bluuebunny/crossref_metadata_2025_split huggingface dataset:
(152) WILL WE LEARN ABOUT SEXUAL HEALTH? A SCOPING REVIEW ON THE INCLUSION OF SEXUAL HEALTH IN THE CURRICULUMS OF EUROPEAN MEDICAL SCHOOLS
Authors: Beatriz F Lopes , Inês Tavares , Ana L Q Gomes 
Published: July 2023

Abstract

Objectives
Sexual health is an insufficiently addressed topic within the scope of medical training programs in both pre and postgraduate Medicine levels, being identified by doctors as a gap area in their professional training. The lack of sexual health topics in medical training programs often leads to insecurity of this professionals in dealing with their patients’ sexual problems. The aim of this study is to collect information on sexuality/sexual health training currently available at pre and postgraduate levels in the main national and European medical schools, as well as specifically within the scope of medical internship.

Methods
Using the mailing list provided by European Academy of General Medicine of the European Academy of General Medicine (EURACT) and available online, we contacted the main national and European medical schools to have access to their medical curriculums and training programs, type of training provided on pre and postgraduate sexuality/sexual health, learning strategies and specific competences in sexuality/sexual health. We examined 1) whether medical curricula included the topic of sexual health/sexuality, 2) which sexuality topics were addressed, and 3) which learning strategies were used.

Results
The results of this study allowed us to understand the state of the European medical training in sexuality/sexual health within and between European countries. Besides, we could evaluate the training content and specific skills on sexuality/sexual health, as well as identify strategies and different types of exposure to training content practiced in national and European medical schools.

Conclusions
We hope the current results will serve as the basis for the development of future studies and practices aimed to enhance medical doctor’s approach when handling sexual health topics. In addition to the scientific implications, we hope it will also have ethical, social, and political impact, by motivating national policies and raising awareness of the lack of education in the community regarding sexual health.

Conflicts of Interest
The authors report no conflicts of interest.
(164) FROM IDEA TO REALITY: A FRAMEWORK FOR THE CREATION AND DISSEMINATION OF NEW EDUCATIONAL MATERIAL ON SEXUAL HEALTH
Authors: Sam Geuens , Anna-Polona Mivšek , Woet Gianotten 
Published: July 2023

Abstract

Objectives
This presentation aims to present sexual health professionals with practical advice on creating, publishing and disseminating new educational source material on a global scale. Drawing on the combined experience of the presenters a framework shall be presented, starting at the early stages of an emerging idea, covering topics as conceptualization of topics, outlining gaps in educational material, deciding on type and form of educational material, gathering a dream team, partnering up with professional organizations, fund raising, etc. to create new educational material usable both in the training of new health care professionals and the lifelong learning of practicing health care professionals.

Methods
An inside look at the developmental process behind the soon to be published Springer Nature textbook ‘Sexuality & Midwifery’ shall function as a case example allowing a step by step reflection on the developmental process of creating globally, free accessible educational material on sexual health.

Results
.

Conclusions
While sexuality and sexual health should be a part of the educational curriculum of all professionals active in healthcare settings, it remains a topic easily passed over in many healthcare oriented training programmes around the world, both in medical, paramedical and psychological curricula.
Educationalists often find it difficult to include sexuality into degree programmes. The lack of ready to use educational material can makes it daunting even for motivated educationalists to adequately incorporate sexuality into training programmes.
On the other hand sexual health experts willing to share their knowledge for educational purposes could use help when it comes to getting from an idea to a fully worked out and easily accessible new educational resource. The framework and practical advice provided in this presentation can help sexual health experts make their ideas for new educational tools become reality.

Conflicts of Interest
No conflicts of interest are present.
(140) DISTAL REPAIR OF PENILE PROSTHESIS HERNIATION WITH POLYPROPYLENE MESH REINFORCEMENT
Authors: Carlo Ceruti , Omid Sedigh , Marco Falcone , Massimiliano Timpano , Mirko Preto , Mattia Sibona , Ilaria Ferro , Natalia Plamadeala , Federica Peretti , Lorenzo Cirigliano , Emanuele Annunziata , Chiara Polito , Luigi Rolle , Paolo Gontero 
Published: July 2023

Abstract

Objectives
Apical erosions are the most frequent clinical presentation of a structural failure of the tunica albuginea.
In cases of limited erosion, if a thick pseudocapsule is available, it is possible to repair the failure without grafts, but in many cases it’s necessary to strengthen the apex with biomaterials.
We present our technique and our experience in apicoplasty for wide distal erosions using a polypropylene mesh reinforcement.

