bluuebunny/crossref_metadata_2025_split huggingface dataset:
(281) Linguistic and Cultural Validation of the Satisfaction Survey for Inflatable Penile Implant (SSIPI) for Brazilian Portuguese and Tri-Continental Spanish Speakers
Authors: Furtado T , Novaes LF , Thorogood S , Becher E , Carrion R , Carvajal A , Fernandez E , Glina S , Martinez-Salamanca JI , Miranda E , Nascimento B , Quesada J , Torremade J , Torres LO , Teloken P , Valenzuela R , Nelson C , Salter C , Mulhall J , Flores J 
Published: February 2024

Abstract

Introduction
The Satisfaction Survey for Inflatable Penile Implants (SSIPI) has been validated in English. No validated Portuguese and Spanish versions currently exist.

Objective
We aimed to linguistically validate SSIPI in Portuguese and Spanish to evaluate satisfaction outcomes with a validated instrument.

Methods
Our methodology adhered to best practices established by the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) and involved: forward translation of the 16-item SSIPI into Portuguese and Spanish by 2 independent IPP surgeons, reconciliation, back translation into English by 2 different independent bilingual IPP surgeons, and comparison to the original SSIPI for conceptual equivalence. The translated SSIPI versions underwent in-parallel cognitive debriefing (CD) at the US, Colombia, Spain, and Brazil centers. All interviews were recorded in person or via secure video conference to determine if misunderstandings or modifications were needed.

Results
12 and 17 native Portuguese and Spanish speakers, respectively, with IPPs, participated in the CD process for their native language SSIPI. Interviews lasted approximately 1 hour each. The Portuguese SSIPI validation was conducted at 2 different centers in Brazil, resulting in 83% of the patients reporting that the survey was easy to answer. Of 16 questions, only 3 (Q7, Q11, and Q16) raised concerns for 6 patients. 5 patients had issues with the concept of the word “naturalness” and “spontaneity” from Q7 and Q16. One patient struggled with interpreting the word “conceal” in Q11. Regarding the duration taken to answer, 10/12 patients said it was acceptable. The Spanish SSIPI was tested at 4 US, Colombia, and Spain academic centers. 63% indicated the survey was easy to answer. In most cases, replacing a single word in the item with another was proposed. 53% had difficulties comprehending the answer choice options with Q3; however, all participants perceived the time required to complete the SSIPI as reasonable.

Conclusions
While the Portuguese SSIPI has been demonstrated to be easier to read and interpret than the Spanish SSIPI, with minor changes to wording/phrasing, both versions have the potential to improve IPP outcomes literature globally. Concerning questions will be modified before conducting the final validation steps.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Roman.
(285) Evaluation of Penile Prosthesis Implantation in Older Adults with Bladder Cancer After Radical Cystectomy
Authors: Abello A , Kaul S , Fleishman A , Morgenthaler A , Korets R , Chang P , Wagner A , Kim S , Olumi A , Gershman B 
Published: February 2024

Abstract

Introduction
Erectile dysfunction (ED) is common after radical cystectomy (RC), but ED treatment in this setting remain understudied. Many such patients will be unresponsive to oral pharmacotherapy, often requiring penile prosthesis (PP) implantation.

Objective
The objective of this study was to evaluate PP implantation in a contemporary, national cohort of older adults with bladder cancer following RC.

Methods
We used the SEER-Medicare database to identify male patients 66 years and older diagnosed with Tany Nany M0 bladder cancer from 2000 to 2017 and treated with RC. We estimated time to PP implantation using the Kaplan-Meier method, and evaluated the associations of baseline characteristics with PP implantation using Cox proportional hazard regression.

Results
The study cohort included 4,468 men who underwent RC, including 75% who were married or had a domestic partner. A total of 334 (7%) patients had baseline ED. Median follow-up after RC was 38.0 (IQR 16.0-84.0) months. After RC, only 71 (2%) patients underwent PP implantation, with a median time to PP implantation of 12 (IQR 5-32) months. In univariable analysis, younger age, black race, and undergoing RC at small bed size hospitals, comprehensive NCI Cancer Centers, higher RC volume hospitals, and hospitals in the West and South/Southeast regions were associated with higher rates of implantation (Table 1). Disease characteristics were not related to PP implantation.

