bluuebunny/crossref_metadata_2025_split huggingface dataset:
(314) An Evaluation of Race-Based Representation Among Men Participating in Clinical Trials for Prostate Cancer and Erectile Dysfunction
Authors: Saltzman R , Zucker I , Campbell K , Gandhi D , Otiono K , Weber A , Masterson T , Ramasamy R 
Published: May 2023

Abstract

Introduction
Inclusion of ethnic/racial minorities in clinical trials is essential to fully assess therapeutic efficacy. It is well-known that populations respond dissimilarly to interventions. This concept has been research ed thoroughly in the context of urologic oncology research, however research into the impact of demographic characteristics in andrology trials is lacking.

Objective
To analyze the inclusion of historically under-represented minority men in clinical trials for Erectile Dysfunction (ED) in comparison to Prostate Cancer (PC) trials.

Methods
We searched ClinicalTrials.gov for the disease keyword: “Erectile Dysfunction” and used “Prostate Cancer” trials for comparison. Completed trials that had available demographic data were included for analysis. Literature was reviewed to determine the prevalence of ED and PC diagnosed among Hispanic, Black, White, and Asian men. The proportion of individuals of each group that participated in trials is divided by the proportion of each group in the disease population to calculate the “Participation to Prevalence Ratio” (PPR). PPRs between 0.8-1.2 indicates adequate representation, 1.2 is over-representation.

Results
A total of 312 trials were assessed: 289 for prostate cancer and 23 for ED. Hispanic men comprised 11.8% of ED trial participants and 4.61% of prostate cancer trial participants, yet represented 18% of ED patients and 7.3% of PC patients. Black/African-American (AA) men accounted for 10.2% of ED trial participants and 9.4% of PC trial participants, but comprised 16% of ED patients, and 16.3% of PC patients. Hispanic and AA men are under-represented in trials for ED and Prostate Cancer (Hispanic ED PPR=0.66; Hispanic PC PPR=0.63; AA ED PPR=0.42; AA PC PPR=0.58).

Conclusions
Our findings show that both Hispanic and AA men are underrepresented in both ED and PC clinical trials. A greater emphasis must be placed on achieving representative enrollment in clinical trials for ED and PC in order to address this disparity and improve generalizability of the findings.

Disclosure
No
(318) Evaluating the Readability of Online Testosterone Search Results
Authors: Pominville R , Callegari M , Pei E , Sarica E , Prunty M , Jesse E , Loeb A , Abou Ghayda R , Thirumavalavan N 
Published: May 2023

Abstract

Introduction
Patients and physicians are increasingly utilizing online platforms to disseminate health information. With the explosive interest and growth in testosterone therapy (TTh) amongst patients, providers and business interests, online health information plays a significant role in patients' healthcare decisions. Nearly all patients engage some form of online tool, search engine or resource when learning about a condition, treatment and alternatives that may exist. While the availability of information can be helpful, left unchecked it could preclude or even obstruct accurate and timely information dissemination to the very target audience.

Objective
Our study evaluated the source and readability of web-based information available to patients regarding TTh found through online search engine results.

Methods
The first 50 web results from Google search terms “Testosterone Therapy” (TTh) and “Testosterone Replacement” (TR) were analyzed. Sources were categorized as Academic, Commercial, Institutional, or Patient Support before being evaluated using validated readability and English language text assessment tools including the Flesch Reading Ease score, Flesch Kincade, Gunning Fog, Simple Measure of Gobbledygook (SMOG), Coleman-Liau Index and Automated Readability index.

Results
77 unique sources were identified. The average grade level required for understanding academic sources was 16 (college senior); commercial, institutional, and patient support sources were 13 (college freshman); 8 and 5 grade levels, respectively above the average U.S. adult. Patient support sources were most prevalent, while commercial sources were the least at 35% and 14%, respectively. The average reading ease score was 36.8, indicative of difficult-to-read material overall. Academic sources utilized 296% and 228% more words compared to commercial and institutional/patient support sources, respectively.

Conclusions
The most immediate online sources for TTh information grossly exceeds the average reading level and understanding of most adults within the U.S. Within the growing realm of TTh, more attention should be taken to publish accurate, accessible, and readable material in order to improve patient health literacy and empower patients.

