bluuebunny/crossref_metadata_2025_split huggingface dataset:
(262) Grumpy Young Men? Factors Associated with Bother in Men with Peyronie’s Disease
Authors: Tyler A , Green B , Savage J , Brearton K , Ziegelmann M , Helo S , Kohler T , Trost L 
Published: May 2023

Abstract

Introduction
Age is often correlated with various medical conditions, including bother with the condition itself. Peyronie’s disease (PD) is a condition which is most often associated with men in their 50-60’s, however, it does affect younger men as well. Anecdotally, younger men with PD appear to be more bothered by their condition compared to older men. We therefore sought to evaluate whether there is a difference among older vs younger men as to the degree of bother linked to PD.

Objective
To evaluate age as a potential predictor of bother associated with PD.

Methods
A prospective database has been maintained of men seeking treatment for PD. Beginning in Feb 2020, we began implementing men routinely completed standardized intake questionnaires relating to PD, including the Peyronie’s Disease Questionnaire (PDQ). The PDQ consists of 15 questions broken down into three key subdomains: psychological and physical, penile pain, and symptom bother. Men who had completed the PDQ questionnaire were evaluated to determine the correlation between various clinicopathologic variables and the PDQ-bother domain.

Results
A total of 645 men were seen for symptoms of PD and had PDQ questionnaire data available for review. Baseline demographics included a mean age was 51.8 years (SD 17.6), mean PD symptom duration 31.3 months (SD 65.3), estimated curve of 40.9 degrees (SD 26.8), and mean PDQ-Bother score 8.9 (SD 3.1 – Note: lower is better). Several clinicopathology variables were found to be associated with increased PDQ-bother scores, including age (younger = less bothered, parameter estimate -.0.03, p=0.03), the presence of indentation or hourglass (yes 9.4, no 8.4, p&lt;0.05), pain (yes 9.3, no 8.5, p=0.16), PD preventing penetrative intercourse (yes 9.5, no 8.7, p=0.07), penile shortening (yes 9.3, no 8.7, p=0.10), subjective erectile dysfunction (yes 9.6, no 8.5, p&lt;0.01), and subjective premature ejaculation (yes 9.8, no 8.4, p&lt;0.01). Interestingly, several variables did not correlate, including the duration of relationship, frequency of intercourse, duration of symptoms, direction of curve, degree of curvature, partner pain with intercourse, or libido.

Conclusions
Several notable factors are associated with PD bother (as assessed by the PDQ-bother domain), and equally importantly, several factors are surprisingly not associated (e.g. curvature degree and direction). These factors provide useful information to the practicing clinician to help better identify men who may be at greater risk for bother associated with the condition.

Disclosure
No
(263) Collagenase Clostridium histolyticum for Peyronie’s Disease: No Need to Postpone, but No Need to Rush
Authors: Roshandel R , Byrne E R , Alom M , Helo S , Kohler T S , Ziegelmann M J 
Published: May 2023

Abstract

Introduction
There is no agreed-upon definition for acute/chronic phases of Peyronie’s Disease (PD). Collagenase Clostridium histolyticum (CCH) is the only FDA-approved treatment for PD, but original phase-3 trials included patients with symptom duration &gt; 12 months (“chronic phase”).

Objective
Here, we sought to evaluate the influence of time between symptom onset and starting CCH on treatment outcomes.

Methods
Men receiving CCH from 2014-2021 were included in an IRB-approved database. Pertinent data were reviewed, including demographics and curvature assessments. The duration between symptom onset and starting treatment with CCH was assessed to determine if the time from symptom onset to treatment impacted objective outcomes.

Results
One hundred forty-five patients completed the entire series of 8 injections and had complete data for review. Mean baseline curvature 53.2o (SD 18). The mean time between symptom onset and CCH was 14.8 months (SD 18). Mean absolute and percentage improvements were 20.3o (SD 16) and 39.4% (SD 35). Symptom duration did not significantly impact curvature improvement (Figure 1). Similarly, symptom duration did not significantly impact the risk for CCH-related side effects.

Conclusions
The time between symptom onset and treatment did not significantly impact outcomes with CCH. Our findings support the utility of using CCH early in the course of PD and emphasize the opportunity to delay if necessary without compromising efficacy.

