bluuebunny/crossref_metadata_2025_split huggingface dataset:
(281) Pelvic Floor Dysfunction in Premenopausal Women with Recurrent Urinary Tract Infections
Authors: Jesse E , Van Dorn C , Badreddine J , Rhodes S , Edwins R , Pope R 
Published: May 2023

Abstract

Introduction
Urinary tract infections (UTI) are the most common outpatient infections in the United States. Recurrent urinary tract infections (rUTI) are 30 times more common in women than men, suggesting differences in genitourinary anatomy and physiologic factors exist that could explain an increased susceptibility in females. One in three women are diagnosed with a UTI by age 24, with a recurrence rate of approximately 2.6 infections/year. A bidirectional relationship exists between rUTI and pelvic floor dysfunction (PFD) in women, however, little is known about the role of pelvic floor dysfunction in the pathogenesis of UTI in premenopausal women.

Objective
We aimed to document the occurrence of PFD among a group of premenopausal women with rUTI to further understand the relationship and identify factors associated with pelvic pain and dyspareunia. We hypothesize PFD will have a high prevalence in this population.

Methods
The Electronic Medical Record Search Engine (EMERSE) database for a single institution was utilize to identify eligible patients. Inclusion criteria included women aged 18-49 with an ICD code for UTI, who still have their ovaries, and who have who have seen a urologist, gynecologist, or urogynecologist within the past 5 years. A total of 610 eligible patients were identified and contacted via email and asked to participate in our survey study. The survey included queries on demographics, medical history, personal experience with UTI symptoms, diagnosis, and treatment. Survey responses were analyzed using chi-squared tests to analyze factors associated with dyspareunia. Pelvic floor dysfunction was defined as baseline pelvic pain outside of the context of UTI or dyspareunia. Internal Review Board approval was obtained for this study (STUDY20211407).

Results
Of the 610 women contacted, 65 (10.7%) responded. Outside the context of UTI, 52 (80%) women reported some degree of pelvic pain (Figure 1) and 40 (62%) women reported dyspareunia. The presence of pelvic pain was significantly associated with dyspareunia (90% with dyspareunia vs 64% without, p&lt;0.05). On multivariable analysis, patients with pelvic pain were more likely to have dyspareunia (aOR 6.6). There was no association between degree of dyspareunia and duration, number, or severity of UTI.

Conclusions
PFD is highly prevalent among premenopausal women with rUTI, and screening for pelvic pain and dyspareunia should be performed in this population. Patients who report pelvic pain are more likely to have dyspareunia. Further investigation is needed to evaluate causation between PFD and rUTI in premenopausal women.

Disclosure
No
(288) Risk Factors and Real-World Short-Term Outcomes of a Failed Trial of Void After Rezum in a Multiethnic Population
Authors: Babar M , Labagnara K , Loloi J , Tang K , Ines M , Singh S , Iqbal N , Ciatto M 
Published: May 2023

Abstract

Introduction
A failed trial of void (TOV) following surgery for benign prostatic hyperplasia (BPH) predisposes patients to have trouble voiding, increases hospital stays and office visits, and increases detrusor muscle injury due to bladder over-distention. Rezum is a minimally invasive surgical therapy that utilizes convective radiofrequency water vapor thermal energy to ablate obstructive lobes of the prostate, resulting in improvement in lower urinary tract symptoms (LUTS) secondary to BPH. Identifying risk factors for a failed Rezum TOV can help identify a group of BPH patients who may need to be counseled preoperatively for an increased risk of postoperative urinary retention and therefore have their period of postoperative catheterization extended.

Objective
The purpose of the study was to identify risk factors for a TOV following Rezum and assess the impact of a failed TOV on real-world short-term outcomes.

Methods
A single office, retrospective study was conducted on patients treated with Rezum between December 2017 and October 2019. Patients were included if they had a follow-up for catheter removal after Rezum. Patients were excluded if they were in urinary retention requiring catheterization on the day of the procedure. A urinary catheter was placed in all patients following treatment. Demographic data and outcome measures, including International Prostate Symptom Score (IPSS), quality of life (QoL), International Index of Erectile Function (IIEF)-Erectile and -Orgasmic function, maximum urinary flow rate (Qmax), postvoid residual (PVR), and adverse events were analyzed at baseline, 1-, 3-, and/or 6-months postoperatively. Risk factors were identified through multivariate logistic regression analyses.