Disclosure
No
(331) Whole Exome Sequencing Identifies Rare CFTR Variant in Two Brothers with CBAVD and CUAVD
Authors: Dullea A , Khodamoradi K , Campbell K , Schuppe K , Griswold A , Masterson T , Arora H , Ramasamy R 
Published: May 2023

Abstract

Introduction
Congenital Bilateral Absence of the Vas Deferens (CBAVD) is a condition leading to obstructive azoospermia and male infertility. CBAVD is associated with mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. Congenital Unilateral Absence of the Vas Deferens (CUAVD), where only one vas deferens is missing, is also associated with mutations in the CFTR gene. However, the genetic causes of both conditions are not fully understood and warrant further investigation. We present two brothers, one with CBAVD and one with CUAVD, who were subjected to whole exome sequencing.

Objective
To assess genetic similarities using whole exome sequencing between two brothers with differing reproductive capacities.

Methods
Whole exome sequencing was performed in two brothers. Subject A was 39-year-old-male who had previously fathered a child and was diagnosed with CUAVD during his vasectomy. Subject B was a 37-year-old male diagnosed with CBAVD, and genetic testing significant for one copy of a mutated cystic fibrosis gene (unaffected CF carrier). Whole blood was collected. DNA was extracted and quality assessed. Finally, whole exome sequencing was completed.

Results
Whole exome sequencing results were subjected to annotation and filtering. Both subjects were noted to share a rare mutation in the CFTR gene (p.R347H). CFTR mutations are the most common cause of CBAVD and have also been linked to CUAVD. However, this is a unique case of two brothers with the same genetic mutation but different phenotypic expressions of the mutation.

Conclusions
We have identified a rare CFTR variant (p.R347H) in two brothers with different reproductive capacities. We present evidence that absence of the vas deferens (unilateral or bilateral) may be associated with CFTR mutations, even in the absence of diagnosed cystic fibrosis. Understanding the phenotypic spectrum of CFTR gene mutations is pivotal to treating associated male infertility.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Acerus Pharmaceuticals, Boston Scientific, Coloplast, Endo Pharmaceuticals, Empower Pharmacy, Nestle Health, Olympus, Hims Inc.
(333) Association Between TNP2 G1272C Polymorphism and Human Male Infertility: A Meta-analysis
Authors: Zulfiqar N , Arshad A , Irfan M , Bibi A 
Published: May 2023

Abstract

Introduction
Infertility is defined as the incapability to achieve fertilization after 1 year following sexual intercourse without any contraceptive measure. Poor sperm quality contributes to 90% of male infertility. Spermatogenesis takes place in the seminiferous tubules of the testis by proliferation followed by complex morphologic, physiologic, and biochemical modifications that result in the formation of mature spermatozoa. These specific events are supported by spermiogenesis-specific gene products. During spermiogenesis, sperm chromatin undergoes a series of modifications in which histones are lost and replaced with transition proteins and subsequently with protamine. Replacement of histones to protamine is impotent in the formation of mature spermatozoa. Histones are important for DNA replication but in spermatogenesis histones replacement with protamine prevents DNA replication and causes sperm maturation. Any problem in this replacement may cause male infertility. The nuclei of elongated and condensing spermatids contain nuclear transition protein 1 (TNP1) and nuclear transition protein 2 (TNP2) but tnp2 is more effective. TNP2 plays a critical role in shaping sperm nucleus, displacement of histones with protamine condensation of chromatin, and binding of protamines to DNA.

Objective
This review aims to determine the association of a TNP2 polymorphism (G1272C) with the risk of male infertility.

Methods
PUBMED, CENTRAL, Google Scholar and PMC articles were searched, whereas case-control, published studies regarding TNP2 polymorphism (G1272C) and male infertility were selected for this meta-analysis.

Results
Based on literature search and inclusion criteria, 3 case-control studies out of the total 16 articles were selected, ranging from 2005 to 2019. The included case-control studies observing G1272C polymorphism in the TNP2 gene contained 534 cases and 516 controls. No significant association (p &gt; 0.05) between G1272 polymorphism and male infertility was found, based on all of the three genetic models. Whereas, when we pooled the data of two population of same region i.e. Iran, significant association (p &lt; 0.05) was found between G1272C polymorphism and male infertility on the basis of additive model (CC vs GG: OR= 0.34, 95% CI [0.20-0.56], I2 = 81%), dominant model (CC+CG vs GG: OR= 0.46, 95% CI [0.32-6.67], I2 = 91%) & recessive model (CC vs CG + GG: OR= 0.48, 95% CI [0.31-0.76], I2 = 85%), showing that this polymorphism might contribute to the male infertility, depending upon the ethnicity.

