, studies are limited providing their relationship between urethral functional status and etiology of pain.

Objective
In this study, we aimed to evaluate female patients pressure flow profiles, urethral pressure profiles (UPP) in particular and to investigate their correlation of clinical symptoms in terms of genital pain disorder in 20’s-30’s aged young female.

Methods
Data of 30 female patients age between 20–39 years old with genital pain and LUTS for more than 6 months were retrospectively analyzed. Pressure flow study (PFS) with free uroflowmetry, overactive bladder symptom score (OABSS), visual analogue scale (VAS), female sexual function index (FSFI) were retrospectively analyzed according to aged groups of 20’s and 30’s. Data were statistically analyzed using t-test (p&lt;0.05).

Results
We divided the subject patients into 2 groups; age of 20’s (n=16, 20–28, median 25 years old) and age of 30’s (n=14, 30–39, median 34 years old). Average MUCP of all patients was 104 cmH2O. In the group of aged 20’s, mean MUCP was 98.75 cmH2O, mean VAS was 5.81; in the group of aged 30’s, mean MUCP was 111.07 cmH2O, mean VAS was 5.57, respectively. All of the data showed high pressure of MUCP in PFS, &gt;60 cmH2O. In group of 30’s, all the parameters of PFS showed higher compared with 20’s. Mean OAB symptom scores (OABSS) showed 3.63 (20’s) and 3.07 (30’s) respectively (p&gt;0.05)

Conclusions
Urethral pressure, PdetQmax and Qmax showed significantly high in young females with genital pain. This study suggests that increased urethral tone or resistance may contribute to urethral/genital pain. Proper evaluation of urethral pressure profile and pelvic floor tone would be helpful to provide optimal management of genital pain disorder.

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(068) The Men’s Training Cup Keep Training: A Masturbation Aid Improves Intravaginal Ejaculatory Latency Time and Erection Hardness Score in Patients who are Unable to Delay Ejaculation
Authors: Shirai M , Ishikawa K , Hiramatsu I , Mizushima K , Tsuru T , Kurosawa M , Kure A , Uesaka Y , Nozaki T , Tsujimura A 
Published: March 2024

Abstract

Introduction
Premature ejaculation (PE) has negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy. In Japan, no oral drugs or devices are approved or used clinically to treat PE. The Men’s Training Cup Keep Training (MTCK), a masturbation aid, was developed for PE. MTCK offers 5 grades of tightness and strength.

Objective
We aimed to investigate the efficacy of the MTCK in patients who are unable to delay ejaculation.

Methods
Inclusion criteria were 20- to 60-year-old men feeling distressed and frustrated by PE and who had the same sexual partners throughout the study period. Exclusion criteria were neurologic disease and uncontrolled diabetes mellitus, as well as the use of antidepressants, α-blockers, and 5α-reductase inhibitors. The protocol comprised an 8-week training period with the MTCK from level 1 to level5, with each level used twice before moving to the next level. The main outcome measure was the extension of intravaginal ejaculation latency time (IELT). The secondary outcome measures were score improvements on the Premature Ejaculation Diagnostic Tool, Sexual Health Inventory for Men, Erection Hardness Score, and Difficulty in Performing Sexual Intercourse Questionnaire–5.

Results
We enrolled 37 patients, and after 19 patients withdrew, 18 concluded the study without experiencing any adverse events. The mean patient age was 39.9 years. Geometric IELT after the 8 week training with the MTCK increased significantly (mean ± SE; 232.10 ± 72.16 seconds) vs baseline (103.91 ± 50.61 seconds, P=.006). Mean scores on the Premature Ejaculation Diagnostic Tool, Difficulty in Performing Sexual Intercourse Questionnaire–5, and Erection Hardness Score after 8-week training improved significantly vs the baseline values. The mean score on the Sexual Health Inventory for Men did not improve significantly after the 8-week training, but domain 1 did significantly improve after 8 weeks of MTCK use.