Results
A total of 289 patients were included, with the majority being Asian (36.0%), followed by non-Hispanic Black (28.7%), Hispanic (22.5%), and non-Hispanic White (12.8%). Thirty-five patients (12.1%) failed their TOV while 254 (87.9%) had a successful TOV. All patients were given a TOV after a median of 5 days (4-5). Those who failed their TOV spent a mean of 13.7 days (SD: 13.3) with a catheter. Patients who failed their TOV were more likely to get a urinary tract infection (20.0% vs. 4.7%, p 200 ml failed their TOV (40.0%) when compared to patients with a baseline PVR &lt;200 ml (10.9%, p=0.008).

Conclusions
Following Rezum, approximately 1 in 8 patients were not able to pass their initial TOV. Baseline PVR was the only independent risk factor for a failed TOV. Nevertheless, all patients experienced significant relief in LUTS with preservation of sexual function. Patients with large baseline PVR, particularly &gt;200 ml, should be counseled on possibly failing their TOV and requiring a catheter for an extended period. These patients should also be counseled on alternative BPH treatment options for which they may be a better candidate for.

Disclosure
No
(292) Impact of Urinary Incontinence on Sexual Function in Patients Presenting for Lower Urinary Tract Symptoms
Authors: Fallara G , Boeri L , Candela L , Costa A , Capogrosso P , Cazzaniga W , Schifano N , Pozzi E , Belladelli F , Cignoli D , Colandrea G , Lanzaro F , Bertini A , Cornelius J , Abbate C , Mattei A , Montorsi F , Salonia A 
Published: May 2023

Abstract

Introduction
Patients with low urinary tract symptoms (LUTS) frequently complain some sexual dysfunction and sometimes even episodes of bothersome urinary incontinence (UI).

Objective
We aimed to assess the relationship between UI (as measured with the ICIQ-UI-SF), and sexual disfunction (as measured with the IIEF), in men presenting with LUTS at a tertiary-referral centre.

Methods
In this cross-sectional study, data were retrospectively retrieved from 938 consecutive patients aged &gt;18 years seeking first medical help for self-reported LUTS (i.e., all patients had IPSS≥1). All patients had a complete clinical assessment and completed the IPSS, the ICIQ-UI-SF, the OAB-q and the IIEF questionnaires. Patients were stratified into “no UI” (ICIQ-UI-SF=0), “mild UI” (ICIQ-UI-SF=1-7), “moderate UI” (ICIQ-UI-SF=8-13) or “severe UI” (ICIQ-UI-SF=14-21). ANOVA test assessed differences in baseline characteristics among these groups. Spearman correlation test was applied to evaluate the correlation between ICIQ-UI-SF and IIEF domain scores. A linear regression analyses tested putative risk factors associated with increased ICIQ-UI-SF scores.

Results
Of 938, 589 (63%) patients had no UI, 237 (25%) had mild UI, 76 (8%) moderate UI and 36 (4%) severe UI. There were no substantial differences in total PSA levels and uroflowmetry parameters among UI groups, whereas prostate volume, IPSS and OAB-q scores were higher as UI symptoms increased (all p≤ 0.03). A negative correlation was found between IIEF-total, IIEF-Erectile Function, IIEF-Intercourse Satisfaction and IIEF-Overall Satisfaction scores and ICIQ-UI-SF scores (i.e., the worse UI symptoms, the worse the overall sexual function (rho= -0.12; p&lt;0.001), IIEF-EF (rho= -0.15; p&lt;0.001), IIEF-IS (rho = -0.1; p=0.004) and IIEF-OS (rho = -0.12; p&lt;0.001). Sexual desire and orgasmic function domains were not correlated with ICIQ-UI-SF. Finally, higher BMI (Coeff 0.12; 95% CI 0.03-0.32; p=0.011), diabetes (Coeff 1.76; 0.35-3.18; p=0.015) and presence of comorbidities (Coeff: 0.9; 0.06-0.1.74; p=0.035) were associated with higher ICIQ-UI-SF scores. Main limitations of the study were that ICIQ-UI-SF does not discriminate between urge or stress UI.