Conclusions
TNP2 G1272C may play role in male infertility suggested by the significant association in the Iranian population.

Disclosure
No
(336) Penile Rehabilitation Programs after Nerve-sparing Prostatectomy: What are the Expectations of the Partners?
Authors: Bannowsky A , Bannowsky S , Osmonov D , Maerker V , Ueckert S 
Published: May 2023

Abstract

Introduction
Several strategies are published for postoperative erectile function rehabilitation after nerve-sparing radical prostatectomy (nsRP). Expectations of the partners of the patients are rarely subject of most of these rehabilitation studies.

Objective
The aim of our study was to evaluate the expectations of the partners of patients undergoing nerve-sparing radical prostatectomy and penile rehabilitation programs.

Methods
We performed a questionnaire sent to the partners of all enrolled patients of 3 different penile rehabilitation studies after nsRP with a regular dose of different PDE5-inhibitors (sildenafil/vardenafil/tadalafil). 124 patients (mean age 69 years) had been enrolled in the rehabilitation studies and their partners (mean age 66 years) were included in this study. The survey consists of different questions, e.g. if the partners believe in the rehabilitation concept and what they expect with regards to the outcome.

Results
78 partners of the 124 patients (63%) completed and returned the questionnaire. Before rehabilitation treatment 51 partners (65%) believed in the concept of rehabilitation, but only 32 partners (41%) expected partly to fully rehabilitation of erectile function of the partners caused by the initiated penile rehabilitation program. After the end of the study treatment, 2 years after nsRP, 45% of the partners are satisfied by the recovery of erectile function of their partners.

Conclusions
Only 41% of the partners of patients within penile rehabilitation programs expect partly to fully recovery of erectile function after nsRP. Satisfaction rate with erectile function recovery was reported by 45% of the partners 2 years after nsRP.

Disclosure
No
(341) Prevalence of Sexual Disorders in a Sample of Patients Suffering from Breast Cancer
Authors: Elfeqi R 
Published: May 2023

Abstract

Introduction
There is scarce evidence on prevalence of sexual disorders at large and particularly in the region where I work and practice psychiatry and sexology. Not to mention, lack or research and evidence in regard to sexual disorders among females suffering from Breast Cancer.

Objective
Assess the prevalence of females suffering from a sexual disorder in my region is a challenge on its own - checking in the prevalence of females suffering from a sexual disorder while in the course of treatment from Breast Cancer is another challenge since sex could be the last thing they want to talk about – possibly.

Methods
1000 female patients were randomly selected at the outpatient clinic of a national cancer hospital over the course of four consecutive months by initial simple questionnaire inquiring about mood, sleep, appetite, level of energy, relationship with partner, intimacy with partner and frequency of having sex and if there is any problems or pain experienced during sex. Those reported to have any sexual symptoms or complaints were taken to sexual interview using the PLISSIT model. When necessary, the partner was called in for assessment too. To implement the first simple survey - I had to psychosexual educate personnel in Pain clinic - where the survey was distributed beside psychiatry clinic - and recruit 4 psychology students under training to help conducting the survey - so I could reach the 1000 sample within the course of four months. Symptoms of depressive mood, disturbed appetite and disturbed sleep, lack of energy, were associated with sexual disorder.

Results
N 708 patients 70 % reported turbulent marital relationship and distant partners before or after illness. N 738 patients reported suffering from a diagnosable sexual disorder mainly Female Sexual Interest/Arousal Disorder plus or minus vaginal dryness as a sequel of chemotherapy regimen indicated at the time. N 200 patients 20% reported partners to be suffering from a diagnosable sexual disorder mainly erectile disorder and/or sexual disorder due to substance use disorder. While N 292 30% reported good relationship with their caring husbands and flowing sexual life fostered by warm intimacy.