Conclusions
Despite the expected prevalence of ED following RC, contemporary, real-world rates of PP implantation are very low. Univariable analyses suggest that both patient characteristics and features of the hospital performing RC are associated with treatment for post-RC ED with PP implantation.

Disclosure
No.
(287) A Patient's Journey with Erectile Dysfunction: Prediction Progression to Penile Implant
Authors: Hernandez N , Naeem T , Saffati G , Guhan M , Pierce H , Lipshultz LI , Khera M 
Published: February 2024

Abstract

Introduction
Inflatable penile prosthesis (IPP) is seen as the gold standard for surgical treatment for ED, specifically for patients that are not amenable to lifestyle changes or oral medications.

Objective
This study aims to explore which patients progress to seeking treatment with an IPP along their journey with erectile dysfunction.

Methods
This retrospective study identified patients with ED as a chief complaint during the primary visit or follow-up from 2009-2022. If patients eventually progressed to treatment with IPP, data was collected to find common features and analyzed.

Results
Of our cohort of 361 men presenting with erectile dysfunction (ED), 21 men progressed to the placement of an inflatable penile prosthesis (IPP). 20 men classified as non-Hispanic, with 13 white, 6 African American/black, and 1 Asian males. Only 1 man was Hispanic. 5 men had either hypertension (n = 11), hyperlipidemia (n = 10), or DM (n = 3), with 6 having both hypertension and hyperlipemia, 1 with hypertension and diabetes, and 1 with hypertension, hyperlipidemia, and diabetes. Median age of the group at surgery was 76 years (IQR: 71 – 82), with median time from initial presentation to surgery of 12 (IQR = 11.5-27.5) months. N = 10 men had trialed oral phosphodiesterase inhibitor type 5 (PDE-5i) therapy, and 7 men failed intracavernosal injection (ICI) therapy. 8 men had been treated for hypogonadal symptoms with testosterone replacement therapy (TRT). Of patients who had data available on their reason for IPP placement, indications included were Peyronie’s disease inhibiting intercourse (8/21), longstanding ED refractory to medical therapy (4/21), post-prostatectomy ED (4/21), history of priapism requiring surgical intervention (1/21), and history of spinal cord tumor (1/21). Among those treated with IPP, the median patient waited almost 1 year from initial presentation following failure with PDE5i, ICI, and TRT. 17/21 men reported satisfaction after IPP treatment. In those who progressed to IPP, the majority of indications were organic forms of ED (Peyronie’s disease, neurogenic, surgery).

Conclusions
Only 5.8% of men in this cohort went on to proceed with an IPP. In summary, our results indicate that IPP is best suited for those presenting with organic ED who have failed more conservative management techniques. Further studies are needed to assess why so few men go on to proceed with an IPP and wait an average of 2 years.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Consultant for AbbVie, Marius, Tolmar, Endo, Petros, Boston Scientific, Coloplast Investor: Sprout.
(288) Trends in Penile Prosthesis Placement in Men with Erectile Dysfunction
Authors: Schardein J , Svare N , Jimbo M , Horns JJ , Driggs N , Das R , Hotaling J 
Published: February 2024

Abstract

Introduction
Erectile Dysfunction (ED) is a common problem impacting 20% of all men. Current treatment options include oral medications, vacuum erection devices, intraurethral suppositories, intracavernosal injections, and penile prosthesis placement (PPP). A shared decision-making framework is increasingly utilized for treatment decisions where an appropriate treatment is selected from all options based on the values and priorities of the patient and their partner.

Objective
Our objective is to identify trends in PPP, including the proportion of patients who pursue PPP as an initial treatment as well as the time from ED diagnosis to PPP.