Conclusions
In patients presenting with LUTS, the presence of urinary incontinence was associated with worsening of overall sexual function (i.e., erectile function, intercourse satisfaction and overall satisfaction).

Disclosure
No
(304) Relevance of Self-masturbation-related vs. Coital Erectile Function in the Real-life Management of Patients with Erectile Dysfunction
Authors: Fallara G , Pozzi E , Belladelli F , Corsini C , Raffo M , Candela L , Costa A , Cignoli D , Schifano N , Lanzaro F , Bertini A , D'arma A , Capogrosso P , Boeri L , Cazzaniga W , Matloob R , Montorsi F , Salonia A 
Published: May 2023

Abstract

Introduction
The Masturbation Erection Index (MEI) has been recently validated in the setting of the investigation of men presenting with erectile dysfunction (ED).

Objective
We sought to analyze the correlation between MEI and the findings of the widely used International Index for Erectile Function (IIEF) in a cross-sectional study in men seeking medical help for ED.

Methods
Data from the last 87 consecutive men presenting for ED at a tertiary referral centre were analyzed. All patients were asked to complete both IIEF and MEI at the same time. Complete sociodemographic and clinical data were collected. ED severity was defined according to Cappelleri’s criteria. Linear regression model tested the association between MEI, IIEF total and IIEF domains scores. Violin plot was used to display distribution of MEI scores into IIEF-EF categories. Loess curve was applied to investigate the probability of MEI to predict ED as a function of age.

Results
Median (interquartile range [IQR]) age at presentation was 44 (3.5-53.5) years. According to IIEF-EF scores, ED severity was: no ED in 9 (10%), mild ED in 14 (16%), mild-to-moderate ED in 19 (22%), moderate ED 12 (14%) and severe ED in 33 (38%) patients, respectively. The more severe the ED, the higher the MEI scores (Figure 1); indeed, median MEI scored 7 (3-8) in men with no ED and 19 (10-26) in men with severe ED (p&lt;0.05). Of note, 16 patients (18%) depicted low MEI scores (i.e., under the median), but moderate or severe ED as for their IIEF scores. Finally, a univariable negative association between MEI scores and IIEF-overall satisfaction and IIEF-intercourse satisfaction scores was found [i.e. the higher the MEI scores, the lower the intercourse and overall sexual satisfaction (p&lt;0.001)]. Although MEI decreased throughout aging, it was not significantly different in younger vs. older men with ED.

Conclusions
As expected, there is a strong association between IIEF and MEI scores, which does not lower with aging. Of all, one out of 5 patients presented with lower overall and intercourse satisfaction notwithstanding high MEI scores, thus outlining the clinical relevance of both investigations in the real-life setting.

Disclosure
No
(308) Oxytocin Troches as an Adjunctive Intervention to Conventional Testosterone and Erectile Dysfunction Medication for Men with Sexuality Concerns
Authors: Krychman M , Ayers R , Allshouse A , Ramos E 
Published: May 2023

Abstract

Introduction
Oxytocin (OT), a peptide hormone, is known to be involved in social interaction and the pleasure we derive from it is produced from the posterior pituitary. This neurotransmitter has a potential role in love, female reproductive functions, and social bonding. OT is released by both males and females, during skin to skin contact sexual arousal and orgasm/ejaculation (1,2). OT effects on the brain are dependent on its interactions with sex homes such as estrogen, progesterone, testosterone, and corticosterone. Oxytocin levels are implicated in male sexual responsivity. Oxytocin biological effects may include decrease social anxiety, increased pair bonding, intimacy and closeness enhance sexual receptivity, enhance perineal contractility, enhances pair bonding, nurturing, trust “cuddle hormone, increased intensity of orgasm in men and women, decreased latency to orgasmic release, increased pleasurable sensations and increased sexual desire and lubrication. Oxytocin troches have been used as an off label investigational compounded oxytocin as an adjunctive therapy for men’s sexual health.

Objective
We report the preliminary responder analysis results of a random retrospective survey on users of this medication.

