bluuebunny/crossref_metadata_2025_split huggingface dataset:
(017) Patient Reported Outcome Measures in Prostate Cancer Patients Treated with Focal Therapy Modality
Authors: Marciano O , Jung D , Pathuri M , Ikedionwu I , Le B , Raheem O 
Published: February 2024

Abstract

Introduction
Although focal therapy as a treatment modality for prostate cancer patients has been increasing in the United States, there has been a paucity of patient reported outcome measures (PROM) specific to urinary, erectile, and sexual function.

Objective
We aimed to systematically review the data of long-term PROM in men undergoing focal therapy for prostate cancer since 2019.

Methods
A web search was performed on the PubMed database. The search was limited to articles published in the English language and reporting focal therapy outcomes between 2019 and 2023, including randomized controlled trials, prospective and retrospective studies. The following data were extracted from each study: year, type of focal therapy, design, participants, demographic, IIEF, ED proportion, IPSS, EPIC, pad incontinence use, fistula rate, urinary retention rate, hematuria, Gleason scores, time to oncologic follow-up, recurrence, and presence of cancer after treatment.

Results
Twenty-three studies, consisting of cryotherapy, HIFU, TULSA, focal and microwave ablation met the inclusion criteria and were reviewed. Oncologic outcomes were reported in 17 of 23 studies. Median follow-up ranged from 3 to 42 months. Main oncologic outcomes analyzed were in-field/out-of-field recurrence and presence of prostate cancer after treatment. The two largest HIFU studies (n=90, n=101) had 9% and 24% respectively for clinically significant recurrence. The two focal microwave ablation studies (n=55, n=5) had 9% and 20% recurrence rates respectively. Functional outcomes were assessed by IPSS and IIEF. IPSS scores were consistent, with most studies reporting only minimal changes in IPSS after treatment. IIEF scores were generally consistent before and 6 months after procedure for all studies, with some reporting only marginal declines in erectile function. Complication rates among studies were low. Nine studies reported UTI rates ranging from 0% (n=6, n=41) to 30% (n=10) in a TULSA prospective study. Urinary retention rates were reported in 14 studies, with a range from 0% (n=41) to 30% (n=10).

Conclusions
This review suggests that focal therapies remain safe and effective treatment modality for patients with low-intermediate risk prostate cancer. PROM pertaining to urinary and erectile functions in men undergone focal therapy modality seems to be adequate without worse oncological or complication outcomes. Larger data with oncological and functional outcomes is warranted to further validate its safety and efficacy over a longer follow up period.

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(019) Malignant Priapism: Case Report and Update on Management Protocols
Authors: Tabei SS , Baas W , Brooks A , Kim EH , Smith Z , Murphy G 
Published: February 2024

Abstract

Introduction
Malignant priapism is a rare condition characterized by persistent erection resulting from the invasion or metastasis of a primary neoplasm. Penile metastases arise from the genitourinary tract 64% of the time (bladder: 28.6%, prostate: 27.9%, kidney: 6.9%, ureter: 0.5%) with colorectal adenocarcinoma, lung cancer, melanoma, and hematologic diseases comprising the remainder. Malignant priapism is reported to occur in 20-53% of patients with penile metastasis. The mechanism of malignant priapism remains unknown. The most accepted theory is an invasion of the corpus cavernosum as well as associated venous systems with malignant cells. This can occur from either hematogenous or lymphatic spread from the source tumor. Resulting derangement of arterial or veno-occlusive mechanism causes priapism. Both ischemic and non-ischemic priapism can occur.

Objective
While treatment guidelines for priapism in non-malignant cases have been established, there is currently no guideline for treating malignant priapism. This study aims to present three cases of malignant priapism resulting from advanced genitourinary cancers and evaluate the efficacy of palliative penectomy as a treatment modality for relieving symptoms associated with malignant priapism.

Methods
We conducted a retrospective analysis of three cases of malignant priapism associated with advanced genitourinary cancers. Data were collected from medical records, including patient demographics, primary tumor characteristics, clinical presentation, treatment modalities, complications, and outcomes. The main treatment approach utilized in all cases was palliative penectomy. Symptom relief and complications were assessed as primary outcomes.

