bluuebunny/crossref_metadata_2025_split huggingface dataset:
(135) CHANGES IN QUALITY OF LIFE AND SEXUAL FUNCTION AFTER LHRH AGONISTS VS ORCHIECTOMY IN MEN WITH METASTATIC PROSTATE CANCER: RESULTS FROM A RANDOMIZED TRIAL
Authors: Niklas Dissing , Prof. Mikkel Fode , Prof. Jens Sønksen , Dr. Peter B Østergren 
Published: July 2023

Abstract

Objectives
To examine changes in quality of life (QoL) in men diagnosed with metastatic prostate cancer randomly assigned to either medical or surgical castration.

Methods
Men with de novo metastatic prostate cancer were randomized (1:1) to either Triptorelin 22.5mg/24weeks or subcapsular orchiectomy as monotherapy. QoL and sexual function were assessed using the validated questionaries EORTC-QLQ-C30, EORTC-QLQ-PR25 and Erectile Hardness Scale (EHS) before treatment and at 12, 24 and 48 weeks. Outcomes were changes in overall QoL, functional and symptom scales. Data was analyzed using linier mixed models for repeated measures.

Results
Fifty-seven men with a median age of 74 years (range 47 to 86 years) were randomized and received allocated treatment from September 2013 through March 2015. The pooled analyses, combining data from both groups, showed that QoL (p=0.003), emotional function (p&lt;0.001), urinary symptoms (p=0.011) and hormonal treatment related symptoms (p&lt;0.001) changed significantly between visits. Improvement from baseline in QoL (mean change 6.8 points [95%CI 2.1; 11.5]), emotional function (6.9 points [3.3; 10.6]) and urinary symptoms (-7.7 points [-12.3; -3.0]) were observed at 24 weeks. Hormonal treatment related symptoms (8.9 points [95% CI 5.9; 12.0]) worsened. No significant differences between treatment groups in any of the scales were observed.
At baseline, 29 men (51%) reported retained interest in sex and 18 were sexually active. At 12 weeks eight continued to report an interest in sex and six were sexually active. Three men had erections hard enough for penetration at baseline. This dropped to one man at 12 weeks.

Conclusions
Men with newly diagnosed metastatic prostate cancer experience improved QoL and emotional function at follow-up after starting androgen deprivation therapy. Urinary symptoms improve while hormonal treatment related symptoms worsened. Interest in sex and sexual activity was retained in a proportion of men despite androgen deprivation.

Conflicts of Interest
None.
(199) “THE ABSENCE OF ORGASM POST-OPERATIVELY IS ASSOCIATED WITH EXTRA-CAPSULAR DISEASE IN RADICAL PROSTATECTOMY PATIENTS: A STUDY OF A SEXUAL REHABILITATION CLINIC”
Authors: Stavros Kontogiannis , Anastasios Natsos , Mohammed Obaidat , Konstantinos Adamou , Evangelos Liatsikos , Petros Drettas 
Published: July 2023

Abstract

Objectives
After radical prostatectomy, sexual dysfunction concerns not only erectile but orgasmic function, as well. The absence of orgasm affects the patients’ quality of life and can motivate them to seek sexual treatment after surgery. Our aim was to study the orgasm frequency after radical prostatectomy and investigate any associations with the pathologic and psychosocial characteristics of the patients.

Methods
We studied retrospectively patients who visited our Sexual Rehabilitation Clinic after radical prostatectomy during the last 18 months. During the first evaluation 2 months post-operatively, we asked if the patient had experienced orgasm during penetrative sex or during masturbation. Following the biopsychosocial model of sexual dysfunctions, the patients filled in two questionnaires: the International Index of Erectile Function-5 (IIEF-5) questionnaire before and after surgery and the Hospital Anxiety and Depression Scale (HADS) after surgery. Extra-capsular prostatic disease was defined as pT3 according to the TNM classification.

Results
Seventy patients were studied with an average age and PSA of 65.7 years and 9.4 ng/dl, respectively. The percentage of patients with pT3 disease was 62.8%. The average of IIEF-5 was 20.2 pre-op and 6.5 post-op. The average HADS sub-scales scores were 7.4 for anxiety and 5.8 for depression. More than half (of the patients (51.4 %) had experienced orgasm after surgery. The absence of orgasm was associated with older age (p=0.022), the absence of morning erections (p=0.009), the absence of masturbation post-op (p=0.009) and with extra-capsular disease (pT3) of prostate cancer (p=0.040).

Conclusions
The absence of orgasm is associated with extra-capsular prostatic disease and with older age. Due to the importance of orgasm in the sexual rehabilitation after surgery, clinicians should be more aware of the orgasmic dysfunction in patients with these characteristics.