Methods
A random convenience sample of 26 men from 5 centers ( Hawaii, Washington, Portland, Salt Lake City and Tulsa) who tried compounded oxytocin were surveyed. Surveys were anonymous, and participation was voluntary and uncompensated. Doses of Sublingual oxytocin were to be titrate up from 25 international units (IU) for optimization, but not to exceed 100 IU)

Results
Fourteen out of 26 participants (56%) were considered responders. Mean age was 43 and range was 22-77. Eighty-six of the participants had used between 50 IU and 100 IU and 50% were on TRT replacement whereas 57% were on Erectile medications. Only 21% were on both ED medications and TRT replacement. 86% of responders reported enhanced intimacy and connection with their partners, 100% would recommend the product to their friends. 93% of users planned to continue the medication. 86% noted increased overall pleasure and sexual satisfaction. 86% reported improved overall quality of their orgasm. There were no adverse events reported. Responders reported positive feedback which included: longer lasting before orgasmic release, increased nipple sensation, improved control with premature ejaculation, improved feelings during climax and increased ejaculate volume.

Conclusions
Oxytocin compounded troches appear to be a helpful addition to a preexisting treatment paradigm for erectile difficulty or testosterone replacement. This is a preliminary report with small numbers, and further larger randomized clinical trials are warranted and planned.

Disclosure
No
(319) The Pandemic, Telemedicine, and Andrology: What Have We Learned?
Authors: El-Achkar A , Hammad M A M , Nguyen T , Barham D W , Jenkins L , Yafi F A 
Published: May 2023

Abstract

Introduction
Telemedicine has gained wide acceptance during the COVID-19 pandemic. It was critical for patient care when lockdowns were implemented worldwide. While there has been evidence to suggest that urology patients were receptive to telemedicine, no systematic review has been done to date on andrology patients and their perception of telemedicine.

Objective
To assess the perception of andrology patients to telemedicine during the COVID-19 pandemic

Methods
Three electronic databases: PubMed, Scopus, and Web of Science, were searched from their inception until June 2022 for relevant articles. Two independent teams reviewed abstracts and extracted data from the selected manuscripts. A meta-analysis was completed in line with PRISMA 2020 and AMSTAR Guidelines. For our study, we limited telemedicine to communication through videoconferencing or telephone encounters between patients and medical professionals. Positive response to telemedicine was defined as patients “wishing for telemedicine consultation”, “preferring telemedicine over in person”, “accepting the current telemedicine arrangement”, “having needs addressed with teleconsultation”, or “willingness to do a teleconsultation”.

Results
Of the 1128 retrieved abstracts, 56 underwent full-text review and 11 were included in the final analysis, comprising a total cohort of 2195 cases. Video visits were used in 7 studies, 2 used only telephone encounters, and one used both methods. 3 studies showed andrology and sexual medicine are compatible with telemedicine with a few 30 and 90-day in-person revisit rates. Telemedicine was shown to save an average cost of $149-252 per patient. All 8 studies that assessed the perception of andrology patients to telemedicine showed that most patients had a “positive perception”. Pooled analysis of the positive response to telemedicine was 73.7% (Figure 1) and that of patients who recommended telemedicine was 58.5%. While the percentage of patients (97%) recommending telemedicine is high among studies using videoconference, the percentage drops to 26.3% in studies using telephone visits only. In the latter group, up to 27.1% of patients preferred in-person visits, with security and privacy of either mode of telecommunication being a concern.

Conclusions
Most patients have a positive perception of telemedicine, particularly with videoconferencing, and less so with telephone visits. These results suggest that telemedicine will likely continue to play a pivotal role in andrology and sexual medicine practices.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast, Clarus Therapeutics, Antares Pharma, Acerus, Hims & Hers Health, Inc.
(330) Trends of Reporting Premature Ejaculation Among Men with Erectile Dysfunction – Findings From a Real-life Cross-sectional Study
Authors: Pozzi E , Fallara G , Belladelli F , Corsini C , Raffo M , Candela L , Costa A , Cignoli D , Schifano N , Bertini A , Lanzaro F , D'arma A , Capogrosso P , Boeri L , Ventimiglia E , Matloob R , Montorsi F , Salonia A 
Published: May 2023

Abstract

Introduction
Patients with erectile dysfunction (ED) may have an increased risk to report concomitant premature ejaculation (PE)

Objective
We aimed to explore the trend of reporting PE across three different age groups of a homogenous cohort of men seeking first medical help for ED (&lt; 40 yr, 40-60 yr, &gt; 70yr) over a 16-year period at a single tertiary academic centre.