Results
All three patients presented with progressive penile pain, and imaging studies confirmed the presence of metastatic disease involving the penile structures. Palliative penectomy was performed in all cases, resulting in sustained relief of symptoms. No major complications were reported during the surgical procedures. Follow-up assessments showed improved quality of life in terms of pain relief, but all patients died within a short period following penectomy owing to the advanced predisposing malignancy. (figure 1)

Conclusions
Treatment of malignant priapism needs to be individualized to the needs of the patient. No matter the primary or secondary nature of the disease, current data suggest that malignant priapism is associated with poor outcomes, and emphasis should be put on palliative care. Although new radiation techniques have shown favorable outcomes, penectomy should be considered the last resort in clinical management. Revisions to the existing management guidelines for priapism are necessary to address its occurrence in malignant contexts. (figure 2)

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(045) Comparing Bacterial Presence with the Usage of 0.05% Chlorhexidine Gluconate (CHG) Lavage During Urologic Prosthesis Revision Surgery: Update on Results
Authors: Henry G , Stuart A , Tong L , Stuart A , Karpman E 
Published: February 2024

Abstract

Introduction
An Inflatable Penile Prosthesis (IPP) is third line surgical therapy for refractory ED. An IPP uses a fluid-filled reservoir with a pump and valve system to activate inflation and deflation. Although penile implants achieve the highest success rates in ED treatment, the possible presence of bacteria on the device itself or bacteria exposure accumulated during the surgery increases the risk of progression into biofilm or infection. Biofilm complicates the bacteria eradication effort and can ultimately jeopardize the implant. Often, the only way to treat the post-op infection is with implant removal. Currently, many preventative measures, such as different perioperative irrigations, are being studied to reduce the number of penile implant infections. Research has shown that irrigation at the time of both infectious and noninfectious surgery lowers subsequent infection rates. Different solutions like saline, antibiotic, betadine, and hydrogen peroxide solutions have been considered. Recently, orthopedic literature has shown that 0.05% Chlorhexidine Gluconate (CHG) lavage has effectively reduced biofilm in artificial joint procedures.

Objective
The purpose of this study is to determine the effectiveness of CHG lavage on bacterial presence in IPP implant spaces. We hypothesize that CHG will lower bacterial presence after washing out implant spaces at time of replacement for infections and mechanical failure.

Methods
We aimed to investigate a series of patients who underwent revision IPP surgery while utilizing FDA-approved CHG lavage for irrigation and compared the bacterial presence before and after CHG washout. Additionally, Next Generation Sequencing (NGS), a DNA sequencing technology, was used to further identify the pathogens involved.

Results
Between 2021 to 2023, 48 patients underwent IPP revision surgery for either infectious or noninfectious reasons. During the operation, a section of the capsule tissue surrounding the implanted IPP pump was first taken and sent for cultures. NGS studies were also sent out. After the implant removal, all implant spaces were irrigated and washed out with CHG (two 450-mL bottles). A second tissue culture was then obtained post washout. Of the 48 patients, there were 4 positive bacterial cultures before washout and 13 positive NGS results. Results of the post CHG washout cultures were all negative.

Conclusions
It appears that irrigation with 0.05% Chlorhexidine Gluconate solution is an effective antiseptic that can decrease bacterial presence, and hopefully reduce IPP infections.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Microgen Dx, Irrisept.
(058) Detection and Transcriptional Profiling of Mesenchymal Stem Cells in Peyronie’s Plaque Explants
Authors: Garabed LR , Witherspoon L , Soltani R , Robinson M , Roberts M , Hach F , Flannigan R 
Published: February 2024

Abstract

Introduction
The mechanisms behind the pathogenesis of Peyronie’s disease largely remain a mystery. Plaques have largely been thought to be derived from epithelial to mesenchymal transformation of fibroblasts to myofibroblasts.

