bluuebunny/crossref_metadata_2025_split huggingface dataset:
(239) SIMULTANEOUS IMPLANT OF VIRTUE MALE SLING AND TITAN TOUCH PENILE PROSTHESIS
Authors: Roger Matheu , Dr. Josep Torremade , Meritxell Costa , Dr. Juan Manel Corral , Dr. Lluis Peri , Maurizio D'Anna , Prof. Antonio Alcaraz 
Published: July 2023

Abstract

Objectives
Stress Urinary Incontinence (SUI) and Erectile Dysfunction (ED) are major adverse effects of Radical Prostatectomy (RP). The oncological result is always a priority but functional result should not be forgotten. After a period of rehabilitation, the treatment of iatrogenic complications should be a priority. In the following video we show a simultaneous surgical treatment of post-RP SUI and ED.

Methods
The patient is a 64-year-old male who received a Robotic assisted Radical Prostatectomy with bilateral Lymph Node Dissection in January 2018 with the result of a Gleason 7 (4+3) T2bN0. Correct oncological follow-up. He developped a Bladder Neck Sclerosis for wich a Bladder Neck Incision (BNI) was performed in March 2019. It relapsed so a new BNI was done in March 2020. After more than a year the post-prostatectomy vesicourethral stenosis was stable as confirmed by a cistoscopy. He presents SUI with a Pad-Test of 80 grams and urodinamyc study with an Abdominal Leak Pressure Point of 127 cm H20 for wich a Virtue Sling is indicated. Also, he presents an ED not responding to medical treatment, a Titan Touch Penile Prosthesis is also indicated.

Results
The first part of the video demonstrates the implant of a Virtue Sling with prepubic and transobturators arms placement within the perineal membrane and new subcutaneous passage and fixation between them. The second part is the simultaneous implant of a Tricompartimental Titan Touch Penile Prosthesis of 18 cm with and extensor tip of 1 cm bilateral and a Retzius reservoir placement. Surgical time was 90 minutes and patient was succesfully discharged the next day. Two weeks after the surgery, a flowmetry was performed demonstrating a non post-voidal urinary volume. The patient does not present SUI anymore and he is satisfied with his sexual intercourses.

Conclusions
Simultaneous implant of an Incontinence Sling and a Penile Prosthesis is safe and feasible.

Conflicts of Interest
None.
(226) SCLEROSING GRANULOMA AFTER PARAFFIN INJECTION FOR PENILE AUGMENTATION: A COMPARISON BETWEEN TWO SURGICAL TECHNIQUES
Authors: Dr. Carlo D'Alterio , Dr. Lorenzo Cirigliano , Dr. Angelo di Giovanni , Dr. Alessandro Giordano , Dr. Claudio Marino , Dr. Luigi Napolitano , Dr. Claudia Mirone , Dr. Roberto La Rocca , Dr. Massimiliano Creta , Prof. Alessandro Palmieri , Prof. Ciro Imbimbo , Dr. Marco Capece 
Published: July 2023

Abstract

Objectives
Our aim is to compare two different surgical techniques for the treatment of penile paraffinoma in order to identify the most suitable technique for the characteristics of each patient.

Methods
We described two different surgical techniques for the correction of penile paraffinoma performed in our Urological Unit.
In this video we report two cases. The first patient was a 23 years-old Bulgarian male admitted to our hospital in 2020 with penile swelling and sexual discomfort due to paraffin injected 1 year before to increase penile girth. The patient underwent a 2-stages surgical technique: during the first stage the paraffinoma was excised. The penis was buried into the scrotum. Three months later a scrotoplasty was performed. The second patient a 40 years-old Serbian men presented to our hospital in 2019 with a severe penile deformity due to multiple paraffine self-injection resulting in pain and sexual discomfort. The patient underwent a paraffinoma excision and split-thickness skin graft in one stage. Two different questionnaires, the international index of erectile function (IIEF-5) and a 6-items questionnaire on the satisfaction of genital aesthetics, were delivered to the paients by email at 3, 6 and 12 months.