Methods
Surgical Technique:
Surgery is performed through a subcoronal incision. The extent of apical dissection depends on the width of the tunical failure: in many cases it is sufficient to dissect the apices from the glans, in others a wider release of the distal corpora with disassembly of the glans is necessary. A conventional Polypropylene hernia mesh has been used, tailored over the apices in order to avoid folds and compressions on the urethra and the neurovascular bundle.
Clinical experience
12 patients, presented with impending erosion after implantation of inflatable implant (7 cases), malleable implant (4 cases), Apollo Expander (1 case), have been treated and followed up (median 16 months).

Results
We didn’t report any major (Clavien&gt;=3) complication; among grade 2 complications we reported transitory numbness of glans (2), glans blister and/or escara with complete restitutio ad integrum (2), peno scrotal haematoma (3) No relapses of herniation nor infections were recorded and all the patients resumed satisfying penetrative sexual activity. The underlying penile implant made the mesh not palpable in 75% of patients, and no patient referred any complaint; in only 1 case the partner reported a mild dyscomfort during intercourse.

Conclusions
After a previous experience with the use of a porcine dermal graft we shifted to polypropylene mesh in order to increase graft resistence. The repair using a polypropylene mesh appears to be a reliable and well accepted solution to definetively treat extensive albugineal failures.

Conflicts of Interest
None.
(191) COMPLEX FEMALE URETHRAL DIVERTICULUM WITH STAGED URETHRALRECONSTRUCTION
Authors: Senad Bajramovic , Prof. Damir Aganovic , Nirvana Sabanovic Bajramovic 
Published: July 2023

Abstract

Objectives
Urethral diverticulum (UD), whether congenital or acquired, represents a rare urological condition, usually presented with diverse and nonspecific clinical symptoms. Although the diagnosis of UD may be assumed by patient’s history and physical examination, appropriate radiological imaging is crucial for establishing the diagnosis.

Methods
In this report, we present a case of a 34 years old female patient, with frequent urinary tract infections (UTIs) accompanied by purulent urethral discharge during the last three years. The patient was sexually active, and was not subjected to any previous gynecological interventions. Physical examination indicated the presence of cystic formation on anterior vaginal wall. MRI scans of urethra revealed one large, saddle bag UD and another, smaller UD.

Results
After the diagnosis was established, we performed diverticulectomy, followed by urethral reconstruction (urethroplasty) using labia minora and surrounding tissue. Following the urinary catheter extraction, the patient was able to control the urination, having weak urinary stream. Instrumental dilatation of urethra was done periodically, although the effect was not long-lasting, and the patient still experienced the weak stream. Local findings were normal without any inflammation. After one year, repeated MRI findings did not show any recurrence of UD, so we performed urethroplasty, using buccal mucosa graft. Following catheter extraction the patient was able to urinate normally, maintaining high uroflow, without any disuric symptoms, or urinary leak.

Conclusions
Individual approach to the patient and gradual resolution of the problem represent a key to treatment success.

Conflicts of Interest
No conflicts.
(22) A PROTOCOL FOR THE DEVELOPMENT OF TWO INTERNATIONAL CORE OUTCOME SETS FOR GENITAL GENDER AFFIRMING SURGERY
Authors: Marleen Vallinga , Pip Roijer , Dr. Tom Pidgeon , Dr. Aline Ceulemans , Alex Bakker , Brenda Carrière , Dr. Tina Rashid , Dr. James Bellringer , Dr. Javier Belinky , Prof. Marlon Buncamper , Shane Morrison , Prof. Walter Bouman , Prof. Mark-Bram Bouman , Prof. Margriet Mullender 
Published: July 2023