Conclusions
Sexual disorders are widespread and remarkably under diagnosed and overlooked in the treatment of breast cancer while prevalence is approaching 80 %. It would be interesting to take this research to the next level and study the prevalence of female sexual interest/arousal disorder in relation to each and every chemotherapeutic agent versus surgery and radiotherapy as well as hormonal therapy between females who underwent female genital mutilation surgery (circumcised) versus those who are not circumcised. It is very important to early diagnose and treat sexual disorders to restore intimacy and create a better quality of life for females suffering from breast cancer - better adherence on follow up and less stress to counteract relapse of cancer.

Disclosure
No
(343) Predictors of Corporo-venocclusive Dysfunction (CVOD) in Men with Bilateral Nerve-sparing Radical Prostatectomy (RP)
Authors: Flores J , Salter C A , Benfante N , Schofield E , Mulhall J P 
Published: May 2023

Abstract

Introduction
Nerve-sparing status (NSS) during RP is a significant predictor of erectile function recovery (EFR). Poor nerve sparing is associated with collagenization of cavernosal smooth muscle and CVOD development with typically poor response to PDE5 inhibitors (PDE5i) and intracavernosal injection therapy (ICI).

Objective
This study aimed to define factors predictive of CVOD in men with bilateral NS RP.

Methods
Study population consisted of (i) men who underwent bilateral NS (defined by the surgeon using an institutional grading system) RP (ii) with poor response to PDE5i and ICI (iii) ≥2 years post-RP (iv) who underwent penile duplex Doppler ultrasound (DUS) (v) using a vasoactive agent redosing schedule. CVOD diagnosis was made with end-diastolic velocity (EDV) values ≥5 cm/sec bilaterally. ADT and radiation therapy were exclusions. We used multivariable modeling to define factors predictive of CVOD. Factors included in the model: patient age, history of diabetes, history of obstructive sleep apnea, number of vascular comorbidities, baseline EF, peri-RP total testosterone (T) level, and total T at DUS (within 3 months).

Results
201 men with a mean age of 66 ± 7 years. 25% of the patients reported 3 or more vascular comorbidities, 17% had diabetes, 36% obstructive sleep apnea, 39% were current or former smokers. Mean baseline PSA and pre-RP total T was 6.7 ± 6 ng/mL and 410 ± 211 ng/dL, respectively. Median baseline EFD score was 24 (13, 29). 49% of the men had an erection less than penetration rigidity during the DUS procedure with a mean total dose administered of 87 ± 21 units of trimix. 69% received 100 units. CVOD was diagnosed in 76%. Mean total T at DUS was 386 ± 177 ng/dL. 32% had low T. Significant predictors of CVOD after RP in men with BL NSS were: OSA (OR = 3.8, 95% CI = 1.7-8.7), ≥ 3 vascular comorbidities (OR = 5.0, 95% CI = 1.7-14.8), age at the time of DUS (per 10 years increase, OR = 1.9, 95% CI = 1.2-3.0), and pre-RP EF domain score (per 1 unit increase, OR = 0.93, 95% CI 0.88-0.98). There was a signal that in a larger sample size, diabetes may be a significant predictor of CVOD in this group of patients (OR = 2.7, 95% 0.9-8.0).

Conclusions
Baseline clinical comorbidities pre-RP have a significant impact on EFR post-RP, in particular, the presence of venous leak. Despite BL NSS, older patients, men with OSA, higher number of comorbidities pre-RP, and lower pre-RP EF increased the likelihood of developing CVOD post-RP.

Disclosure
No
(348) Implementation of Opioid- Free and Opioid-Reduced Protocols for Postoperative Pain Management After Penile Prosthesis Surgery
Authors: Henry A , Novicoff W , Kennady E , Ali M , Smith R , Baumgarten A , Ortiz N 
Published: May 2023

Abstract

Introduction
Postoperative pain management after (PP) penile prosthesis is challenging and it has traditionally required opioid medication. In light of the ongoing nationwide opiate epidemic and in an effort to reduce the risk of postoperative opioid dependence, urologic prosthetic surgeons have sought to establish opioid-free and/or opioid-reduced protocols (OFP, ORP respectively) for PP postoperative pain management.

Objective
This study seeks to investigate the patterns of adoption of OFP or ORP among surgeons who perform PP surgery and potential barriers to their implementation.

Methods
A 13-question confidential survey was sent to members of the Sexual Medicine Society of North America (SMSNA) via email. The survey was administered via Qualtrics. T-test was used to analyze survey responses.