Conflicts of Interest
No conflict of interest.
(242) CLINICAL PREDICTORS AND CONSEQUENCES OF INCREASING SHBG LEVELS OVER TIME: RESULTS FROM THE EUROPEAN MALE AGEING STUDY
Authors: Prof. Giulia Rastrelli , Prof. Gyorgy Bartfai , Prof. Felipe Casanueva , Prof. Aleksander Giwercman , Prof. Ilpo Huhtaniemi , Prof. Margus Punab , Prof. Jolanta Slowikowska-Hilczer , Prof. Terence O'Neill , Prof. Dirk Vanderschueren , Prof. Frederick Wu , Prof. Mario Maggi 
Published: July 2023

Abstract

Objectives
Testosterone (T) circulates bound to sex hormone-binding globulin (SHBG). Although it is commonly deemed that only the amount of T not linked to proteins (free T) is biologically active, evidence supporting this hypothesis is lacking.
To investigate the predictors and clinical consequences of developing or maintaining increased SHBG levels in ageing men from European general population.

Methods
3369 men from the general population of eight European countries were recruited in the longitudinal population-based study “European Male Ageing Study”. Subjects completed questionnaires, underwent physical examination, physical and cognitive functional tests and blood sampling during two visits (one baseline and one after a median of 4.3 years of follow-up).

Results
Among a series of putative candidate predictors for new occurred-stable high SHBG, older men, reporting physical inactivity, with liver diseases and with higher T and LH at baseline were more predisposed to maintain or develop high SHBG; conversely, obesity, higher LDL and IGF1 were protective towards the occurrence of SHBG. Concerning the clinical consequences, men who develop or maintain high SHBG levels reported the new occurrence or worsening of erectile dysfunction, impaired morning erections and low sexual desire. Moreover, they had new or worsened feelings of sadness, worse physical functioning, vitality, mental and social well-being. This was confirmed by worse scoring in physical performance and memory tests, as well as by higher scores on the Beck Depression Inventory.

Conclusions
The development or maintenance of high SHBG levels is associated with symptoms of hypogonadism, independently of total T levels. Besides sexual symptoms, also physical and depressive symptoms are present. The cognitive and physical performance is also compromised. This study demonstrates that increased SHBG favor the development or worsening of hypogonadism-related symptoms. This provides evidence for the role of SHBG in limiting the biological activity of T, thus supporting the free hormone hypothesis.

Conflicts of Interest
None
(230) MICROSURGICAL VASECTOMY REVERSAL: THE EXPERIENCE OF THE SINGLE CENTER
Authors: Dr. Débora C Araújo , Dr. Rui Maciel , Dr. Samuel Bastos , Dr. Vitor Oliveira , Dr. Jorge Dias , Dr. Carolina Marramaque , Dr. Alexandre Gromicho , Dr. Luis Xambre 
Published: July 2023

Abstract

Objectives
We report our experience with microsurgical VR and identify predictive factors of success.

Methods
We retrospectively reviewed all patients submitted to VR by a single surgeon from 2008 to 2021 at Centro Hospitalar Vila Nova de Gaia e Espinho. Patency and pregnancy rates were evaluated. The main outcome was procedure success rate, defined by a natural pregnancy with a healthy baby. The secondary objective was to identify predictive factors of success and patient satisfaction with the procedure.

Results
Forty VRs were performed with a patency rate of 97.2%. Among those who became patent, pregnancy occurred in 14 of 35 couples by natural conception (40%). Twelve of them had a healthy delivery (34.3%). Two-layer anastomosis was significantly associated with a successful procedure (p=0.0001). We did not identify significant association between any of the other variables and successful outcome. Even without successful surgery most of the patients would do the procedure again and were very satisfied with the results (p=0.58 and p=0.46, respectively).

Conclusions
This is the largest national cohort regarding the outcomes of VR. In our study, the observed patency rate was 97.2%, resulting in a pregnancy by natural conception with a healthy delivery in 34.3%. We believe that VR is a useful technique to restore fertility in men after vasectomy wishing children by natural conception. A significant association was found between the two-layer anastomosis and a successful surgery.

Conflicts of Interest
The authors declare that they have followed the protocols of their work center on the publication of patient data.
(108) SEXUAL ANHEDONIA AND SEROTONIN 4 RECEPTOR BRAIN BINDING IN DEPRESSED PATIENTS – A NEUROPHARM POSITRON EMISSION TOMOGRAPHY STUDY
Authors: Annika L Rasmussen , Søren V Larsen , Brice Ozenne , Dea S Stenbæk , Prof. Martin B Jørgensen , Annamaria Giraldi , Vibe G Frokjaer 
Published: July 2023

Abstract

Objectives
Sexual dysfunction is a prominent feature of Major Depressive Disorder (MDD), which affects depressed women more frequently and more pronounced compared to men. