bluuebunny/crossref_metadata_2025_split huggingface dataset:
(153) ORGASMIC FUNCTION WORSENING COULD LEAD TO ERECTILE FUNCTION DECREASE AFTER HOLEP – RESULTS FROM A PROSPECTIVE TRIAL (ExpHo)
Authors: Dr. Paolo Capogrosso , Prof. Andrea Salonia , Dr. Giuseppe Fallara , Dr. Edoardo Pozzi , Dr. Eugenio Ventimglia , Dr. Nicolò Schifano , Dr. Federico Belladelli , Dr. Alessandro Bertini , Dr. Luigi Candela , Prof. Francesco Lanzaro , Dr. Federico Dehò , Francesco Montorsi 
Published: July 2023

Abstract

Objectives
Holmium laser enucleation enucleation of the prostate (HoLEP) has been associated with a low risk of erectile dysfunction (ED). We investigated factors associated with risk of erectile function (EF) worsening after surgery for men with normal pre-operative EF

Methods
The ExpHo trial (NCT03583034) is a prospective study collecting data of consecutive patients treated with HoLEP by one highly-experienced surgeon (&gt;1500 cases), at a single centre. All patients completed the International Index of Erectile Function (IIEF) at baseline and those with normal IIEF-EF (&gt;26) were considered for this analysis. Patients have been re-assessed at 1 week, and at 1, 3, 6 and 12 months throughout the follow-up (FU). Kaplan Meier analysis investigated the risk of EF decrease over time. Cox-regression model tested predictors of post-operative EF worsening

Results
Of 242 patients, 66 reported normal IIEF-EF before surgery. Baseline median (IQR) age was 65 (60-70) years and prostate volume (PV) was 75 (58-100) mL. Median pre-operative IIEF-orgasmic function (OF) was 10 (7-10). Median follow-up was 6(1-12) months. At Kaplan-Meier analysis, estimated rates of EF impairment depicted an increase over time, with 12%(95%CI: 6,25) and 19%(95%CI: 11,33) of patients with normal pre-operative EF reporting a post-operative worsening at 3 and 6 months, respectively. Median IIEF-EF score decrease was 4 (2-11). At cox regression analysis, baseline factors (i.e., age, BMI, Charlson Comorbidiy Index, PV, IPSS) and intraoperative factors (i.e., total energy used, capsule perforation) were not associated with EF decrease over time (all p&gt;0.6). Conversely, patients experiencing a post-operative decrease of IIEF-OF were at higher risk of reporting IIEF-EF worsening (IIEF-OF: HR 0.81; 95%CI: 0.59, 0.94; p=0.009) (Figure 1)

Conclusions
Sexually active patients with normal pre-operative sexual function may experience a non-negligible EF worsening after HoLEP, which appears associated with post-operative OF decrease, thus suggesting that the impairment of antegrade ejaculation could play a major influence in post-HoLEP sexual function.

Conflicts of Interest
NA
(181) APPLICATION OF A VERY LOW CALORIES KETOGENIC DIET (VLCKD) PROTOCOL IN WOMEN'S ENDOCRINOLOGY: PSYCHOSEXUAL CORRELATES OF WEIGHT LOSS
Authors: Dr. Elisa Maseroli , Dr. Sarah Cipriani , Prof. Linda Vignozzi , Dr. Serena Ravelli 
Published: July 2023

Abstract

Objectives
To evaluate the psychosexual correlates of obesity and the Metabolic Syndrome (MetS) in a large sample of women consulting for sexual symptoms; to investigate the change in measures of arousal after weight loss obtained with Very Low Calories Ketogenic Diet (VLCKD).

Methods
In a retrospective study, n=322 women consulting for sexual symptoms were enrolled. The patients underwent a clinical, laboratory, sexual and psychometric examination and were studied by color-Doppler ultrasound with measurement of the Pulsatility Index (PI) of the clitoral artery. Twelve patients underwent a lifestyle intervention based on a VLCKD protocol and compared with patients treated with different strategies for sexual symptoms, in a 1: 1 case-control study.