Results
Erectile dysfunction was not reported and the scores of the IIEF-5 were comparable during the follow up. Both patients were satisfied with the aesthetic of their genitalia, however the first patient scored better in the 6-items questionnaire. No intra/post-operative complications were observed in both techniques.

Conclusions
In our experience patients with no scrotal involvement and suitable scrotal size benefit a dual stage technique with scrotoplasty in terms of better aesthetic outcome rather than a split-thickness skin graft. Otherwise patients with small scrotum size or scrotal involvement might undergo split thickness skin graft which provides good aesthetic outcome and a comparable sexual function. From our experice the surgeon should be skilled in both technique and a careful evaluation of patient's charactheristics should suggest wich technique fits the patient.

Conflicts of Interest
The Authors declair no conflict of interest.
(90) ERECTILE FUNCTION IN AMATEUR CYCLISTS
Authors: Dr. Duarte Brito , Dr. Jose Alberto , Dr. Ana Fereira , Dr. Gustavo Gomes , Dr. Miguel Eliseu , Dr. Mario Lourenço 
Published: July 2023

Abstract

Objectives
Cycling is a popular means of transport and recreational activity; bicycles are also a source of genitourinary injuries and there is the idea that cycling may have a significant impact on sexual function. To evaluate the effect of amateur cycling on erectile function

Methods
We used a questionnaire comparing amateur cyclists (n=199) and footballers (n=43), regarding sexual related comorbidities and hours of practice per week. The cyclists were also characterized in terms of road vs cross-country, breaks during cycling, saddle, and shorts. To evaluate erectile function, the International Index of Erectile Function questionnaire was applied.

Results
There was no difference in International Index of Erectile Function total score between groups. Age and presence of erectile dysfunction associated comorbidity were negative factors in the International Index of Erectile Function score in cyclists but not in the footballers.

Conclusions
Cycling is usually associated with perineal numbness, but that numbness did not lead to lower International Index of Erectile Function scores.
Amateur cycling has no effect on EF.

Conflicts of Interest
None
(24) INTRODUCING THE PENILE IMPLANT INTRAOPERATIVE MEASUREMENTS PLANNING (PIIMP) CHART: A CHART USED FOR INTRAOPERATIVELY DOCUMENTING PENILE DIMENSIONS DURING PENILE PROSTHESIS IMPLANTATION PROCEDURES.
Authors: Prof. Adham Zaazaa , Dr. Ramzy Elnabarawy , Dr. Mahmoud Elbitar 
Published: July 2023

Abstract

Objectives
In this study, the Penile Implant Intraoperative Measurements Planning (PIIMP) chart was used to find out whether inflatable penile implants were more likely to procure a longer penile length in comparison to malleable implants.

Methods
193 men undergoing penile prosthesis implantation were included in the study. 153 had malleable implants, while 40 had three piece inflatable implants. Penile measurements were recorded intraoperatively using the PIIMP chart. Penile length and circumference were taken in both a stretched and unstretched state. Measurements were repeated after pharmacologically induced tumescence by means of a PGE1 intracorporal injection (ICI). Postoperative penile dimensions were re-taken after implantation and documented together with cylinder dimensions.

Results
In malleable penile implants, postoperative penile length ranged between pre-operative pre-ICI stretched length and post-ICI stretched length 71.4% of times (n = 110/153). It fell below pre-operative pre-ICI stretched length in 26.2% of cases (n=40/153) and reached beyond pre-operative post-ICI stretched length in 1.96% of cases (n=3/153).
In inflatable penile implants postoperative penile length ranged between pre-operative pre-ICI stretched length and post-ICI stretched length 60% of times (n= 24/40). It fell below pre-operative pre-ICI stretched length in 27.5% of cases ( n = 11/40) and reached beyond pre-operative post-ICI stretched length in 12.5% of cases (n = 5/40).
Using Fisher's exact test, it was found that postoperative penile length was 6.37 times more likely to rise above preoperative post-ICI stretched length in inflatable penile implants compared to malleable implant cases (12.5% vs 1.96%) (P value=0.0105)