Disclosure
No
(269) Research Action on Massive Open One line Courses (MOOCs) Rights, Sexual Health & Education
Authors: Troussier T , Dinh M , Itodo O , Gerbase A , Ward S 
Published: May 2023

Abstract

Introduction
The general objective of this Rights, Sex & Education MOOC, composed of 6 to 8 units, is inviting our learners and empowering them to act autonomously in their interventions in sexual health, by ensuring that their speeches, behavior and attitudes will follow and respect human rights values. In this context, learners are not only (medical) health professionals but rather engaged citizens.

Objective
To advance knowledge and practice in the priority area of human rights in relation to sexual health. This includes a variety of aspirations: ➢ the protection of young people from sexual violence, ➢ the fight against gender inequality, incest, sexual mutilation, sexual exploitation, ➢ the fight against sexist and homophobic prejudices.

Methods
The modules and sub-modules are combination of several formats: animated videos, podcasts, video interviews, infographics, cartoons, and evaluation, pedagogical and post-evaluation quizzes. This variation of formats allows us to keep learners engaged. This MOOC is also part of a Blended-learning approach. Therefore, we worked on animating throughout the opening sessions of the MOOC private groups on social networks, where learners discussed and exchanged material regularly. Our aim is the creation of a horizontal learning dimension as well as a group entity.

Results
This MOOC is a training tool designed at its core to be adapted and carried worldwide. Its first French version, in 2021, has been created with formats easily adaptable to the contexts and contents that will be imagined and redrawn in an English version. With a satisfaction rate of 93%, 4500 subscribers and more than 600 certifications.

Conclusions
We used the international format of a MOOC to fulfill the role that UNESCO chair plays in promotion of sexual health and human rights. Our ambition is to become an international reference in the field of sexual health and human rights. To take this project to the international level by consulting experts from each region in order to add and enrich this MOOC with information needed and adapted to each population and ecosystem and to respond to concerns raised by the context in which the region or the target population lives. Therefore UNESCO Chair Sexual health and Human rights created a network UNITWIN “EducationS and health for human sustainable development”.

Disclosure
No
(294) Trends and Clinical Practice Patterns of Prostatic Urethral Lift (PUL): An Analysis of the American Board of Urology Case Logs
Authors: Thorogood S , Zhang T , Sze C , Strasser M , Demeo G , Lee R , Chughtai B , Te A , Hu J 
Published: May 2023

Abstract

Introduction
Prior studies have shown that among benign prostatic hyperplasia (BPH) surgical treatments, PUL has a higher likelihood of preserving sexual function. As a result, the 2021 AUA guidelines on management of BPH note that PUL may be offered as a treatment option to those eligible patients who desire preservation of erectile and ejaculatory function.

Objective
We investigated practice trends associated with PUL utilization and hypothesized that PUL would be performed more frequently for younger patients and by urologists subspecializing in andrology (infertility and/or sexual medicine).

Methods
We obtained de-identified, self-reported American Board of Urology (ABU) case logs from 2015-2021. We identified 4,131 urologists who performed 48,610 surgeries with an indication for BPH per ICD codes. CPT codes distinguished PUL from transurethral incision, electrosurgical resection, laser coagulation/vaporization, laser enucleation, and thermotherapy. We identified 786 urologists who performed 7,895 PUL procedures representing 19.2% of all BPH surgeries. Additionally, 24 urologists only performed PUL, and 3,345 urologists did not perform any PUL. A logistic regression model assessed factors independently associated with performing PUL.

Results
The number of annual PUL performed has ranged from 101 to 2,852, comprising an increasing proportion of BPH surgeries from an initial 1.6% in 2015 to 32.5% of all BPH surgeries performed in 2020. In adjusted analyses, factors associated with higher odds of performing PUL included subspecialization in andrology (odds ratio [OR] 4.01, 95% CI 1.94-8.29); practice area population &gt;1,000,000 (OR 1.55, 95% CI 1.01-2.38); and government (OR 4.22, 95% CI 1.83-9.74), private practice group (OR 2.68, 95% CI 1.53-4.68), and salaried hospital employment (OR 1.94, 95% CI 1.00-3.96). The operative year (OR 1.66 per year, 95% CI 1.54-1.80) and surgeon BPH surgical volume (OR 1.02 per case increase, 95% CI 1.01-1.02) were associated with increased odds of performing PUL. Endourology subspecialization was associated with lower odds of PUL (OR 0.40, 95% CI 0.2-0.8). Geographic region, surgeon age, surgeon gender, certification vs recertification status, and patient age were not associated with use of PUL.