Conclusions
The MTCK may be one possible treatment option for patients who are unable to delay ejaculation. Also, the MTCK may offer benefits for erectile function.

Disclosure
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(085) Investigating the Relationship Between Experiences of Sexual Health Education and Sexual Health Outcomes
Authors: Bednarczyk E , Orogun L , Perna A , Edokpayi K 
Published: March 2024

Abstract

Introduction
Young people (16–24-year-olds) experience the highest diagnosis rates of STIs. Lack of engagement, public awareness, lack of training, and long-standing, widespread stigma around STIs remain barriers to greater and more effective use of interventions such as sexual health education and other services. Whilst relationship and sexual health education (RSE) has been part of many school curriculums for generations, young people’s experiences of RSE can vary widely.

Objective
This research aims to provide insight into the experiences of sexual health education, sexual health behaviours and recommendations to improve engagement and sexual health outcomes amongst adolescents.

Methods
An online quantitative survey was conducted between June and July 2021 (n=5,457). 855 respondents were recruited from a market research panel (answering a 20-minute survey) and a further 4,602 respondents were recruited via public links (answering a cut-down survey). All respondents were living in the UK and aged 18+. Data were analysed using descriptive statistics and adjusted to reflect the sample size of LGBTQ+ and heterosexual respondents.

Results
90% of respondents received formal sex education, however, only 12% agreed sex education had a positive long-lasting effect on their sexual life. Reproductive biology, pregnancy, safe sex, and avoiding STIs were the core pillars of sex education, whilst different sexualities, pleasurable intimate relations, gender identity and trans-specific topics were covered less than 13% of the time. Although 90% of respondents declared they have a good understanding of sexual health risks, sexual health outcomes in this group were sub-optimal; safe sex was only consistently practiced by 43% of respondents and regular testing only carried out by 25% of respondents.

Conclusions
Whilst most participants reported receiving sexual health education, their experiences varied. Despite a high self-reported understanding of sexual health risks, sexual health outcomes were sub-optimal. This research highlights the potential beneficial effects of an exhaustive sexual health education on attitude, knowledge, and behaviours among adolescents to improve the long-term sexual health outcomes. Recommendations include designing programmes based on young people’s experiences of sexual education, reviewing current guidance and practices adding on key topics outside the main pillars of sexual education, increasing guidance and training for educational institutions and supporting RSE provisions in alliance with external educators and services.

Disclosure
Yes, this is sponsored by industry/sponsor: Reckitt.
Clarification: Industry initiated, executed and funded study.
Any of the authors act as a consultant, employee or shareholder of an industry for: Reckitt.
(089) Psychological Distress and Coping Mechanisms among Women with Sexual Dysfunction Using Hormonal Contraceptives at Kawempe Hospital - A Cross-sectional Study
Authors: Aujo B T , Nakasujja N , Turiho A , Gumikiriza J L , Kakaire O 
Published: March 2024

Abstract

Introduction
Sexual dysfunction is very distressing to women of reproductive age. Hormonal contraceptives (HC) are often reported to be highly associated with sexual dysfunction. The occurrence of female sexual dysfunction (FSD) varies across African regions however, the literature is scanty. This study, therefore aimed to assess the psychological distress (PD) and coping mechanisms of women with sexual dysfunction using hormonal contraceptives at Kawempe Hospital (KH).

Objective
To determine the prevalence of psychological distress among women with sexual dysfunction using hormonal contraceptives at Kawempe Hospital To examine the factors associated with psychological distress among women with sexual dysfunction using hormonal contraceptives at Kawempe Hospital To evaluate the coping mechanisms of women with sexual dysfunction using hormonal contraceptives at Kawempe Hospital

Methods
The study was cross-sectional and conducted by a female team at the family planning clinic of KH. Participants were sexually active females aged 18 to 50 years, who had used HCs for at least six months, and had a positive FSD score below 26.55 on the female sexual function index. PD was assessed using the Kessler Psychological Distress Scale K-6, with a score over 13 indicating PD. Coping mechanisms were determined using the SexFlex scale. The data was analyzed using proportions, means, chi-squares and logistic regression to determine characteristics associated with PD at a significance level of 0.05.