Conclusions
The PIIMP Chart demonstrated that aggressive penile sizing was more attainable with inflatable rather than malleable implants. The chart may be used as an intraoperative measurements guide for surgeons as well as serving as an objective postoperative counseling tool for patients, where their pre and postoperative penile dimensions would be documented and easily comparable.

Conflicts of Interest
I hereby declare no conflict of interest for all authors free from any commercial influence or bias, that the entire contents of this abstract are the sole work of the authors credited and that all authors credited herein are aware of their name being used and are in agreement with it being used in this manner. I hereby agree that this abstract may be openly published and may be used in the planning of this conference and that I have read the guidelines for submitting an abstract and that I agree with all of them in their entirety.
(134) EFFICACY AND SAFETY OF TREATMENT WITH THE USE OF INTRAURETHRAL ALPROSTADIL (VITAROS©) ON DEMAND IN MEN WITH SPINAL CORD INJURY AND MULTIPLE SCLEROSIS. A PROSPECTIVE STUDY.
Authors: Dr. Charalampos Thomas , Dr. Panagiotis Kartsaklis , Dr. Charalampos Konstantinidis 
Published: July 2023

Abstract

Objectives
To evaluate the efficacy and safety of intraurethral alprostadil (Vitaros©) on-demand in men with neurogenic ED due to SCI or MS.

Methods
We prospectively collected data of 54 men suffering from SCI and 50 from MS who used Vitaros© for ED. The treatment protocol required a minimum administration of intraurethral alprostadil for at least twice a week, even without a subsequent sexual intercourse for a period of 6 weeks. Inclusion criteria included absence of ED prior the accident or the onset of the disease (IIEF-5 score &gt;21, Erection Hardness Score-EHS ⩾3, affirmatively answers to Sexual Encounter Profile Questions 2 and 3 -SEP2 & SEP3) and absence of moderate/severe cardiovascular disease, diabetes mellitus and metabolic syndrome. All men with SCI were performing intermittent catheterizations (ICs) and 75% of MS group (35 patients) respectively. Average age was 43.5 and 38.5 respectively, mean IIEF score prior the therapy 15 and 16 and EHS score 1.7 and 1.9.

Results
After 6 weeks, 6 patients dropped out from the group of SCI due to hypotension or urethral pain and 3 from MS group due to urethral pain. Vitaros© implied an improvement of 4.4 points for the IIEF-5 score and 1.0 for the EHS score in the SCI group, while the improvement for the MS group was 4.1 points and 1.3 points respectively. The subgroup of MS patients who did not perform ICs benefited the most in comparison with the other patients and none of them discontinued the treatment. At the end, 23 SCI patients and 27 MS patients selected Vitaros© to be added in their treatment agents of choice, as an alternative.

Conclusions
It seems that Vitaros© is an alternative treatment for neurogenic patients suffering from SCI and MS, less effective though in ICs users, and the most apparent reason of failure might be the alteration of urethral epithelium to squamous due to repetitive injuries as catheters pass through, making the agent less absorbable through it.

Conflicts of Interest
None
(227) PROGNOSTIC VALUE OF DOPPLER ULTRASOUND PRIOR TO PENILE PROSTHESIS IMPLANTATION
Authors: Rodrigo Garcia-Baquero , Carolina Valle Herrera , Araceli Ogalla García , Luis Alvarez-Ossorio Jose 
Published: July 2023

Abstract

Objectives
Penile Doppler ultrasound prior to penile prosthesis implantation is useful for aetiological diagnosis and to assess the response to intracavernous injections. The objective of our study was to analyze the relationship between the parameters collected in the preoperative Doppler ultrasound of the penis, performed per protocol, and postoperative complications and patient satisfaction.