Results
Clitoral PI was significantly higher in obese women (p = 0.018) and in those diagnosed with MetS (p=0.043). A statistically significant inverse correlation emerged between WC ≥ 88 cm and FSFI Arousal score (R=-0.126, p=0.028). In patients undergoing a lifetsyle intervention (n = 12), after a mean follow-up of 20±2 weeks, BMI showed a reduction of 6.7±2.8 kg/m2 (p &lt;0.001). At follow-up, the total FSFI and FSDS-R scores significantly improved (17.0±13.6 vs. 11.2±7.9, p=0.016, and 7.4±8.3 vs. 13.3±10.6, p=0.039, respectively). A significant increase was observed in FSFI Arousal (p=0.035), whereas clitoral PI displayed a non-significant reduction (p = 0.218). At multivariate analysis, the change in Total FSFI was correlated with the improvement in Body Image (BUT-B PSDI score: β=0.744, p=0.031; Eating Disorder Evaluation “Shape” domain: β=0.523, p=0.043), after adjusting for confounders. Finally, in the case-control study (subjects matched for age, BMI and menopausal state), the improvement in FSFI total score was more relevant in cases than in controls (p = 0.046).

Conclusions
Our data suggest that weight loss obtained by VLCKD is associated with an improvement in sexual function, and in particular in Arousal, which could be mediated by improved body image.

Conflicts of Interest
LV received scientific research grants, advisory board attendance and speaker honoraria from Therascience, Theramex, Bayer Schering Pharma, Intercept, Lipocine, Ibsa. EM and SC have nothing to declare.
(280) THE INTERPLAY OF SEXUAL DISTRESS AND SEXUAL PLEASURE: THE POTENTIAL OF VIBROTACTILE DEVICES TO FOSTER SEXUAL WELLBEING OF BREAST CANCER SURVIVORS
Authors: Magdalena S Große-Rüschkamp , Selina M Kronthaler , Iron J Hahn , Prof. Klaus M Beier , Laura Hatzler 
Published: July 2023

Abstract

Objectives
Breast cancer is the most common cancer in women. The severe impairment of sexual function affecting more than 80% of breast cancer survivors (BCS) is associated with sexual distress, poor mental health, and body image. The biological mechanisms of chemotherapy and endocrine therapy leading to vulvovaginal atrophy are well understood. Guidelines recommend the usage of lubricants and devices like vibrators to overcome these physical impairments. However, data on the impact of sexual distress on genital arousal and the experience of sexual pleasure is limited. The aim of this study is to provide evidence on the interplay of sexual distress and sexual pleasure during the use of vibrotactile stimulation.

Methods
In a psychophysiology lab setting BCS (n=40) and healthy controls (HC, n=20) use sexual stimuli (visual, tactile, visual + tactile) while subjective arousal, vaginal pulse amplitude (VPA) and heart rate variability are recorded continuously. Hormone serum levels, patient reported outcome measures (PROMs) assessing sexual function, sexual self-esteem, and health related quality of life are analyzed as potential moderators.

Results
Preliminary results of healthy participants indicate that vibrotactile stimuli provoke higher VPA in HC. Furthermore, i.) differences between BCS and HC, ii) interactions of PROMs and continuously recorded measures and iii.) intraindividual differences between different stimulus conditions are analyzed based on a 2-level mixed effect models for each outcome variable.

Conclusions
To our knowledge, this translational study is the first to provide data on genital arousal, sexual pleasure and PROMs in women with breast cancer during the use of vibrotactile stimulation. Findings can contribute to a better understanding of the interplay of psychological and physiological aspects the sexual function of breast cancer survivors to reveal targets to improve sexual function in this target group.

Conflicts of Interest
The authors are grateful to WOW Tech™ GmbH for their donation in support of the present research.
The funders do not participate in the study design, data collection, data analysis, or drafting of this abstract or future manuscripts.
(154) A CROSS-SECTIONAL STUDY OF FEMALE MASTURBATION PRACTICES AMONGST DIFFERENT POPULATIONS, AGE GROUPS AND THE INFLUENCING FACTORS
Authors: Markus van Niekerk 
Published: July 2023

Abstract

Objectives
To assess efficacy of sexual education in schools, whether female masturbation was included and whether it is sufficient in preparing adolescents for safe, consensual sex.To assess effects of religious, cultural, and parental factors on women’s views towards masturbation. To assess the frequency of the female orgasm when masturbating solo versus with a partner. To assess the nature of women’s emotions experienced when masturbating.

Methods
Cross-sectional anonymous online questionnaire with 24 questions both multiple choice and open ended. Inclusion criteria was female/identify as female, 18 years and older. Approval of the study by Riga Stradins Research Ethics Committee. Analyzation of data was conducted via the SPSS 27 system.