Results
Of the 401 individuals screened, 288 who had positive FSD scores were enrolled. The average age of the participants was 28.8 years, and 46.18% used implants for contraception. The prevalence of PD was 55.56%, with 28.47% using reflexive-only coping mechanisms, 24.35% using approach-only mechanisms, 13.19% using both, and 63.19% using neither. Being married (AOR=0.45) and breastfeeding (AOR=0.41) were negatively associated with PD, while using injectables (AOR=7.43), implants (AOR=5.17), levonorgestrel IUD (AOR=4.17), having relationship dissatisfaction (AOR=4.65), and sexual pain (AOR=2.60) were positively associated with PD.

Conclusions
PD was prevalent among women with FSD using HCs at Kawempe Hospital and associated with modifiable characteristics. It is recommended that health workers regularly screen for PD among women with FSD using HCs and provide education on malleable characteristics, such as breastfeeding and relationship satisfaction.

Disclosure
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(096) Attachment Orientation Moderates the Sexual and Relational Implications of Sexual Desire Discrepancies
Authors: Attaky A , Kok G , Dewitte M 
Published: March 2024

Abstract

Introduction
Discrepancies in partners’ levels of sexual desire (SDD) are common in long-term relationships and can be experienced as distressing. Because sexual compatibility is a strong prescriptive among Western couples, it is relevant to examine the sexual and relational implications of SDD in relationships that are marked by cultural restrictions and gender stereotypic norms.

Objective
We examined discrepancies in sexual desire between partners and assessed how such discrepancy relates to sexual and relational functioning, taking into account both partners’ attachment orientation

Methods
100 couples of which more than half experienced sexual problems completed an Arabic version of questionnaires on sexual desire, sexual function, sexual satisfaction, relationship satisfaction and attachment orientation.

Results
Men and women reported better sexual function, sexual satisfaction, and relational satisfaction when they matched on higher levels compared to lower levels of sexual desire. In case there was a mismatch between partners, women reported higher sexual satisfaction when their partner’s level of sexual desire was higher than their own desire. Attachment orientation was found to moderate the associations between the degree and direction of SDD and the outcome variables. Male attachment avoidance moderated the association between SDD and both male and female sexual function. Male attachment anxiety moderated only the association with female sexual function, indicating that women with high anxious partners reported better sexual function when their partner’s level of desire was higher than their own desire. In addition, the female attachment dimensions moderated the association between SDD and female satisfaction outcomes, with attachment anxiety moderating the association with sexual satisfaction and attachment avoidance moderating the association with relational satisfaction.

Conclusions
We showed the importance of considering both the level and direction of SDD and the partners’ attachment history to understand its sexual and relational implications. Therapeutic interventions should be directed at understanding the attachment meaning of sexual desire, facilitators and barriers of sexual desire across time and context, and the reasons why some couples cope better with SDD than others.

Disclosure
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(110) Evaluation of Penile Anatomy with MRI
Authors: Baran C , Culha M G , Aksoy K , Bayraktarli R Y , Ozcan L , Otunctemur A 
Published: March 2024

Abstract

Introduction
Penile enlargement interventions have become increasingly popular in recent years. The common lengthening procedure involves dividing the fundiform and suspensory ligaments to enable the outward movement of the concealed part of the penis. Nevertheless, the outcomes of these surgeries can vary, and clear patient selection criteria have yet to be established.

Objective
In this study, our objective was to assess penile anatomy using MRI and to identify penile anatomical variations that can aid in the selection of patients for penile enlargement surgeries.

Methods
We conducted a retrospective study to assess penile anatomy in the context of lengthening surgery. Pelvic MRIs taken for various reasons were evaluated, and the angle between the penile shaft and the symphysis pubis (a), as well as the distance from the pubis to the skin (b), were measured. Patients were categorized into three groups (I, II, III) based on the highest point of the penis relative to the symphysis pubis in the sagittal plane (Figure 1).

