bluuebunny/crossref_metadata_2025_split huggingface dataset:
(352) Erection Hardness Score (EHS) Correlates With Resistive Index but Not Cavernosal Artery Dilation During Penile Doppler for Erectile Dysfunction and Peyronie's Disease
Authors: Myrie A , Leelani N , Bole R , Lundy S , Bajic P 
Published: May 2023

Abstract

Introduction
Penile Doppler Ultrasound (PDU) is a non-invasive diagnostic test used to assess organic erectile dysfunction (ED) and Peyronie’s disease and characterize functional changes in penile blood flow. Quantitative measurements taken during penile Doppler testing include changes in cavernosal artery diameter, the velocity of blood flow in the cavernosal artery in systolic and diastolic phases, and a calculated resistive index. It remains poorly understood which of these parameters best predict response to intracavernosal injection therapy and how they are influenced by comorbidities such as age, diabetes, smoking, hypertension, and obesity.

Objective
The objective of this study is to assess which parameters best predict response to intracavernosal trimix injection and determine the utility of measuring cavernosal artery diameter during penile Doppler testing.

Methods
This study is a single institutional retrospective cross-sectional review of men undergoing workup for organic ED and/or Peyronie's disease who elected to undergo penile Doppler testing. Only patients who received a standardized 30-1-10 trimix injection were included. Dosing was determined based on age and risk factors using a nomogram, and redosing was performed if the erection quality was below subjective optimal erection quality at home. Baseline cavernosal artery and plaque imaging were performed, and repeat measurements were obtained at 10 minutes following trimix injection.

Results
93 men were included in the study with a median age of 59 (IQR 51-67). 47% carried a diagnosis of Peyronie's, 41% had hypertension, 29% were obese, and 30% were smokers. 40% met the criteria for venous leak (RI &lt;0.8). Erectile hardness scale (EHS) scores of 1-4 were documented in 5, 21, 61, and 5 patients, respectively. Linear regression demonstrated no significant relationship between the change in cavernosal artery diameter and trimix dose, resistive index, comorbidities or other Doppler parameters measured. There was no direct relationship between the EHS scores and cavernosal artery dilation. However, there was a statistically significant relationship between EHS and age (p=0.004), trimix dose (p=0.008), and resistive index (p=0.001) on univariate regression. A multivariable model containing age, comorbidities, and these parameters correctly explained 31% of the variance demonstrated (p=0.001).

Conclusions
Provider-determined EHS scores were directly proportional to patient age, trimix dose, and resistive indices but not to changes in cavernosal artery diameter. Our findings suggest that this measurement may be safely omitted during the evaluation of organic ED and Peyronie’s Disease without changes in diagnostic or management pathways.

Disclosure
No
(361) Novel treatments for Erectile Dysfunction and Peyronie’s Disease - A Survey of Clinics Across the USA
Authors: Best J , Sencaj M , Thomas J , Zucker I , Ghomeshi A , Ramasamy R 
Published: May 2023

Abstract

Introduction
Over the past several years there has been a rise in the number of clinics offering novel treatments for erectile dysfunction and Peyronie’s disease such as stem cell therapy, platelet rich plasma, and shockwave therapy

Objective
In this study, we attempt to identify to identify experimental treatment approaches for ED and PyD used by various clinics across the country.

Methods
Using a systematic search of online website directories, we identified 26 clinics were surveyed for PRP treatment, 27 for shockwave therapy, and 26 for stem cell therapy A standard questionnaire was used to retrieve information from all clinics regarding cost of treatment, duration of therapy, medical staff involved, and patient outcome data.

Results
We found that the cost of treatment varied widely between groups. PRP cost between $500 to $2400, Shockwave total cost was between $1500 - $7500, and stem cell therapy cost ranged between $3,800 to $16,000 USD. Across all clinics surveyed, a physician was involved in 67% of treatments and over 75% of clinics reported patient satisfaction following treatment.

Conclusions
Although the number of human clinical trials evaluating novel treatments for ED and PyD are limited, several clinics are offering these therapies with promises of success without evidence to support the claims. Our data demonstrates the wide use of experimental therapies for ED and PyD across the US. Clinical outcome data available for patients is largely up to the clinics discretion, and was only given to us in subjective measurements and testimonials.

Disclosure
No
(369) Sexual Satisfaction After Wearable Device Use For Erectile Dysfunction
Authors: Body A , Kyle C 
Published: May 2023

Abstract

Introduction
Erectile dysfunction (ED) is the inability to achieve and maintain an erection firm enough for sexual performance. ED devices such as pumps and constriction devices and prescription oral phosphodiesterase inhibitors are commonly known ED treatments.