Conclusions
Based on 7 years of ABU case log data, PUL is more likely to be performed by andrologists, urologists practicing in large metropolitan areas, higher volume BPH surgeons, and urologists in private practice group, government, or hospital salaried employment. Contrary to our hypothesis, lower patient age was not associated with a higher odds of undergoing PUL. The use of PUL has increased significantly and currently comprises one third of all BPH surgeries. More study is needed to determine the extent to which patient demand for ejaculation preservation is driving the rapid adoption of PUL reflected in the ABU case logs.

Disclosure
No
(295) Prostatic Urethral Lift (PUL) is Superior to TURP in the Preservation of Ejaculatory Function in Patients with Obstructive Median Lobes (OML)
Authors: Eure G , Gratzke C , Barber N , Sievert K , Gange S , Mueller T 
Published: May 2023

Abstract

Introduction
For the past several years, the AUA has recommended PUL as a treatment option for eligible patients who desire preservation of erectile and ejaculatory function.

Objective
This analysis serves as the first detailed assessment of sexual function and symptom outcomes among patients treated with PUL, TURP or sham in controlled and real-world studies of PUL.

Methods
Outcomes including MSHQ bother and ejaculatory function scores were compared for the following groups through 12 months: 66 patients from the L.I.F.T. pivotal RCT with lateral lobe (LL) obstruction randomized to sham, 36 men with LL obstruction in the BPH6 RCT randomized to TURP, and 45 men with OML in MedLift, the FDA-approved IDA extension of the LIFT trial. Patients in the large RWR study were filtered to approximate the MedLift population and results for the 187 OML patients were compared with MedLift.

Results
OML patients treated with PUL demonstrated superior ejaculatory function and bother scores compared to TURP LL only at all timepoints (Figure 1); at 1- and 3 months, MedLift subjects also experienced significantly better IPSS and QoL improvement post-PUL compared to TURP. IPSS improvement was 170% greater for MedLift subjects than sham LL at 3 months; MedLift subjects experienced significantly better QoL, Qmax, and BPHII improvements over the same time period. IPSS, QoL, Qmax, and PVR outcomes were equivalent for MedLift and RWR OML groups at 3-, 6-, and 12 months post-PUL; overall adverse events were not elevated in the RWR OML group.

Conclusions
Compared to TURP, PUL provides quicker symptom improvement during the early post-operative period with superior ejaculatory function outcomes through 12 months post-treatment in patients with OML. PUL continues to preserve sexual function for BPH patients despite LL or OML obstruction.

Disclosure
Yes, this is sponsored by industry/sponsor: Neotract, Inc./Teleflex

Clarification
Industry initiated, executed and funded study
Any of the authors act as a consultant, employee or shareholder of an industry for: Neotract, Inc./Teleflex.
(307) Is Vitamin D Deficiency Associated with Low Testosterone Levels in Asian LUTS Patients?
Authors: Lee J , Cho M C , Choi H , Son H , Kim S W 
Published: May 2023

Abstract

Introduction
It has been hypothesized that vitamin D and testosterone levels are associated, but the evidence is still unclear.

Objective
We aimed to investigate the association between hypogonadism and vitamin D deficiency.

Methods
A retrospective analysis was performed on 471 Asian male who visited for the first time with LUTS (mean age 60.56±10.79 year) of two medical centers between 2014 and 2018. Serum vitamin 25(OH)D and testosterone levels in morning samples were measured. 25(OH) D was also classified as sufficiency (&gt;30ng/mL), insufficiency (30-20ng/mL), deficiency (&lt;20ng/mL), and testosterone as hypogonadism (&lt;300ng/dL) and non-hypogonadism (≥300ng/dL). The association between 25(OH) D and total testosterone (T), free testosterone (FT), bioavailable testosterone (BT), and international index of erectile function (IIEF)-5 was analyzed using t-test, partial correlation analysis, and propensity matching (propensity score 1:2). The seasonal variation of 25(OH) D and testosterone were also analyzed by one-way ANOVA.