Results
43 urologists responded to the survey, with representation from every American Urologic Association geographic section. Most respondents (73.18%) performed penoscrotal PP and 43% of respondents performed more than 30 PP per year. OFP was used most of the time by 24.39% of respondents and ORP was used most of the time by 73.18%. No significant relationship was found between the use of an OFP/ORP and geographical region, number of implants performed per year, surgical approach, or location of reservoir placement. Of the respondents using an ORP, 100% prescribed 10 doses of opioid medication or less upon discharge. 41.51% of respondents used an OFP/ORP from published literature and 9.43% consulted their local anesthesia or pain management department. The most commonly used modalities of non-opioid analgesia were: non-steroidal anti-inflammatories (95.1%), acetaminophen (87.8%), dorsal penile block (80.4%), gabapentin (46.3%), and pudendal block (43.9%). Following initiation of an ORP/OFP, 9.3% reported an increase in phone calls and 11.6% reported an increase in refill requests. There were no reports of increased patient dissatisfaction. Most respondents (65.8%) were extremely satisfied with their protocols.

Conclusions
OFP/ORP after PP surgery appear to be widely adopted by the urologic prosthetic community without a significant increase in patient or surgeon dissatisfaction.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast (ASB).
(350) Narcotic Requirements and Operative Outcomes of a Pudendal Nerve Block Prior to Primary Inflatable Penile Prosthesis Implantation in a Multiethnic Population
Authors: Labagnara K , Loloi J , Babar M , Aalami Harandi A , Zhu M , Salami A , Patel R , Bernstein A , Davuluri M , Davila J , Maria P 
Published: May 2023

Abstract

Introduction
There are various analgesic regimens for post-operative pain control following inflatable penile prosthesis (IPP) implantation. Specifically, post-operative pain control with opioids is a common practice, but efforts to minimize narcotic usage are vital given the current opioid epidemic in the United States. Pudendal nerve block (PNB) provides regional perineal and penile anesthesia and represents an attractive option to maximize pain control while minimizing post-operative narcotic use. However, there is a paucity of studies describing whether utilization of PNBs decreases intra- and post-operative narcotic requirements following IPP implantation.

Objective
To determine whether PNB utilization in a multiethnic population undergoing primary IPP implantation can decrease rates of post-operative opiate usage. Secondary objectives were to assess PNB utilization on intra-operative and 30-day safety outcomes.

Methods
A single institution retrospective study was conducted of patients who underwent primary IPP implantation between December 2015 and February 2022. Demographic data, intra-operative characteristics, and outcome measures were extracted from electronic medical records. Baseline characteristics of PNB (yes or no) were summarized and analyzed using a Student’s t-test, Chi-square test, or Mann-Whitney U for non-normally distributed variables. PNB usage and PACU opioid administration (yes or no) were analyzed using binary logistic regression for univariate and multivariate analysis.

Results
A total of 363 patients were included, 294 (81.0%) in the PNB group and 69 (19.0%) in the non-PNB group. The majority of patients were of Hispanic race (62.3%). History of chronic pain (17.7% vs. 7.2%, p=0.03) and hyperlipidemia (52.0% vs. 34.8%, p=0.01) were more prevalent in the PNB group. Significantly more IPPs in the PNB group had cylinders measuring 20 centimeters or greater (57.1% vs 41.2, p=0.017). Estimated blood loss of 50ml or greater (43.1% vs. 20.0%, p&lt;0.001), PACU narcotic usage (61.6% vs. 75.4%, p=0.040) and time (minutes) spent in the PACU (144 [111-185] vs. 238 [162-307], p&lt;0.001) were all significantly lower in the PNB group. There were no significant differences in postoperative and 30-day safety outcomes. On univariate analysis, both PNB (OR=0.52, p=0.043) and age above 65 (OR=0.53, p=0.004) were associated with a lower likelihood of receiving opiates in the PACU, while only age remained significant (OR=0.53, p=0.006) on multivariate analysis.

Conclusions
Pre-operative PNB decreases intra-operative estimated blood loss, post-operative opioid analgesic requirements and time spent in PACU in patients undergoing a primary IPP implantation. Thus, PBN represents a potentially attractive, non-opioid means of analgesia in patients undergoing primary IPP surgery.

Disclosure
No