Objective
Our aim was to evaluate an alternative therapy for ED for the approximately 80 percent of men who currently do not use any form of the aforementioned ED treatment options. Eddie by Giddy™ is a device that allows patients to use a novel constriction device to enhance the normal physiology of an erection to treat ED. Medical comorbidities such as anxiety, ADHD, obesity, hypertension, diabetes and depression, as well as medications such as antidepressants, anti anxiety medications, opioids and cardiac medications can impact erectile function. Our goal was to specifically evaluate the efficacy of the device in the general patient populations.

Methods
Our research team surveyed 60 male participants (59 who completed the study), 26 to 81 years of age, about their erectile performance over a 12 week period of time, during which participants utilized the Eddie by Giddy device. Participants completed an intake assessment, medical history, and reported on their sexual behavior and erectile performance as they used the device over the 12 weeks, during which patients rated their experience with the device, self-esteem, quality of life changes, the impact on their relationships, frequency of erections, duration of erections and the quality of erections.

Results
Participants showed improvement in all but one question in the survey over the 12 week period, with a particularly higher improvement between weeks 4 and 8, and sustained that improved sexual function and erection quantity and quality through week 12. Of the participants who concluded the study, 95 percent reported having overall positive results from using the Eddie by Giddy device. With respect to the survey questions, participants on average showed a 63 percent improvement in number of times attempting to receive oral sex, a 53 percent improvement in ability to maintain an erection during masturbation, a 52 percent improvement in confidence to perform sexually, and a 47 percent improvement in satisfaction of erections when attempting sexual intercourse.

Conclusions
Attitudes of participants with ED using Eddie® showed strong, significant improvement in erectile function, quality of life, hopefulness for future sex life and overall self-esteem in all categories of patients. Eddie by Giddy use over 12 weeks was shown to improve satisfaction among male participants of sexual health and mental health without the need for oral medication.

Disclosure
Yes, this is sponsored by industry/sponsor: Giddy, Inc

Clarification
Industry funding only - investigator initiated and executed study
Any of the authors act as a consultant, employee or shareholder of an industry for: Giddy, Inc.
(374) Reviewing the Long-Term Effectiveness of Artificial Urinary Sphincter and Urethral Sling Insertion for Post-Prostatectomy Male Stress Urinary Incontinence
Authors: Goetz J , Labagnara K , Cheung T , Loloi J , Babar M , Bernstein A , Davuluri M , Maria P 
Published: May 2023

Abstract

Introduction
Stress urinary incontinence is the second-most common complication male patients face post-prostatectomy. Artificial urinary sphincters (AUS) and urethral slings are two effective surgical treatments recommended for patients with incontinence who have failed conservative therapy. Slings are often preferred in cases of mild to moderate SUI, whereas AUS is preferred in severe cases. Although prior studies have shown the AUS to be superior in restoring continence, few have compared them in a diverse patient population. We aim to determine the effectiveness of both devices both in the short-term and long-term postoperative setting.

Objective
To review the 1 and 3 year effectiveness of both AUS and urethral slings in post-prostatectomy patients, measured as the change in median pads per day.

Methods
This was a single-institution retrospective chart review study of 124 patients who received either an AUS or sling between the years 2015-2022. Patients were divided into one of two groups depending on if they underwent surgery for a urethral sling or AUS. Demographic, intra-operative, and post-operative characteristics were collected. Median pads used per day was the primary measure of outcome. A two-sample t-test, chi-square, or Mann-Whitney U test was used to compare baseline characteristics based on distribution normality. Wilcoxon signed-rank tests were used to compare 1 and 3 year pad usage to baseline.

Results
A total of 116 patients were included, of which 72 (62.1%) underwent sling placement while 44 (37.9) received an AUS. Patients receiving an AUS were older (67.2 [7.5] vs 64.0 [7.1], p=0.024), had a higher rate of prior radiation therapy (29.5% vs 11.1, p=0.012), and used more pads per day preoperatively (3 [2-5] vs 2 [1-3], p&lt;0.001). Patients with an AUS showed statistically significant lower usage of pads per day at 1 year (1 [0-2]; p&lt;0.001) and 3 years (2 [1-3]; p&lt;0.017). The sling cohort showed a significant difference at 1 year (1 [0-1]; p&lt;0.001) but not at 3-years (1 [0-2], p=0.123).

Conclusions
Post-prostatectomy insertion of an AUS results in a significant improvement to continence at 1 and 3 years, while the urethral sling is only significantly effective at 1 year.

Disclosure
No
(378) Still One Out of Five Men Presenting for Erectile Dysfunction are Young than 40 years of Age: Findings of a Real-life Cross-sectional Study over Last Decade
Authors: Pozzi E , Capogrosso P , Fallara G , Boeri L , Belladelli F , Corsini C , Cignoli D , Bertini A , Lanzaro F , Raffo M , Candela L , Schifano N , D'arma A , Matloob R , Montorsi F , Salonia A 
Published: May 2023

Abstract

Introduction
Erectile dysfunction (ED) has been demonstrated to be reasonably prevalent among young men (≤40 yr).