Results
With a sample size of 1068 participants, majority were European (46%) and North American (43%) ranging from age 18 and older. Sexual education was insufficient in 64.6% of cases with 43.3-55.8% of participants stating that sexual education was insufficient in preparing them for safe, consensual sex. With 84.4-85.2% stating that female masturbation was not discussed, 59% of participants indicated that female masturbation needs allocation during sexual education. Amongst 39.2% of participants, parents didn't discuss any sexual education with them with 29.8% of all participants being forbidden to engage in pre-marital sexual activity. Amongst those prohibited 38% still masturbated.
1.3% of participants underwent genital mutilation. Assessing frequency of masturbation majority (40.3%) reported to masturbate more than once weekly with the most popular mode of masturbation being sex toys (44%) followed by hands (42%).Comparing the frequency of orgasm while masturbating versus during sexual intercourse with a partner, 59% always report having an orgasm while masturbating solo; compared to 15% when with a partner. Emotions experienced by women during masturbation were mostly positive with the majority feeling relieved (68.7%).

Conclusions
Sexual education programs in schools need reassessment as they are insufficient in teaching about female masturbation and preparing students for safe and consensual sexual intercourse. Female masturbation should be considered a right to female sexual health, this needs to be ensured and included as a normal topic of discussion, no longer considered a taboo in society.

Conflicts of Interest
The abovementioned author, has no conflicts of interest to declare concerning the originality of the paper and there is no financial interest to report.
(248) DIRECT AND INDIRECT IMPACT OF INTERNAL WORKING MODELS OF SELF ON MALE SEXUAL FUNCTION
Authors: Dr. Daniele Mollaioli , Prof. Giacomo Ciocca , Dr. Erika Limoncin , Andrea Sansone , Dr. Elena Colonnello , Jannini Prof Emmanuele A 
Published: July 2023

Abstract

Objectives
Internal working models (IWM) represent the internal representation about the self, expressed by a sense of self-worth (+) or self-blaming (-), and significant others, expressed by the expectation of availability and support (+) or indifference (-), guiding the interpersonal strategies to regulate intimate affects and choosing romantic and sexual partners. Even if the relationship between IWM and close relationships has been deepen investigated, only few studies evaluate the impact of IWM on sexual function. Thus, we aim to investigate the interplay among IWM, dyadic cohesion and erectile and orgasmic function in males.

Methods
Through an online platform, a convenience sample of 1052 partnered males were recruited (age: 40.45±12.94). Enrolled subjects compiled a psychometric protocol composed of: the Dyadic Adjustment Scale (DAS); the Relationship Questionnaire (RQ); the Sexual Health Inventory for Men (SHIM); the Premature Ejaculation Diagnostic Tool (PEDT) and the Male Orgasmometer. Correlation, linear regression and mediation model analyses were performed.

Results
A significant positive correlation was found between the Model of Self (MS) and dyadic cohesion and sexological variables; on the other hand, no significant correlation was found between the Model of Other (MO) and sexological variable, unlike a positive correlation emerged between the MO and dyadic cohesion. Mediation Analysis evidenced the significant influence of MS towards erectile function (β=0.05), premature ejaculation (β=-0.03) and perceived orgasmic intensity (β=0.04), both directly and indirectly. Furthermore, dyadic cohesion significantly mediates the indirect pathways between the MS and sexological variables (β=0.03).

Conclusions
These results highlighted the important role of MS in the relational and sexual health and showed how internal representation of Self could, both directly and indirectly impact on the perception of dyadic and sexual experience and the onset of sexual dysfunctions, such as erectile dysfunction and premature ejaculation in male population.

Conflicts of Interest
The authors have no conflicts of interest to declare.
(73) STEREOTYPES ABOUT SINGLES: IS PUBLIC PERCEPTION OF ANOTHER PERSON’S LIFE- SATISFACTION AND SELF-SATISFACTION DEPENDENT ON THE OTHER PERSON’S RELATIONSHIP STATUS?
Authors: Priv-Doz. Nikola Komlenac , Carmen Mair , Prof. Margarethe Hochleitner 
Published: July 2023

Abstract

Objectives
The belief that everyone has a strong desire to be involved in a committed relationship can lead to stereotyping of singles (i.e., singlism). One stereotype is the characterization of single people as being unsatisfied with life. The current study explored whether people judge another person’s life-satisfaction and self-satisfaction differently, based on the information about the other person’s relationship status.