Abstract

Objectives
Various procedures and techniques for genital surgery are available to transgender and gender diverse individuals. Prior research on feminizing (i.e., vaginoplasty, vulvoplasty, labiaplasty, and clitoroplasty) and masculinizing (i.e. phalloplasty, metoidioplasty, scrotoplasty and coronaplasty) genital gender affirming surgery measures and reports a heterogeneous and non-standardised range of outcomes. It is not known whether these outcomes used by researchers are important or relevant to the population. Yet, no attempt has been made to reach consensus on a standardized set of outcomes and uniform definitions. This inconsistency precludes the comparison and combination of data between studies on similar procedures. In order to advance the practice of genital surgery towards a robust evidence-based one, it is necessary to standardize outcome measurements in retrospective and prospective intervention studies. The aim of this project is to develop a Core Outcome Set (COS) for feminizing- and one for masculinizing genital gender surgery. A COS; i.e., the minimum set of outcomes recommended to be reported in clinical trials, pertaining to this subject will ensure that the most relevant outcomes are measured and reported in a standardized way.

Methods
The stages of development are; i) A systematic review to identify all outcomes measured and reported in previous research; ii) Identifying outcomes important for transgender and gender diverse individuals during focus groups; iii) Combining these outcomes into preliminary lists iv) Distribute e-Delphi surveys among experts- by experience and profession, in which all potential outcomes will be rated v) An online consensus meeting to decide on the final COS. See figure 1.

Results
This project will produce two minimum sets of outcomes for genital surgery, based on an international consensus from expert stakeholders, including the population.

Conclusions
The development and implementation of these COS for genital surgery will ensure that relevant outcomes will be reported. This will facilitate guideline-development and evidence-based informed decision-making.

Conflicts of Interest
None.
(237) LONG TERM FOLLOW-UP OF GENDER AND SEXUALITY IN EARLY TREATED TRANSGENDER ADOLESCENTS
Authors: Frédérique B B de Rooy , Marijn Arnoldussen , Thomas D Steensma , Prof. Arne Popma , Prof. Baudewijntje Kreukels , Annelou de Vries 
Published: July 2023

Abstract

Objectives
This study is the first to gain insight into long-term effects into adulthood of early gender affirming medical treatment in transgender adolescents on the development of gender identity and sexuality.

Methods
Transgender adolescents who started medical treatment between 1989-2000 and were treated with gender-affirming hormone treatment (GAHT), as well as transgender adolescents who received gonadotropin-releasing hormone agonist and subsequently started GAHT at least 9 years ago, were recruited for participation. Gender identity, experienced gender dysphoria and sexuality were measured with the Gender Diversity Questionnaire (GDQ), Utrecht Gender Dysphoria Scale (UGDS) and self-developed questions on sexuality and relationships.

Results
All 101 participants had used GAHT and 74 also used puberty suppression before starting hormonal treatment. Most identify as either “man” or “woman”, with 25% also identifying as “transgender”. In 81.2% the gender identity remained stable over time. On the UGDS, a mean total score of 14.5 (standard deviation 2.92) was found, indicating little to no experienced gender dysphoria. Over two-thirds of participants have had a relationship. For women, this was in 81.0% with a cisgender man and in men, this was in 83.1% with a cisgender woman. 73.3% of women reported to be attracted only to men and 13.3% to mostly men, but also women. 62.7% of men reported to be attracted only to women and 19.4% mostly to women, but also men. In both men and women, in almost 80% of participants the sexual attraction has never changed.

Conclusions
In this first long term follow-up into adulthood of transgender adolescents who received early medical gender affirming treatment, it was seen that after treatment participants experience gender congruence and experience little to no dysphoria. Gender identity and sexual attraction remain mostly stable throughout life. Sexual attraction is mostly to the opposite gender of particpants’ gender, with slightly more variety being seen in men.