Methods
We retrospectively reviewed all men with an ED diagnosis based on ICD9/ICD10 codes using the IBM MarketScan insurance claims database. The initial treatment option processed through an insurance claim following an ED diagnosis was identified and categorized using ICD, HCPCS, NDC, J, and CPT codes. Time from ED diagnosis to PPP was also recorded. Only patients with at least one year of enrollment pre-ED diagnosis and with at least one year of follow-up were included. Linear regressions were performed to investigate the trends of each year based on the time of initial ED diagnosis.

Results
We identified a total of 670,096 patients diagnosed with ED between 2012-2019. The mean age was 56 years (47-62). Of those patients, 11% were smokers, 29% had diabetes, 24% had cardiovascular disease, 65% had hypertension, and 29% were obese. Among those who received treatment, the most common initial treatment was oral medications in 26% of patients. PPP was an initial treatment in &lt;1% of patients. The proportion of patients who underwent this surgical intervention as an initial treatment significantly decreased from 2012-2019 (P&lt;0.001) as patients utilized other initial treatment modalities more commonly. Over the same period, the time from ED diagnosis to PPP significantly decreased from approximately 500 days in 2012 to &lt;200 days in 2019 (P=0.001).

Conclusions
Although the proportion of patients who utilize other ED treatment options prior to PPP is higher, patients diagnosed with ED more recently undergo PPP in a significantly shorter timeframe. Utilization of other treatment modalities as an initial treatment option may stem from changes in insurance coverage. Patients moving more quickly from an ED diagnosis to PPP is likely due to several factors, including improvements in the device leading to less mechanical and infectious complications, familiarity with the device due to marketing, and an earlier discussion with the physician about the device based on a shared decision-making model.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Inherent bio, Paterna bio, Firmtech, Turtle health, Maximus, Carrot.
(291) Seasonal Variation in Serum Testosterone Levels: Evidence from Two Large Institutional Databases
Authors: Miller D , Gurayah A , Weber A , Schuppe K , Zarli M , Hwang K , Ramasamy R , Dullea A 
Published: February 2024

Abstract

Introduction
For accurate evaluation clinicians must consider the variations that testosterone undergoes in the human body. The diurnal variation of testosterone is well characterized, levels peak in the morning and decline during the day. Seasonal variations in testosterone levels have been reported in some studies, but the results are inconsistent. Thus, there is a lack of consensus on whether there are significant seasonal variations in serum testosterone levels.

Objective
In this study, we aimed to determine if clinically relevant seasonal variability in testosterone levels exists using a large cohort of men from two different institutions, one located in an area with seasons (Pittsburgh, Pennsylvania) and one without seasons (Miami, Florida).

Methods
Using two institutional databases, testosterone levels were obtained for men ages 18-99 from 2010-2021 who had at least 2 morning testosterone levels drawn within a 2-year period. All samples were analyzed with liquid chromatography with tandem mass spectrometry (LC-MS/MS). To avoid potential confounding by testosterone altering medications patients who were currently or previously on exogenous testosterone, endogenous testosterone stimulating medications, testosterone suppressing medications, and aromatase inhibitors were excluded from the study.

Results
There were 9495 and 16171 total testosterone levels measured from Miami and Pittsburgh respectively, with all men having 2 or more levels (Table 1). There was no statistically significant variation in T levels for the overall cohort in Pittsburgh or Miami, respectively (Table 2). Additionally, when stratified by age group, no individual groups were found to have significant seasonal variability (Table 3).

Conclusions
Our findings suggest that although there is differing total testosterone levels between men who reside in two different climates, there is no significant variability in testosterone levels between seasons. Therefore, testosterone levels can be checked and interpreted without the need to account for the season during which they were drawn.

Disclosure
No.
(300) Systematic Review and Meta-analysis of Seasonal Variation on Human Semen Quality in the United States
Authors: Dehghanbanadaki H , Randell Z , Fendereski K , Ramsay JM , Horns JJ , Gross KX , Pastuszak AW , Hotaling JM 
Published: February 2024

Abstract

Introduction
Different environmental exposures such as daylight hours and temperature influence spermatogenesis, which vary across seasons. However, studies on the variation of semen analysis across different seasons reported inconsistent results.