Methods
Complete data of 1258 men consecutively assessed for ED as primary complaint by a single Sexual Medicine expert between 2005 and 2021 were analysed. Patients were divided into three age categories: i) &lt;40 years, ii) 40-69 years, and iii) ≥ 70 years. All patients were assessed with a comprehensive medical and sexual history. Comorbidities were scored with the Charlson Comorbidity Index (CCI). All patients completed the International Index of Erectile Function (IIEF) at baseline. Between the three groups i) descriptive statistics tested the sociodemographic and clinical differences; ii) regression models tested the probability of reporting concomitant PE over time; and, iii) local polynomial regression models graphically explored the probability of reporting PE (primary/secondary) together with ED over the analysed time frame.

Results
Overall, median (IQR) age was 51 (40-61) years. Of all, 326 (25.9%) reported either life-long or acquired PE at time of first clinical assessment. Among the three age groups (70) there were no significant differences in terms of baseline IIEF domains. Younger patients reported higher rates of PE in respect to older ones (0.5% vs. 0.4% vs. 0.3%, p=0.001). Logistic regression analysis showed a statistically significant trend of reporting PE over the years among the &lt; 40yr (OR: 1.4; 95%CI: 1.3-1.5) and 40-69yr (OR: 1.3; 95%CI: 1.2-1.4) groups respectively (all p&lt;0.0001). A not significant trend was found in the ≥ 70yr group. Figure 1 graphically displays the probability of reporting PE in the whole cohort and among the three age-matched groups between 2005 and 2021.

Conclusions
Almost one out of four patients seeking first medical help for ED also reports to suffer from PE. The probability of reporting PE (either primary or secondary) has been exceptionally increasing over the last 15 years among young (&lt;40) and middle-age (40-69) men with ED. This finding is of major clinical relevance in order to a better tailored therapeutic work-up in the real life setting.

Disclosure
No
(337) The Impact of COVID-19 Related Restrictions on the Prevalence of Intimate Partner Violence in the Republic of Armenia
Authors: Sahakyan S , Grigoryan A , Azatyan R , Hakobyan A 
Published: May 2023

Abstract

Introduction
Intimate partner violence (IPV), which is domestic abuse committed by an intimate partner, is the most prevalent type of violence against women. Growing evidence shows that the incidence of IPV has increased since the application of COVID-19 related restrictive measures. Evidence from past pandemics and crises has revealed that the most common factors that increase the risk for violence include economic insecurity, poverty-related stress, job loss or reduced working hours, quarantine, and social isolation.

Objective
This research aimed to identify the impact of COVID-19 related restrictive measures on the prevalence of IPV during the pandemic in the Republic of Armenia.

Methods
This study was an online cross-sectional survey conducted as part of the second round of the International Sexual Health and Reproductive Health (I-SHARE), a series of surveys conducted in more than 30 countries to study sexual and reproductive health during COVID-19 measures. The instrument consists of 14 sections of which only the IPV section was used for this analysis. In order to be eligible for the study the participants had to be 18 years of age or older, currently reside in the Republic of Armenia, speak Armenian, and be able to provide informed consent online. The data collection was conducted during a 4-week period (from 22 October until 20 November 2021).

Results
Overall 296 people participated in this study of which 196 (66.2%) were female at the time of birth. 14% of the respondents were physically abused by their partner at least once during the last three months. Meanwhile 13% of the respondents were sexually assaulted many times of which 72.4% were also physically abused during the same period. 30% and 33% of people who were physically and sexually abused, respectively, began to experience more violence after COVID 19 restrictions.

Conclusions
To the best of our knowledge, this is the first study to examine the incidence and prevalence of IPV as a result of COVID-19 related restrictive measures in the Republic of Armenia. It is worth noting that approximately one third of the people who were physically and/or sexually abused, began to experience more violence after the COVID-19 restrictions. Meanwhile, the situation with sexual and physical violence among the majority of people who are silent about violence has generally worsened since the restrictions of COVID-19.

Disclosure
No