Conflicts of Interest
The authors declare that they have no competing interests.
(198) THE EFFECT OF PUBERTY SUPPRESSION ON SEXUAL FUNCTIONING IN TRANSWOMEN AFTER GENDER AFFIRMATIVE SURGERY
Authors: Isabelle van der Meulen , Anna van der Miesen , Sabine Hannema , Annelou de Vries 
Published: July 2023

Abstract

Objectives
To improve informed and evidence based care for transgender adolescents by gaining insight into the long-term effects on sexual development and functioning of early treatment with puberty suppression in transgender adolescents. This is the first study to specifically evaluate postoperative sexual function in transgender women who have not gone through endogenous pubertal development, with a special focus to their ability to orgasm.

Methods
A questionnaire on sexual experiences was used approximately one year after genital gender affirmative surgery. We then compared the answers of transwomen that were treated with puberty suppression in early puberty (Tanner stage 2 or 3), with those that were treated with puberty suppression in late puberty (Tanner Stage 4 or 5), under more with the use of Pearson ChiSquare tests.

Results
37 transwomen that received gender affirmative treatment, consisting of puberty suppression, cross-sex hormones and vaginoplasty, were included. Of all transwomen, 76% was able to reach an orgasm after vaginoplasty. Of the transwomen that were treated with puberty blockers early in puberty, 81% was able to experience an orgasm postsurgery. When looking at the ability to reach an orgasm after vaginoplasty, we found that there was no difference (p=0,278) between those that were treated with puberty blockers in early versus those that were treated in late puberty. Of the transwomen who did not experience an orgasm before surgery, 75% was able to reach one after. Approximately half to three quarters of the transwoman experienced sexual difficulties when having sexual intercourse.

Conclusions
Both transwomen treated with early and late puberty suppression are equally able to experience an orgasm after vaginoplasty. Likewise, it is not necessary to experience desire, arousal or orgasms presurgery to be able to experience these postsurgery. The majority of transwomen sometimes experience some difficulties in their sex life, but this is not dependent on the puberty stage they started blockers in.

Conflicts of Interest
We have no conflicts of interest to disclose.
(215) IS THERE A ROLE OF HISTAMINE IN THE PATHOPHYSIOLOGY OF ERECTILE DYSFUNKTION?
Authors: Dr. Viktoria Maerker , Prof. Stefan Ueckert , Prof. Armin Becker , Harrina Rehardjo , Priv-Doz. Andreas Bannowsky , Prof. Markus Kuczyk 
Published: July 2023

Abstract

Objectives
Histamine is a bioactive amine related to the control of vascular tissue and the vasorelaxation mediated by nitric oxide and cyclic GMP. The role and function of histamine in the control of penile erectile tissue (corpus cavernosum penis) is only poorly understood. The aim of our study was to evaluate the course of histamine plasma levels through different stages of sexual arousal in the systemic and cavernous blood of healthy males and in patients with erectile dysfunction.

Methods
34 healthy adult males (mean age 26) and 46 patients with ED (mean age 52) were exposed to erotic stimuli in order to elicit sexual arousal. Blood was simultaneously aspirated from the corpus cavernosum and a cubital vein during the penile conditions flaccidity, tumescence, rigidity and detumescence. Plasma levels of histamine were determined by means of a radioimmunoassay.

Results
In the healthy individuals, histamine slightly decreased in the cavernous blood with the beginning of sexual arousal, when the flaccid penis became tumescent (0.95 ± 0.5 to 0.87 ± 0.36), decreased further during rigidity (0.8 ± 0.3) and remained unaltered in the phase of detumescence. In the systemic circulation, no alterations in plasma histamine were observed with the initiation or termination of penile erection. In the ED patients, a moderate rise in cavernous histamine was registered from flaccidity/tumescence to detumescence (1.2 ± 0.3 to 1.33 ± 0.52). In the patients, at all penile conditions, plasma histamine was significantly higher in the cavernous blood than in the systemic circulation.

Conclusions
Based on the results, it seems unlikely that histamine has excitatory function in the control of penile erection. It remains to be established whether in the patients with ED the amine, potentially acting as a mediator of a neuroendocrine feedback system, may mediate local biological events modulating sexual function in terms of counteracting erectile capability.