Results
Mean testosterone level and ages of hypogonadism (n=88) were 2.3±0.6ng/dL and 60.0±10.8 year, and those of non-hypogonadism (n=383) were 5.3±1.8ng/dL and 63.0±10.3 year. The mean value of 25(OH)D (20.6±11.4ng/mL vs. 20.1±8.5ng/mL, p=0.649) and number of 25(OH)D classification (sufficiency=13 [14.8%], insufficiency=24 [27.3%], deficiency=51 [58.0%] vs. sufficiency=52 [13.6%], insufficiency=124 [32.4%], deficiency=207 [54.3%], p=0.648) did not differ between hypogonadism and non-hypogonadism groups. There was no significant difference of 25(OH)D even after propensity matching for the ages, BMI, diabetes, coronary heart disease, cerebrovascular disease of the two testosterone groups (p=0.811). 25(OH)D also showed no association with the level of T, FT, BT or IIEF-5 total scores even after adjusting for age by partial correlation analysis (p=0.470, p=0.375, p=0.735 and p=0.461, respectively). In one-way ANOVA analysis, 25(OH)D was significantly higher in summer than winter (26.8±12.5ng/mL vs. 19.0±8.6ng/mL, p=0.02), whereas testosterone showed no seasonal variation.

Conclusions
We could not find a significant association between vitamin D deficiency and hypogonadism in elderly Asian LUTS patients, even after adjusting for age, BMI, diabetes, coronary heart disease, cerebrovascular disease. The association of vitamin D levels on sexual function and seasonal variation of testosterone remains still unclear. Further large and well-designed studies are needed to determine the association between vitamin D and testosterone levels in healthy individuals.

Disclosure
No
(316) In Search of the Client Characteristics in an Embedded LGBT Health Clinic in Vietnam
Authors: Nguyen H V P , Tran N T , Nguyen N A T , Dinh B Q , Truong T K T , Mai D T B 
Published: May 2023

Abstract

Introduction
Today in Vietnam, LGBT people face barriers in accessing healthcare services mainly due to the lack of reliable and friendly healthcare facilities. The limited knowledge about gender diversity makes it difficult for LGBT people to be accepted. The percentage of transgender people taking hormones without medical supervision is up to 70%. In order to help LGBT people avoid risks, get psychology counseling, and be able to treat physical problems, a hospital that specializes in andrology and sexual medicine opened an LGBT Health Clinic was established in June 2019. This was the first and only embedded clinic for LGBT people in a Vietnamese public hospital.

Objective
This study aimed to ascertain the salient characteristics of the clients who come to Binh Dan Hospital LGBT Health Clinic in the first 24 months of implementation. From these findings, there will be appropriate content and communication channels strategies for reaching local LGBT people.

Methods
One hundred fifty-eight clients were included in a cross-sectional descriptive study from June 2019 to June 2021. The data on demographic characteristics, how customers know about the clinic, and unmonitored gender-affirming hormone therapy (GHT) behavior are all noted.

Results
There are 50.6% transgender, 29.1% gay, 11.4% lesbian, 5.1% bisexual, and 3.8% heterosexual. The primary demand of 42.4% of transgender people is to receive advice and follow-up on transgender procedures. Hormonal users without medical supervision accounted for 32.5% and are associated with a low level of education (r=-0.348, p&lt;0.01). The chief demand of 38% of the LGB group is check-up programs for gender-diverse and gender-non-conforming or counseling for family acceptance. LGB group knew about the clinic through mass media (48.61%) equivalent to word-of-mouth (51.39%), while the majority of transgender (65%) used word-of-mouth. While the majority of transgender (65%) used word-of-mouth, 51.39% of the LGB group knew about the clinic through word-of-mouth.

Conclusions
There are differences in demands and communication channels for approaching the transgender and LGB group. There is an inverse correlation between unmonitored GHT behavior and education level in transgender clients.