Results
A total of 519 pelvic MRIs were initially reviewed, and 344 met the protocol's eligibility criteria. The participants had a median age of 53 years (IQR 38-65) and a median body mass index of 26 (IQR 24-29). The median angle between the penile shaft and pubis was 23 degrees, with a pubis-skin distance of 38 mm. Age was significantly correlated with the angle between the penile shaft and pubis (r=0.61, p&lt;0.01). Patient distribution across the groups based on penis highest point and pubis location was as follows: 36.1% in Group I, 47.4% in Group II, and 16.5% in Group III. Additionally, a significant positive correlation existed between BMI and suprapubic fat thickness (r=0.65, p&lt;0.01). The analysis unveiled noteworthy variations in penile anatomy, suprapubic fat distribution, peno-pubic angle, and the anchoring point of the fundiform ligament to the penis. Some penises also displayed an S-shaped anatomy. Figure 2 visually illustrates the range of observed penile anatomical variations.

Conclusions
Our study revealed a significant variability in penile anatomy. The distinctions among patients should be carefully considered when planning any penile enhancement intervention.

Disclosure
No.
(152) Efficiency Improvement Veno-Occlusive Surgeries for Treatment of Venous Leak with Autologous Stem Cell, VEGF and PRP
Authors: Knigavko O 
Published: March 2024

Abstract

Introduction
The venous leakage is one of the most often reason of erectile dysfunction (ED) in young and middle age men. The main reason of venous leakage or veno-occlusive Erectile Dysfunction (VOED) is the insufficiency venous obstruction under tunica albuginea of corpora cavernosa. Accordingly all types of veno-occlusive operations have particular and short term effect up to renovation of venous leakage in half year. Conservative treatment of VOED with PDE-5 has a low or mild effectiveness. Evermore young patients deny penile prosthesis implantation for psychological reason.

Objective
We want to stimulate growth of endothelial valves under tunica albuginea with injections autological mesenchymal stem cells (ASC) and autological VEGF (Vascular endothelial growth factor) and combine it with veno-occlusive surgeries.

Methods
2012–2022 we treated 178 patients with VOED. The average patient age is 36.5 +4.1 years. Patients with prostatitis or depression/anxiety were excluded from the investigation or treated previously. We embolizated deep dorsal and Santorini plexus veins for patients with distal form of VOED–47 patients -Group 1. We ligated deep dorsal and penile veins for proximal form of VOED – 68 patients – Group 2. And we made both methods together for 65 patients –Group 3 with combination of proximal and distal leak. Patients with only surgical methods created subgroup A – 105 men. For improving of veno-occlusive mechanism for 73 patients (subgroup B) we injected to each corpus cavernosa 1 mln of autological stem cells 6 times (2 times before, during surgery and 3 times after surgery) each month and we performed 15 microinjections of VEGF each 10 days. Then we compared short (2 months) and long term (10 months) results.

Results
The efficacy of surgical treatment according to subjective data (questionnaires on IIEF-5) in 2 months was almost equal (16.7+3.1 and 16.9+3.0), but in 10 months significantly higher in SubGroup B(14.3+3.2 and 19.6+3.4). According to Doppler Penile Ultrasound in 10 months adding microinjections ASC and VEGF to surgery significantly improves Erectile function (absence of venous leakage) 56.4% - subgroup A and 87.4% - subgroup B. Only 6.8% patients subgroup B (opposite to 35.9% subgroup A) have to take PDE-5 inhibitors for maintain erectile function.

Conclusions
Half year injections of ASC and VEGF improve of veno-occlusive mechanism and increases effectiveness and long term result of veno-occlusive operations for treatment of VOED. Combine occlusive method (embolisation and ligation of veins) has the highest effectiveness and should be used in different types of leakage.

Disclosure
No.