Methods
An online cross-sectional study with an experimental design was conducted among 642 persons (Mage = 39.2, SD = 13.1; 64.3% women, 35.7% men) in German-speaking countries. Each participant read one vignette, either describing a woman or a men, being either single (single), in an uncommitted relationship (uncommitted) or in a committed relationship (committed). Validated questionnaires for the assessment of life-satisfaction and self-satisfaction were modified so that participants could indicate how they perceived the character. Three informative hypotheses (H1: single=uncommitted=committed; H2: single&lt;uncommitted&lt;committed; H3: single&lt;uncommitted=committed) were compared with Bayesian ANCOVA.

Results
Data did not support the hypotheses that single people, people in uncommitted relationships, and people in committed relationships were perceived to have similar life-satisfaction or self-satisfaction (H1). Support for H2 was found when people judged the male character’s life-satisfaction or self-satisfaction with social relationships. When participants judged the female character’s life satisfaction or self-satisfaction with social relationships H3 was supported strongest by the data. When participants judged the character’s self-satisfaction in regards to sexuality none of the hypotheses was supported.

Conclusions
Participants perceived lowest levels of self-satisfaction and life-satisfaction in single people. Thus, singlism seem to prevailing in the German-speaking sample, but differ for women and men. Whereas men who are in an uncommitted relationship were perceived less favorably than men who were in a committed relationship, such a difference in the perception of women in uncommitted and committed relationships was not found.

Conflicts of Interest
The study is funded by the Region of the Tyrol.
(77) ANAL POSITIONING IN GAY MEN. ARE THERE REALLY SO MANY BOTTOMS? THE TBORNOTTB STUDY: A SURVEY OF 8,755 MEN
Authors: Rafael J Herrero , Aurélie Bourmaud , Priv-Doz. Priscilla Boizeau , Dr. Michel Ohayon 
Published: July 2023

Abstract

Objectives
Sexual anal positioning amongst men who have sex with men (MSM) is central to the understanding of this population, with important repercussions on the sexological fulfillment of these individuals. The purpose of our study was to determine the real frequencies of the anal positions frequently referred to as “bottom,” “top,” “versatile,” and “side.” We also set out to verify if there were clear differences between “anal sexual identity (ASI),” “anal sexual behavior (ASB),” and “anal sexual preference (ASP).”

Methods
An on-line anonymous questionnaire was made available in the French language to all cisgender MSM of at least 18 years of age between June 25 and October 26 2020, on the subject of anal positioning. The questionnaire presented 104 questions, with a total of 190 items being evaluated. Descriptive and analytical analyses were performed according to a statistical analysis plan drafted prior to implementation of study. Parametric or non-parametric tests were performed according to the distribution of variables. Statistical significance was set at 0.05.

Results
9.734 individuals clicked on our questionnaire. After informed consent, 9,686 declared they desired to participate. 8,755 respondents met all inclusion criteria for statistical analysis. For ASI, 40.8% of respondents declared to be “bottoms,” 30.8% to be “versatile, and 24,0% to be “tops.”

Conclusions
The TBornotTB study is the largest study to date on anal sexual positioning amongst MSM. Anal intercourse is clearly important to MSM. Receptive ASI was by far the most frequent ASI, the least frequent ASB was versatile, but Versatile ASP was what was desired by the vast majority. Our study underscores the importance of distinguishing three categories: identity, behavior, and desire. Significantly, it puts the spotlight on an area of sexuality that therapists may need to consider while working with MSM: the reduction of the splitting between these three sexological entities.

Conflicts of Interest
No conflicts of interest to be declared.
(61) UNLEASHED DESIRE: IS THERE ALTERED RESTING STATE FUNCTIONAL CONNECTIVITY IN MEN WITH COMPULSIVE SEXUAL BEHAVIOR DISORDER?
Authors: Dr. Jannis Engel , Dr. Christopher Sinke , Maria Veit , Dr. Jonas Kneer , Prof. Uwe Hartmann , Prof. Tillmann H Krüger 
Published: July 2023

Abstract

Objectives
Problems arising from compulsive sexual behavior disorder (CSBD) are often seen in clinical settings. In the sex@brain study we aimed to extend the knowledge about the clinical characteristics and the underlying neurobiology of individuals with CSBD.

Methods
We used a seed-based resting state fMRI approach investigating state functional connectivity in CSBD. A group of men with CSBD (n = 39) was compared to a group of healthy controls (n = 33). Groups were matched for age and educational level. The focus of this investigation lies on frontal and limbic regions highly relevant for emotional processing and behavioral control.