Disclosure
No
(382) Trimodal Therapy for Erectile Dysfunction: Combination of Low-intensity Shock Waves, Platelet Rich Plasma (PRP) Injections and Vacuum Erectile Device Physiotherapy
Authors: Ruffo A , Esposito F , Iacono F , Stanojevic N 
Published: May 2023

Abstract

Introduction
Nowadays it is proved that low intensity shockwave therapy (LISW) have a positive effect in men with erectile dysfunction (ED). Platelet rich plasma (PRP) as well is used to treat ED. PRP contains many growth factors, such as IGF-1, BDNF and VEGF play a significant role in neural regeneration and up-regulation nNOS, as well as in the recovery of erectile function. Vacuum erectile device is used as physiotherapy to treat many penile disease.

Objective
The goal of our study is to investigate the efficacy of this trimodal treatment (Rigenerection ®) to treat ED

Methods
This prospective, randomized, controlled, interventional study enrolled 150 pts and randomly divided in two groups: Group A receiving LISW alone (1 weekly sessions) for 6 weeks and Group B receiving LISW + PRP (1 shot a week per 6 weeks) + Vacuum erectile device physiotherapy (15 minutes/daily per 3 months). Main outcome measures were: erectile function (evaluated through the IIEF5 questionnaire) and the peak systolic velocity (PSV) of the cavernosal artery (evaluated through color Doppler ultrasonography). Follow-up was at 3 months. The Mann-Whitney and Wilcoxon tests with a p&lt;0.05 where used to analize the data.

Results
In both groups, at 3 months follow-up, mean IIEF score and mean PSV ameliorated significantly. Intergroup analysis revealed a statistically significant higher mean IIEF score and PSV increase in patients receiving the trimodal treatment (p&lt;0.03; p&lt;0.001 respectively). Group A: IIEF score from a baseline of 14.2 to 17.9 at 3 months. PSV from 24.4 +/− 12.4 at baseline to 33.8 +/− 8.2 at 3 months. Group B: IIEF score from a baseline of 13.8 to 21.4 at 3 months. PSV from 27.3 +/− 42.6 +/− 7.3 at 3 months.

Conclusions
The trimodal therapy proved to be a valid tool in the treatment od ED. The combination of these procedures leads to better outcomes compared with the only therapy with LISW.

Disclosure
No
(392) The Impact of Radical Prostatectomy (RP) On Testosterone (T) Levels
Authors: Flores J , Benfante N , Mulhall J P 
Published: May 2023

Abstract

Introduction
Severe illness is associated with a decrease in T levels and in particular, radical cystectomy has previously been shown to result in a decrease in T levels. There is a lack of data on the impact of RP on T levels. This analysis aimed to address this question.

Objective
To evaluate the impact of RP on T levels.

Methods
The study population included (i) men who underwent RP (ii) with morning total T (TT) levels pre and post-RP (iii) measured using LCMS. We considered men who had TT levels measured ≤ 12 months before and after RP. Patients with radiation therapy, androgen deprivation therapy, or T therapy pre or post-RP were excluded. Differences in TT level pre and post-RP were measured. Low total T was defined as total T levels &lt; 300 ng/dL. Difference ≥ 100 ng/dL between pre and post-RP was considered clinically significant. Multivariable analysis was performed to define predictive factors associated with low T after RP. A p-value &lt;0.05 was considered statistically significant.

Results
569 patients were analyzed. Mean age was 62 ± 7 years, median pre-RP PSA level was 6.1 (4.3, 8.9) ng/mL, mean pre-RP TT level 402 ± 172 ng/dL. Median Gleason score (GS) was 7 (6,7). Post-RP, the mean TT levels were 425 ± 169 ng/dL. 30% of men had low T pre-RP, 27% post-RP. No significant difference was observed between the rate of low T pre and post-RP. 13% of the men had a significant decrease and 23% a significant increase in total T levels between pre and post-RP. After multivariable logistic regression assessments, lower baseline T was a predictor associated with low T post-RP (Pre-RP Testosterone (per 100 ng/dL decrease) OR = 3.96, 95% CI = 3.03-5.18).

Conclusions
Approximately 1 in 4 men with prostate cancer and RP had low T before and after surgery in our cohort. One tenth of men had a significant drop in TT level and about a quarter had a significant increase. Only lower pre-RP TT levels were a significant predictor of low T post-RP.

Disclosure
No