Objective
We sought to transcriptomically profile explanted cells from Peyronie’s plaques and evaluate their profiles with transforming growth factor B (TGF-B) stimulation.

Methods
Peyronie’s plaque were excised from 3 patients undergoing penile incision and grafting surgery. Cells were explanted from biopsy tissue and propagated. Cells were profiled using single cell RNA sequencing (scRNAseq). These cells were then exposed to TGF-□ to simulate the active phase of Peyronie’s disease, and profiled with scRNAseq at baseline and 24 hours following TGF-□□ stimulation. We used principle component analysis (PCA) to reduce the dimension of data and built the nearest-neighbors graph using PCA weights. We performed clustering over the nearest-neighbor graph and visualized the clusters using UMAP algorithm. Differential gene expression and pathway analyses were performed using the top 50 genes with increased expression between 0- and 24-hour time points. Multi-channel flow cytometry and immunofluorescence were used for mesenchymal stem cell (MSC) phenotypic validation.

Results
Assessment of cell clustering identified profiles of fibroblasts, myofibroblasts, smooth muscle, and mesenchymal stem-like cells. We further confirmed rare presence of mesenchymal stem cells using multi-channel flow cytometry in our cultured cells and plaque biopsies. Differential gene expression of the 50 genes showing the greatest induction showed that genes involved in cellular binding and catalytic activity were most commonly upregulated following introduction of TGF-B.

Conclusions
This analysis provides unique insight into the expression profiles of Peyronie’s plaque cell populations explanted in culture and stimulated via TGF-B to activate myofibroblasts akin to the active phase of Peyronie’s disease. Using the information gained from this single-cell RNA sequencing analysis ongoing efforts can be performed to identify therapeutic targets for active phase Peyronie’s disease.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast; Boston; Teumo Health Technologies.
(072) Comparing Risk of Post-Infection Erectile Dysfunction Following SARS Coronavirus 2 Stratified by Acute and Long COVID, Vasopressor Administration, and Hospitalization Status
Authors: Grutman A , Gilliam K , Maremanda A , Able C , Choi U , Kohn T 
Published: February 2024

Abstract

Introduction
While multiple studies have shown an association between acute COVID-19 infection and subsequent development of erectile dysfunction (ED), no study has yet assessed the risk of developing ED after a diagnosis of long COVID. It is unclear if there is an increased risk of ED in those with long COVID compared to only those diagnosed with acute COVID. In addition, the impact of vasopressor use and hospitalization for an acute COVID infection on ED development is uncertain.

Objective
This study sought to assess the risk of ED in individuals with acute COVID-19 when compared to individuals with long COVID-19, as well as risk of ED following more severe cases requiring vasopressors and hospitalization.

Methods
The TriNetX COVID-19 Research Network was queried from December 1st 2020 through June 2023. We included men aged ≥ 18-years old and analyzed cohorts comparing the following 1) men diagnosed with long COVID-19 (ICD-10: U09) were compared to those that were diagnosed with or had positive test for acute COVID-19 but no diagnosis of long COVID. Men were included if they had at least one outpatient follow-up visit 2 weeks after the initial positive test result and excluded if they received a prior ED diagnosis or treatment, prostatectomy, pelvis radiation, or pulmonary hypertension diagnosis at any time. Additional analyses were performed with the same above criteria including men that were and were not hospitalized within 1 month of acute COVID diagnosis and whether men needed vasopressors or not. Cohorts were propensity score matched and compared for differences in new ED diagnosis and/or prescription of phosphodiesterase-5 inhibitors (PDE5i). Variables on which propensity scores were matched are detailed in Table 1.

Results
A total of 2839 men were included in each cohort after propensity score matching with an average age of 54.5 +/- 16.7 years and 55.1 +/- 17.1 years in the long and acute COVID cohorts, respectively. Men diagnosed with long COVID-19 were more likely to develop ED or be prescribed PDE5i (3.63%) when compared to men with only acute COVID-19 infections (2.61%) [RR 1.39; 95% CI 1.04, 1.87]. There was no statistically significant increased or decreased risk of developing ED or being prescribed PDE5i for individuals who received vasopressors [RR 0.922; 95% CI 0.774,1.098] or were hospitalized [RR 0.933; 95% CI 0.824,1.056].