Objective
We aimed to i) assess changes in patterns of reported ED in men ≤ 40 yr, and ii) compare the sociodemographic and clinical characteristics of ED men ≤ 40 yr vs. &gt; 40 yr of age over a 8-yr period at a single academic centre.

Methods
Comprehensive data of 1179 patients seeking first medical help for ED and assessed by a single Sexual Medicine expert between 2013 and 2021 were analysed. Health-significant comorbidities were scored using the Charlson comorbidity index. All patients completed the International Index of Erectile Function (IIEF) at baseline. Descriptive statistics tested the sociodemographic and clinical characteristics of ED men ≤ 40 yr vs. &gt; 40 yr of age. Within the two groups, multivariable linear regression models tested the association between advancing age and IIEF scores. Local polynomial regression models were applied to explore and graphically display ≤ 40 yr patients’ likelihood to report ED over the analysed time frame and to display changes of the IIEF-EF scores over increasing age between the two groups (≤ 40 yr vs. &gt; 40 yr).

Results
Overall, median (IQR) age was 52 (41-62) yr. Median (IQR) IIEF-EF was 18 (15-22) at baseline. Of all, 268 (22.7%) were ≤ 40 yr whereas 911 (77.3%) were &gt; 40 yr at baseline. Rates of severe ED according to IIEF-EF did not differ between men ≤ 40 yr and &gt;40yr (60 (22.4%) vs. 155 (17%)). No significant differences were found for the IIEF domains (-IS, -OS, -SD) but IIEF-OF domains, which scored higher in younger men (9 () vs. 8 (), p=0.002). At baseline, younger patients reported less comorbidities, less active smoking, lower BMI, higher total testosterone (tT) levels than older patients (all p 40 yr, increasing age was linearly correlated with decreasing IIE-EF (all p 40 yr).

Conclusions
We observed that one out of five men seeking first medical help for ED at a single academic centre were younger than 40 yr. This trend has remained stable over the last 8-years, but slightly lower than the previous decade. Increasing age among younger patients is not associated with worse erectile function as oppositely occurs among patients &gt; 40 yr.

Disclosure
No
(379) The Effectiveness of Low-intensity Shock Wave Therapy as an Emerging Non-invasive Management of Erectile Dysfunction Among Adult Males: A Systematic Review and Meta-analysis
Authors: De Guzman S 
Published: May 2023

Abstract

Introduction
Erectile dysfunction (ED) is the penile inability to sustain erection necessary for sexual function due to physiological, psychological, or emotional factors. While the WHO promotes sexual health for all individuals, ED remains a major influence in attaining satisfying sexual performance among the aging population of men. The effective management and treatment of ED has been primarily pharmacologic and the research to support other non-invasive management such as low-intensity shock wave therapy (Li-ESWT) is apparently limited.

Objective
This systematic review and meta-analysis of available randomized controlled studies investigates the effectiveness of Li-ESWT for ED among adult males based on the International Index of Erectile Dysfunction (IIEF) score.

Methods
The literature search was conducted using the PubMed database. The search was limited to randomized controlled trials on the effectiveness of Li-ESWT on ED, written in English from Medline and Nursing journals, and are publicly accessible without monetary cost published from 2012 to 2020. PRISMA guidelines were used as framework for literature search and review. The RevMan software was utilized for data collection and analysis. A fixed effect model was used in the meta-analysis.

Results
A total of 19 randomized controlled trials were reviewed of which three were included in this meta-analysis. There were total of 120 participants with overall mean age ranges from 41 to 61 years, 61 were enrolled in Li-ESWT group and 59 in the sham group. The heterogeneity of the data shows □2 = 7.70, df= 2, (p= &lt;0.05); I2 = 74%, the overall effect is Z= 3.35, p = &lt;0.05. This meta-analysis demonstrates that the control group (sham) was favored over the experimental group (Li-ESWT) (SMD= 0.64, 95% CI, [0.27, 1.02]) based on the mean IIEF score at the end of the studies.

Conclusions
The use of shock wave therapy in addition to pharmacologic and non-invasive modalities in the treatment and management of ED is promising. However, while the dearth of randomized clinical trials using Li-ESWT for ED management is evident, the decision to proceed with treatment is based on the informed and collaborative decision between the urologist and the patient. This review highlights that sham therapy is not inferior to Li-ESWT treatment. The urologists may consider the cost, adverse effects, time, and effort of using Li-ESWT provided that there is no significant difference in the effectiveness of Li-ESWT compared with sham treatment. Further research is needed to support effectiveness and safety of Li-ESWT in managing ED compared to current pharmacologic regimen.