Objective
To investigate the seasonality of human semen parameters in the United States through a systematic review and meta-analysis.

Methods
We systematically searched PubMed, Scopus, and Web of Science for studies on seasonal variation of human semen parameters in the United States from conception to December 11, 2022, without language restriction, and also scrutinized the reference list of included studies for any additional related study. We determined the pooled standardized mean difference (SMD) and its 95% confidence interval (95%CI) between seasons using the random effect model in a case of substantial heterogeneity (I2 index≥50%) and the fixed-effect model in a case of low heterogeneity (I2 index&lt;50%) in STATA version 17. The methodological quality was checked using Newcastle–Ottawa Quality Assessment Scale (NOS).

Results
Our search yielded 548 studies. After screening, 7 studies on 131,306 semen analyses were included for meta-analysis. All included studies had high methodological quality (NOS ≥ 7). Figure 1 shows the pooled SMD of semen parameters between seasons. Semen analysis in winter had a higher volume than those in spring (p-value=0.010; I2=4.63%). Winter had better semen quality than summer in terms of concentration (p-value=0.014; I2=0%) and total sperm count (p-value=0.044; I2=47.80%). Semen quality was also better in winter than in fall, in terms of volume (p-value=0.001; I2=0%), concentration (p-value=0.016; I2=23.68%), and total sperm count (p-value=0.022; I2=13.95%). Spring had better semen quality than summer in terms of concentration (p-value&lt;0.001; I2=33.74%) and percent of normal morphology (p-value&lt;0.001; I2=0%), and also had higher concentration than fall (p-value&lt;0.001; I2=42.82%). Semen analysis in summer had a lower percentage of total motility than those in fall (p-value=0.045; I2=0%).

Conclusions
Semen parameters follow a seasonal pattern, with winter and spring showing better sperm quality regarding concentration and total sperm count than other seasons.

Disclosure
No.
(307) Prevalence of Sexual Dysfunction and Pursuit of Sexual Medicine Evaluation Among Male Physicians
Authors: Lin J , Greenberg D , Dubin J , Aguiar J , Brannigan R , Halpern J 
Published: February 2024

Abstract

Introduction
While the epidemiology of male sexual dysfunction in the general population is well studied, little is known regarding the prevalence of sexual dysfunction in male physicians and their likelihood of seeking treatment.

Objective
To characterize the prevalence of sexual dysfunction, evaluation patterns, and barriers to treatment among male physicians.

Methods
Between June 2022 and October 2022, male physicians were invited to complete a questionnaire regarding sexual function. Surveys were disseminated electronically via social media and professional medical societies using Qualtrics (Provo, UT).

Results
235 responses were included in the final analysis. The mean age of respondents was 36.3 ± 7.4 years. 27 (11.5%) reported having seen a doctor for sexual health. Of these 27,11 (40.7%) saw a physician for erectile dysfunction, 8 (29.6%) for low libido, 6 (22.2%) for premature ejaculation, 2 (7.4%) for delayed ejaculation, and 9 (33.3%) for some other concern. An additional 29 (13.9%) respondents considered establishing care for sexual issues but didn’t, mostly due to being too busy (N=18, 62.1%). Of the 56 respondents who had either seen or thought about seeing a physician for sexual health issues, the mean IIEF score was 24.4 ± 8.7 with 18 (32.1%) qualifying as having at least mild ED and 7 (12.5%) having severe ED (Table 2). 46 (19.6%) respondents reported having taken medication to improve erectile function. Only 12 (5.1%) respondents reported having ever been diagnosed with low testosterone. Among the 56 respondents who had either seen or thought about seeing a physician for sexual health issues, those who worked more hours (&gt;60 hours per week) were least likely to see a physician (7.2%) compared to those working the fewest hours (33.3%), p=0.02.