Conclusions
We found that long COVID-19 infection was associated with greater risk for ED diagnosis or PDE5i prescriptions when compared with men diagnosed with only an acute COVID-19 infection, while there was no significantly increased risk for individuals requiring vasopressors or hospitalization.

Disclosure
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(100) Urinary and Gynecologic Adverse Events Associated with Ssri Use
Authors: Grzyb C , Durrani K , Boyd Md S 
Published: February 2024

Abstract

Introduction
SSRIs are the most prescribed psychiatric drug in the United States, with approximately 40% of patients reporting side effects to their provider (1,2). It is accepted that side effects of SSRIs may include sexual dysfunction, including decreased libido and anorgasmia (3,4). However, the safety of SSRIs on the functions of the genitourinary and reproductive systems in real-world settings remains unclear.

Objective
The aim of this study was to identify urinary and gynecologic adverse events associated with SSRIs using data from the FDA Adverse Events Reporting System (FAERS). Secondarily, we identify variability of adverse events across individual SSRIs.

Methods
A specialized software to analyze adverse events, OpenVigil 2.1, was used to query the FAERS data. We defined 445 search terms related to genitourinary and reproductive system related events. We performed disproportionality analysis to identify associations between search terms and SSRIs as a class, then each SSRI (fluoxetine, sertraline, paroxetine, escitalopram, citalopram). Subgroup analysis was performed to stratify adverse events by age.

Results
Adverse events related to SSRI usage include a variety of genitourinary and reproductive system related side effects, not limited to sexual dysfunction. Gynecologic bleeding, urinary retention, hypersexuality emerged as surprisingly statistically significant signals across females. Statistically significant adverse events related to sexual dysfunction were present up to age 60, with the strongest signals found in the 40-59 years age group. Urinary symptoms were most prevalent in the 0-18 years and over 60 years age group. Of the SSRIs, citalopram had the strongest association with sexual disorders and dysfunction.

Conclusions
In this study, we offer the most granular side effect profile of SSRIs related to the urinary and reproductive systems to date. While the pathophysiology of each adverse event remains unclear, an understanding of potential risks of these drugs is valuable in the management of patients taking SSRIs, particularly in the event of rare side effects that are often not associated with SSRI use. These are important considerations for clinical practice as side effects of SSRIs can impact treatment compliance and patient quality of life. References 1. Cascade EM, Kalali AM, Kennedy SHMF. Real-World Data on SSRI Antidepressant Side Effects. Psychiatry. 2009;16–8. 2. US National Library of Medicine. Mental Health Medications. National Institute of Mental Health. 2022. 3. Segraves RT. Sexual Dysfunction Associated with Antidepressant Therapy. Vol. 34, Urologic Clinics of North America. 2007. p. 575–9. 4. Rosen RCP, Lane RMM, Menza MM. Effects of SSRIs on Sexual Function: A Critical Review. J Clin Pharmacol. 1999;19(1):67–85.

Disclosure
No.
(109) Characterization of Traditional and Household Items Used Globally for Sexual Pleasure Amongst Adults
Authors: Ikedionwu I , Jung DH , Sun J , Pearlman A , Raheem OA 
Published: February 2024

Abstract

Introduction
Sexual health is an important aspect of overall health. Though sex toys are commonly used by people of all genders, little research exists to explore their safety and efficacy when it comes to optimizing pleasure and improving sexual function in various patient populations. Global barriers to use of sex toys, including limited access, legality, and cost, also have important implications on people being able to use these devices. Household devices have been used, likely as they provide more accessible, cost effective means of optimizing pleasure, though no research exists to assess safety and efficacy of such items.

Objective
The purpose of our study is to categorize the demographics, usage, behaviors, and safety concerns of adults who use traditional and household items for sexual pleasure.