Disclosure
No
(383) Sexual Healthcare in Oncology: Description of a Sexual Health Clinic Utilizing an Innovative Blended Model of In-person and Facilitated Virtual Care
Authors: Matthew A , Guirguis S , Jamnicky L , Ferguson S , Croke J , Finelli A , Fleshner N , Incze T , Elterman D 
Published: May 2023

Abstract

Introduction
Sexual health is compromised by the diagnosis and treatment of virtually all cancer types. Although sexual dysfunction (SD) can manifest uniquely within each cancer population, it consistently involves biological, psychological and relational elements that affect overall health-related quality of life. Breast and pelvic cancers constitute 53% of cancer cases diagnosed in Canada with over 30% of colorectal, 73% of breast, 90% of prostate/gynecological, and 20% of non-breast/non-pelvic cancer survivors experiencing long-term SD. Despite the prevalence and negative impact of SD, sexual health clinics are the exception in cancer centres worldwide. Unfortunately, this gap in care hinders cancer survivors from achieving optimal sexual health recovery, sexual satisfaction, and relationship intimacy post-treatment.

Objective
We are establishing an innovative Sexual Health Clinic (SHC) that fosters accessibility and efficiency via virtual care, and personalized medicine via in-person care. The goal of the SHC is to assist patients/couples in achieving optimal sexual function, satisfaction (vs distress), and relational intimacy.

Methods
The SHC evolved from a fusion and expansion of the Prostate Cancer (Sexual) Rehabilitation Clinic (in-person care) at Princess Margaret, and the TrueNorth Sexual Health And Rehabilitation e-Clinic (virtual care). The SHC is theoretically founded in a biopsychosocial framework and utilizes a blended model of in-person and facilitated virtual care. The SHC virtual visits are tailored to the patient via content (text, videos, animations, and graphics) based on gender, cancer type, and treatment type. The SHC virtual platform also allows for chat-based synchronous and asynchronous facilitation with highly trained sexual health counsellors. In-person visits are designed to provide for a comprehensive sexual health assessment and sexual medicine prescription. A Hybrid Type 3 implementation research design will be used as a methodological framework for ensuring seamless integration of the SHC into the patient workflows of a high-volume cancer centre.

Results
An empirically-based, systematic approach to the development of a SHC based on a blended care model will be presented. Outcomes will include the process of developing: 1) personalize care pathways in a virtual setting; 2) efficient modes of digital facilitation; 3) approaches to integration of in-person and virtual care; and 4) empirically-based procedures for patient workflow implementation.

Conclusions
Innovative care provision is essential given the prevalence of sexual dysfunction and the limitations of resources within cancer centres. If successful, the proposed SHC will offer an efficient and effective model of care without compromising personalized patient care.

Disclosure
No
(390) Therapeutic Groups of Men With Penile or Testicular Cancer
Authors: Silva I , Naccarato A , Denardi F , Ferreira U , Matheus W 
Published: May 2023

Abstract

Introduction
Testicular cancer (TC) primarily affects men aged 15 to 40 years, and the incidence is around 5/100000. Tumors are usually aggressive and have a great psychological impact on patients. Penile cancer (PC) represents 2 of all types of tumors that affect men in Brazil Most of the affected population are elderly men. Usually, the tumor is identified at an advanced stage, when the only treatment available is total or partial penectomy, causing a great emotional impact.

Objective
This work aims to evaluate the impact of psychotherapy, in an open group, on Health Related Quality of Life (HRQOL) and Sexuality in patients with TC and PC who have been diagnosed, are undergoing treatment - surgery, radiotherapy, chemotherapy or hormone therapy - or who are being followed up after treatment

Methods
Data is been collected through an initial interview (Identification, Anamnesis, Health Anamnesis, Degree of Satisfaction with Life and Sexuality, Affective Emotional Assessment and Treatment Data), SF 36 short form and IIEF 5 short form questionnaire, in patients who are diagnosed, who have undergone treatment - surgery, radiotherapy or supervised monitoring - or who are being monitored at the clinic, and reapplication after 12 sessions At each session 5 questions related to the perception of the previous session will be answered. The group will be available for 2 years, once a week, and the patient will attend 12 sessions. The sessions last 90 minutes, conducted by the same psychologist. The research will be developed considering the ethical principles of secrecy, privacy, confidentiality and non identification of the interviewees' data. The study will not pose risks to the subjects and invasive techniques of the body or psychological suffering will not be used Before starting the process, the Informed Consent Form (will be delivered, as well as the provision of all details regarding the research It will also be explained that participation is voluntary and that the participant can leave the research at any time, without prejudice to their treatment and monitoring. Only patients who meet all these criteria will be included, after signing the informed consent.

Results
Currently, the screening of patients is being carried out to offer the possibility of participating in the open group. The project was on hold due to developments related to the COVID-19 pandemic.

Conclusions
As the work is at the beginning of development, there are still no preliminary conclusions.

Disclosure
No