Methods
We conducted a retrospective observational study, selecting patients undergoing penile prosthesis implantation in our center from 2017 to 2020, with at least 1 year of follow-up after surgery. The baseline characteristics of the cohort, basic parameters of penile Doppler ultrasound, surgical aspects, postoperative complications according to the Clavien-Dindo classification, and postoperative pain were collected. In addition, satisfaction was assessed by telephone interview.

Results
A total of 36 patients were selected, of whom 28 participated in the study (77.8% response rate). The mean age was 64.6 years and the mean time of evolution of erectile dysfunction prior to surgery was 5.7 years. Using Doppler ultrasound, 36.1% were diagnosed with arterial insufficiency and 22.2% with failure of the venocorpo-occlusive mechanism. Neither the maximum peak systolic velocity (p 0.58), nor the minimum end-diastolic velocity (p 0.99), nor the maximum resistance index (p 0.41), were related to the rate of complications or the level of satisfaction after surgery. Using linear regression, it was found that the shorter the corporotomy time (p 0.0001) and the shorter the surgical time (p 0.0001), the greater the satisfaction with the implant.

Conclusions
Doppler ultrasound prior to penile prosthesis implantation does not seem to have any prognostic value after surgery, neither in relation to the rate of complications nor in relation to satisfaction. A shorter surgical time, possibly reflecting a simpler surgery and a lighter postoperative period, seems to be related to greater satisfaction after implantation.

Conflicts of Interest
No conflict of interest with this presentation.
(246) SEXUAL FUNCTION RESULTS AFTER FOCAL CRYOTHERAPY FOR THE TREATMENT OF LOCALIZED PROSTATE CANCER
Authors: Dr. Raphael Curvo , Dr. Esaú Fernandez-Pascual , Celeste Manfredi , Dr. Cristina Martín , Dr. Claudio Martinez-Ballesteros , Dr. Carlos Balmori , Dr. Enrique Lledó-García , Dr. Luis Miguel Quintana , Prof. Joaquin Alberto Carballido , Jr Dr. Fernando Bianco , Ignacio Martinez-Salamanca Juan 
Published: July 2023

Abstract

Objectives
To assess the sexual functional results in patients with primary localized PC treated with FC guided by MRI/US fusion.

Methods
Prospective, monocentric study with patients with localized and primary PCa, low or intermediate risk, with unifocal or multifocal lesions, PSA ≤ 15 ng/mL, undergoing FC. The main variables studied were the International Index of Erectile Function-Erectile Function domain (IIEF-EF) and the ejaculatory function. The follow-up included evaluation before treatment, at 6 months and at 12 months. Recurrence was defined as the presence of clinically significant PCa in the treated areas. Other functional outcomes were assessed (continence, lower urinary tract symptoms).

Results
A total of 75 patients were recruited. The median age was 67 (62-72) years. Pretreatment PSA and IIEF-EF were 6.56ng/ml (IQR 5.1-8) and 17 (IQR 7-22), respectively. The volume of the lesions was 1cc (IQR 0.5-2.5), the majority (76%) were peripheral and the Gleason-Score was 6 in 44%, 7 (3+4) in 26.7% and 7 (4+ 3) in 22.7%. Ten subjects developed a recurrence (RR: 15.2%), with a median follow-up of 25 (18-38) months. At 12 months, we found a statistically significant difference (p&lt;0.001) in the IIEF-EF (17 (7-22) VS. 16.5 (8-20)), although not clinically significant. In addition, 15/69 (21.7%) subjects had started or increased the dose of PDE5i. Before treatment, 7 patients had ejaculatory disorders (alpha-blockers). At 12 months, there were 8 affected patients. No significant differences (p&gt;0.05) were observed in urinary functional results (IPSS, ICIQ-UI), all patients were continents at one year.