Results
Initial results showed increased connectivity between the left amygdala and left Precuneus/superior parietal cortex as well decreased connectivity between the right middle OFC and gyrus rectus in men with CSBD compared to healthy controls. Moreover, attenuated connectivity between putamen and anterior cingulate cortex was found in men with CSBD when compared to healthy controls.

Conclusions
The results highlight the importance of a strong functional connectivity between limbic regions and areas involved in attention. In addition, a diminished connectivity between parts of the reward system and areas involved in sexual inhibition was observed. These results, however, should to be interpreted with caution, as different studies in the field show very divergent results. Further research is needed for the understanding of the interplay between emotional and behavioral control and may contribute to a better understanding of sexual compulsive behavior and may lead to more differentiated and effective diagnostics and treatment.

Conflicts of Interest
none
(194) EXTERIORIZATION OF ADULT-ACQUIRED BURIED PENIS WITH SCROTAL FLAP AND SKIN MESH-GRAFT, GLANS MUCOSECTOMY, AND VENTRAL MEATOTOMY
Authors: Omid Sedigh , Andrea Gobbo , Nicola Faraone , Ernesto Giargia , Devis Collura , Marisa Kurti , Paolo Caccia , Andrea Formiconi , Alessandro Giacobbe 
Published: July 2023

Abstract

Objectives
We present the treatment of a patient with partial Adult-acquired buried penis (AABP) and extreme tissue retraction, complaining of genital skin tension and LUTS.

Methods
Penile exteriorization was performed after circumcision. Glans mucosectomy was carried out because of suspicious glans mucosa. Ventral meatotomy was performed because of the stenotic meatus. For penile covering, we used scrotal skin for the shaft and skin mesh-graft for the glans. The scrotum was positioned around the penile shaft with a rotation flap. For the skin mesh graft we chose as donator the anterior thigh. Harvesting with a scalpel was preferred, so closure by primary intention was possible. We did not use the dermatome considering the low general self-care of the patient and the likely inadequate management of the wound with subsequent risk of infection or dysfunctional scarring. For the same reason we decided to use the smallest graft possible and to mesh it, to allow a better attachment and prevent hematoma or seroma under the graft. After the surgery the medication was sutured to the penis and maintained for one week, afterwards medications were performed 2 times per week for 21 days.

Results
The operation lasted 165 minutes. No complications occurred intraoperatively. Stretched penis measured 7cm before surgery and 14cm after. At the first medication there was scrotum necrosis with wound dehiscence, it was removed entirely and exudative material covering the graft was cleaned. At successive medications, the genitals showed good healing process and minimum scarring of the mesh-graft. The patient referred good urinary function and aesthetic satisfaction without genital discomfort.

Conclusions
For AABP at risk of non-optimal management of the wound after the operation, tissues with good attachment proprieties like scrotum and mesh-grafts can be safely used with good functional results.

Conflicts of Interest
none
(34) MULTIPLE SLIT INCISIONS WITH TACHOSIL® GRAFTING FOR TREATMENT OF PEYRONIE’S DISEASE AND ED
Authors: Ahmed Ragheb , Prof. Daniar Osmonov 
Published: July 2023

Abstract

Objectives
We demonstrate step-by-step the treatment of a case of severe ED with an over 60 degree dorsal curvature mainly on the left side and an hour glass indentation on the right side of the penile shaft. We highlight the advantages of multiple plaque incisions and Tachosil® grafting combined with inflatable penile prosthesis (IPP) implantation for these specific cases.

Methods
After IPP implantation via the penoscrotal approach, the neurovascular bundle was mobilized. For the left sided dorsal curvature we underwent multiple deep transverse slits starting from and around the point of maximum curvature using a low energy cutting current (20 to 30 Watts). Our transverse incisions were complimented with the modeling technique. For the right sided waist formation we underwent longitudinal slits. Subsequently, the area of incisions was covered by a Tachosil® graft.

Results
The multiple horizontal incisions led to a vertical release thus straightening of the curved penile shaft. Longitudinal slits led to a horizontal release, therefore expanding and obliterating the waist formation.

Conclusions
The multiple slit technique together with Tachosil® grafting may have added advantages compared to the conventional plaque incision/excision utilizing the same graft. The smaller defects created by the multiple tunical incisions may avoid potential cylinder protrusion, facilitate better sealing of the collagen fleece, lower the incidence of hematoma and/or infections and allow complimentary modeling of the penis. Moreover, complex deformities may also be treated simultaneously with success.

Conflicts of Interest
The authors have no conflict of interest.