Conclusions
In a cohort of young male physicians, 25.4% had seen or considered seeing a doctor for sexual health concerns, and nearly 1 in 5 had taken medication for erectile dysfunction. Given the highly demanding work schedules, occupational stress, and a variety of other factors associated the medical profession, male physicians appear to be at higher risk for sexual dysfunction than the general population. Moreover, male physicians face significant and unique barriers in access to care for sexual dysfunction.

Disclosure
No.
(308) Vasectomy Regret: Is Having Children Protective?
Authors: Charles D , Dietrich P , Sandlow J 
Published: February 2024

Abstract

Introduction
Vasectomy is reliable form of male contraception with prior data suggesting low levels of regret in child-bearing men. We recently published similarly low regret in childless men. There is a paucity of data comparing these two cohorts head-to-head.

Objective
Compare incidence of post-vasectomy regret in men with children and childless men.

Methods
The records of all patients who underwent vasectomy via a single surgeon between 2006 – 2021 were retrospectively reviewed. We created two cohorts: one of childless and one of child-bearing men. Childless cohort was the limiting factor; thus we randomly chose an equal number from our child-bearing cohort. We analyzed demographics of age at time of vasectomy, marital status, number of children and time since vasectomy. Patients’ regret was queried, both immediately after vasectomy and present day. We devised a 6-question survey inquiring about regret and thoughts on vasectomy reversal and assisted reproductive technology (ART). The questions are listed in Table 1.

Results
There were 4,812 overall patients who underwent vasectomy in this time interval, with 205 (4.3%) who were childless. The response rate for child-bearing men was 41.9% (86/205) and 33.2% (68/205) for childless men. Average age for child-bearing men was 35.3 years and 36.6 years in childless men, with time since vasectomy at time of phone call was 6.2 and 5.5 years, for child-bearing and childless men, respectively. The majority of patients 150/205 (73.1%) were married in both childless, 150/205 (73.1%) and child-bearing, 192/205 (93.6%). Average number of children was 2. When comparing our cohorts, regret rates (answering 4 or 5) immediately were 1.2% in child-bearing vs. 4.4% in childless men (p&lt;0.0001), compared to 3.5% vs. 7.4% in present day regret (p&lt;0.0001).

Conclusions
Regret in childless men is more prevalent than child-bearing men, suggesting raising children is protective.

Disclosure
No.
(309) A Novel Circumferential Reconstructive Surgery For Male Erection Restoration and Corporoplasty Based on De Novo Penile Fibro-vascular Assembly
Authors: Chueh J , Chueh J 
Published: February 2024

Abstract

Introduction
Albeit the present human penile anatomy has remained unchanged for three thousand centuries, and extensive study has been conducted on anatomical architecture and male potency reconstructive strategies for many centuries, it might not above be sustainable.

Objective
Given only evidence can speak volumes, and practice is the criterion for testing truth, we sought to report an innovative circumferential approach for fulfilling penile erection restoration and morphology reconstruction on an ambulatory basis microsurgical in recent years.

Methods
From October 2013 to October 2020, 33 men aged 21–59 underwent penile venous stripping (PVS) and corporoplasty via a circumferential approach on an ambulatory basis. The abridged five-item version of the International Index of Erectile Function (IIEF-5), erection hardness scales (EHS), and cavernosography was used for assessment, as required. 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. Subsequently, a tunic corporoplasty is conducted before and after artificial erection with autologous venous wall bi-layered patches, whereby a water-tight running suture is undertaken for the inner layer and interrupted for the second layer for idealizing penile morphology using 6-0 nylon.

Results
The average follow-up period was 5.1±1.3 years, and the surgery time was 5.2±1. 4 hours, respectively. The radiopacity was unexceptionally enhanced postoperatively. There was a significant difference (P&lt;0.01) between the preoperative (9.8±2.7) vs. Postoperative IIEF-5 scores (20.7±2.3). The EHS improved on at least one scale. The penile shape (&lt;10°) was deemed reported in 93.9% (31/33) patients.

Conclusions
This combination of physiologically penile venous stripping and anatomy-based corporoplasty is ideally suited to the simultaneous restoration of penile erectile function and morphological reconstruction via a circumferential approach.

Disclosure
No.