Conclusions
FC in selected patients with localized PCa is an option to consider in patients who wish to preserve sexual function and who assume a low, although not negligible, recurrence rate.

Conflicts of Interest
None
(206) EFFICACY AND SAFETY OF INTRALESIONAL INJECTION OF HYALURONIC ACID (HA) FOR THE TREATMENT OF CHRONIC PHASE PEYRONIE’S DISEASE (PD): PRELIMINARY RESULTS FROM A PILOT STUDY
Authors: Dr. Claudio Marino , Dr. Carlo D'Alterio , Dr. Alessandro Giordano , Dr. Angelo di Giovanni , Prof. Paolo Verze , Dr. Lorenzo Cirigliano , Prof. Marco Capece , Prof. Roberto La Rocca 
Published: July 2023

Abstract

Objectives
HA is a natural component of the human body. It fulfills several biological functions including immune-modulation and anti-inflammatory effects. HA is considered to treat several andrological issues such as premature ejaculation, penile enlargement and recently Peyronie disease.
The aim of this study is to evaluate the safety and the efficacy of a new protocol based on intraplaque injection of cross-linked hyaluronic acid plus modeling and stretching, in men with the chronic phase of Peyronie's Disease.

Methods
At baseline all the patients were evaluated via intra-cavernous injection of a vasoactive agents and performed also the PD Questionnaire (PDQ) and the International Index of Erectile Function (IIEF) questionnaires.
The protocol consisted in an intraplaque injection of HA (under block of 15 mL plain mepivacain 1%) every other week for a total of three injections in six weeks, plus penile modeling after each injection. Each patient also performed a daily use of vacuum erection device and (self) modeling and stretching in the days following the injections.

Results
23 patients were recruited in the study. Two patients were excluded because they did not correctly performe home protocol. Median curvature at baseline was 55° (IQR= 45 - 65).
Nineteen out of 21 patients (90%) showed a reduction in the degree of curvature by a mean of 11.9 ± 7.3°. A statistically significant improvement in IIEF - Intercourse satisfaction domain (from baseline: 6.41 ± 3.8 to 8 week: 8.76 ± 2.8; p&lt;0.001) and PDQ- Symptoms Bother domain (from baseline: 8.75 ± 4.1 to 8 week: 7.4 ± 3.3; p&lt;0.001) was also detected.

Conclusions
The findings of the study show that this new protocol based is able to significantly reduce penile curvature in patients suffering from a chronic phase of PD.
Our intent is to continue the study further to better understand the impact that IIHA therapy on the management of PD in terms of patient satisfaction and reduction in the need for surgery.

Conflicts of Interest
The authors involved in this study certify that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.
(185) SELF-EXPANDABLE, METALLIC, PTFA-COVERED URETHRAL STENT WITH ANTI-MIGRATION FLAPS (UVENTA). COMPLICATION REPORT AND OUTCOMES FROM THE LARGEST MULTICENTER SERIES
Authors: Omid Sedigh , Ettore Dalmasso , Andrea Gobbo , Devis Collura , Andrea Formiconi , Marisa Kurti , Ernesto Giargia , Nicola Faraone , Paolo Caccia , Alessandro Giacobbe , Maria Buffi Nicolò 
Published: July 2023

Abstract

Objectives
In the last years a new generation of temporary urethral stent was designed. We report complications and outcomes from the largest case history available of self-expandable, metallic, PTFA-covered urethral stents with anti-migration flaps.

Methods
225 patients that underwent urethrotomy with Uventa stent placement between April 2016 and August 2021 in 7 different centers were included. Indication was patient preference as a first surgical approach or failed urethroplasty not willing to undergo a second invasive surgery. Surgical success was defined as absence of strictures requiring further treatments. The outcomes measured were complications during the stent indwelling time and treatment success.