Conflicts of Interest
no conflict of interest.
(75) ERECTILE DYSFUNCTION IS ASSOCIATED WITH LEFT VENTRICULAR DIASTOLIC DYSFUNCTION: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Dr. Emil Durukan , Christian F S Jensen , Dr. Kristoffer G Skaarup , Peter B Østergren , Prof. Jens Sønksen , Prof. Tor Biering-Sørensen , Prof. Mikkel Fode 
Published: July 2023

Abstract

Objectives
Erectile Dysfunction (ED) is associated with an increased risk of cardiovascular morbidity and mortality. It is suggested that ED precedes CVD by 3-5 years due to progressive or concomitant microvascular endothelial dysfunction and/or vascular obstruction. This systematic review and meta-analysis evaluated cardiac structure and function in men with ED.

Methods
A meta-analysis on studies evaluating cardiac structure and function in men with ED compared to controls without ED using echocardiography was performed. We assessed and analyzed mean differences in left ventricular ejection fraction (LVEF), the ratio of early transmitral filling velocity to early diastolic mitral annular velocity (E/e’), early to late diastolic transmitral flow velocity (E/A), isovolumic relaxation time (IVRT), and left ventricular mass index (LVMi) in a random effects model computed using means and standard deviations.

Results
We included 10 studies with 763 men diagnosed with ED (mean age of 55.6 years) and 358 control men (mean age of 54.4 years). Figure 1 displays the pooled analyses. E/e’ was significantly higher in men with ED compared to controls (mean absolute difference = 1.17, 95% CI [0.68, 1.65], p &lt; 0.005). Meanwhile, no significant differences were observed in LVEF, E/A, IVRT, or LVMi.

Conclusions
In this meta-analysis, LV diastolic dysfunction, as assessed by E/e’, was more frequent in men with ED compared to matched controls without ED.

Conflicts of Interest
The authors have no conflicts of interest to declare. All co-authors have seen and agree with the contents of the manuscript.
(86) IS PSYCHODIAGNOSTIC THE USEFUL INSTRUMENT FOR DIFFERENTIAL DIAGNOSIS BETWEEN PSYCHOGENIC AND ORGANIC FORMS OF ERECTILE DYSFUNCTION?
Authors: Zurab Marshania , Nino Chochnidze , Marika Injgia , Mariam Samteladze 
Published: July 2023

Abstract

Objectives
Erectile Dysfunction (ED) is a fairly common problem, affecting millions of men depending on their age group. It is a common difficulty to differentiate between different forms of ED. When we say about the psychogenic form of ED, we should remember that the ways that people think, feel, and behave - can powerfully affect their erectile response. Consequently, objective assessment of psychogenic factors can help physicians in the correct diagnostic and treatment of patients with ED.

Methods
In our study, participants were 109 men with ED aged 25 to 45. All patients had some emotional problems, due to which a psychodiagnostic. For assessment of psycho condition, we used four diagnostic tests: MMPI-I, STAI (State-trait Anxiety Inventory), Beck's Depression Inventory, and OCI-R (Obsessive-compulsive-inventory-revised).

Results
As the result of the examination, we detected anxiety disorder in 38 patients. 10 patients had dysthymia, and 14 had depression. Five patients had Obsessive-compulsive disorder. In 43 men with ED, we could not find any psychogenic problems. Psychodiagnostic allowed us to suppose that 66 patients (60%) had psychogenic ED and 43 (40%) had organic ED. Together with PDE 5 – inhibitors, all 66 patients with psychogenic ED received Serotonin and Dopamine Selective reuptake Inhibitors (SSRI). 100 mg Trazodone per day had received in 43 patients. 19 patients received 30 mg Duloxetine per day, and four received 10 mg. Citalopram per day. The treatment mentioned above was very successful. After several months of treatment, erectile function had been restored. Also, anxiety and depression decreased. The well-being and quality of sexual life improved.

Conclusions
The psychodiagnostic examination we used in our study is quite an effective objective method for differential diagnoses between the psychogenic and organic forms of ED among 25-45 aged men. It can be considered a simple and routine tool in the algorithm for diagnosing and treating ED.

Conflicts of Interest
There is no conflict of interest.