Methods
An electronic survey was distributed across several Reddit forums, including r/sex, r/menshealth, and r/womenshealth. People who consented were 18 years of age or older and those who answered “yes” to having used household item(s) for sexual pleasure were invited to participate in the survey. Demographic information was collected about survey respondents. Types of traditional and household tools used for sexual pleasure were also recorded along with degree of satisfaction, cost, and safety concerns for each item used.

Results
Two hundred thirty-four people responded to the survey over a 72 hour period. Seventy-five percent of those who started the survey, completed it. Participants were most commonly from the United States (40%), Canada (7%), and the United Kingdom (5%). Forty-eight percent did not specify their country of residence. Fifty-five percent of respondents were between the ages of 18 and 45, with an almost even split between men (30%), women (36%), and not specified (35%). The most popular traditional sex toys used were vibrators (n=112), dildos (n=90), and anal toys (n=70). Showerheads (n=92), pillows, (n=52), and electric/pulsating toothbrushes (n=50) were the most common household items used for sexual pleasure. The leading safety concerns were cleanliness and hygiene (n=87) followed by allergies and insensitivity (n=50).

Conclusions
The global sex toy market is a multi-billion dollar industry. The sexual medicine literature is expanding to now include the use of sex toys and tools in various patient populations, though much is still unknown, particularly when it comes to the use of household items used for pleasure. Our study suggests that use of traditional and household items for sexual pleasure can be both safe and effective. When considering global barriers to the use of sex toys, understanding the safety and efficacy of household items is critical, as these may expand our armamentarium of tools to offer patients.

Disclosure
No.
(112) Efficacy and Safety of Platelet-Rich Plasma Injections for Peyronie’s Disease: A Randomized Double-Blind Placebo-Controlled Cross-Over Study
Authors: Ledesma B , Molina M , Velasquez D , Ramasamy R 
Published: February 2024

Abstract

Introduction
Peyronie's Disease (PD) is currently treated with intralesional collagenase injection, the only FDA-approved medical therapy. Platelet-derived therapies, such as autologous platelet rich plasma (PRP), have shown potential in tissue regeneration. We are investigating the safety and efficacy of PRP in PD with an ongoing randomized, placebo-controlled, crossover study.

Objective
The objective of this study is to assess the safety and efficacy of autologous platelet-rich plasma (PRP) treatment in Peyronie's Disease (PD) through a randomized, placebo-controlled, crossover trial.

Methods
We analyzed data from an ongoing trial conducted between April 2021 and June 2023. Men with PD (write degrees/dorsal only etc) were randomly assigned to receive two 0.5 ml injections of PRP obtained using an autologous platelet separator (Arthrex Angel, Arthrex Inc.) or placebo directly into the dominant plaque, with a two-week interval between injections. Immediate post-procedure assessments included Visual Analogue Pain Scale, and follow-up evaluations focused on identifying complications. After three months, participants crossed over to the other treatment arm for two additional injections. Goniometer measurement assessments were performed prior to each crossover (NCT04512287). Related Samples Wilcoxon-Signed Rank test was used for dependent repeated groups, the serial measurements of degree of curvature at different time points for each patient within a specific group. Findings at p&lt; 0.05 were considered statistically significant.

Results
The analysis includes data from 29 men who completed all injections and the 6-month follow-up. No minor or major adverse events, such as penile bruising, swelling, edema, allergy, or penile fracture, were reported. Regarding efficacy, we observed a significant reduction in curvature after six months compared to baseline. The pretreatment median curvature was 40.0 (IQR: 15), the median post-treatment curvature 30.0 (IQR: 30) (p=0.014). Furthermore, we did not observe worsening of curvature in subsequent evaluations.

Conclusions
Our findings from our ongoing clinical trial suggest that PRP treatment for Peyronie's Disease is safe, with minimal adverse events reported. The preliminary efficacy data indicates a significant reduction in curvature after 2 injections each of placebo and PRP treatment compared to baseline. Nevertheless, study completion is necessary prior to reporting true efficacy data comparing PRP vs placebo.

Disclosure
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