Results
The stricture was located at a proximal bulbar level in 190 patients, distal bulbar in 29 and penile in 6. Median follow-up was 37.9m. 109 (48.4%) patients had at least 1 complication, the figure shows the percentage distribution. Low flow (LF) after stent placement (17, 7.6%) was reported in a significantly higher proportion in penile strictures (2/6, p=0.025). Proximal bulbar strictures had a higher number of per-patient complications (p=0.024). 23 patients (12.9%) underwent early stent removal (ER, before 6m), of these 20 stents were dislocated. ER was more likely in penile strictures (3/6, p=0.047). LF and penile strictures were predictors of ER at univariable logistic regression (p&lt;0.001, p=0.017). Penile stricture was also predictor of LF occurrence (p=0.034). 32/150 (21.3%) experienced treatment failure. Kaplan-Meier estimates by LF occurrence were significantly different (cumulative treatment success: 80.4% vs 42.8%; p=0.011) and Cox regression HR was 3.4 (p=0.022).

Conclusions
Urethrotomy with Uventa placement is a feasible treatment for simple strictures. A detailed discussion about complications, with particular attention to stent displacement, and expectations should be carried out. LF after placement is suggestive of a subsequent ER and treatment failure. Penile strictures should not undergo urethral stent placement considering the association with ER and LF.

Conflicts of Interest
None.
(257) SHOULD ALL AZOOSPERMIC KLINEFELTER MEN UNDERGO ENDOCRINE STIMULATION THERAPY PRIOR TO MICROSURGICAL TESTICULAR SPERM RETRIEVAL (mTESE)?
Authors: Dr. Giovanni Chiriaco , Katy Naylor , Elizabeth Williamson , Prof. David Ralph , Dr. Philippa Sangster 
Published: July 2023

Abstract

Objectives
Klinefelter syndrome (47XXY) is a common genetic cause of non obstructive azoospermia (NOA) and hypogonadism. MTESE has provided potential for these men to experience fatherhood although surgical sperm retrieval (SSR) rates are low. This study aims to evaluate the role of endocrine stimulation therapy prior to mTESE in men with NOA secondary Klinefelter syndrome (KS).

Methods
Retrospective study on KSmen who underwent mTESE with-or-without prior endocrine stimulation therapy. Demographic data, previous exogenous testosterone therapy, duration and type of stimulation, pre-and post-stimulation hormone levels (T, FSH, LH), SSR, average Johnsen score and total number of vials cryopreserved were all recorded. The success criteria for mTESE was defined as at least 1 vial of viable sperm retrieved.

Results
64KSmen underwent mTESE out of which 39men received prior endocrine stimulation therapy for a mean duration of 11.8±8.5month. Thirty patients received human chorionic gonadotropin and 9 clomiphene. The mean pre-stimulation serum testosterone level was 6.1±3.7nm/L increased to 9.4±6.9nm/L post-stimulation. Testosterone levels significantly increased after endocrine stimulation (6.1±3.7nm/Lvs9.8 ± 6.9nm/L, p&lt;0.001) with mean change in serum testosterone (ΔT) of 4.9nm/L. In the stimulated Johnsen score was 1.6±0.8 and successful sperm retrieval (SSR) rate 28.2%(17/39). The 25 men who did not received stimulation had pre-mTESE serum Testosterone of 10.5±4.9, Johnsen score of 1.6 the average Johnsen score 1.5±6 and SSR of 28%(7/18). Comparing men who had successfulvs unsuccessful mTESE - higher level of serum T seemed to correlate with successful sperm retrieval (p: 0.036). Among men who received endocrine stimulation therapy ΔT before and after stimulation did not correlate with successful outcome. Age had no affect success.

Conclusions
Our study shows that there is a significant improvement of serum T concentration following endocrine stimulation therapy in KSmen. Overall the hormonal stimulation seems not to be related to a higher success rate of mTESE but our data do suggest positive correlation between higher level of preoperative serum Testosterone and successful mTESE in patient suffering from KS.

Conflicts of Interest
None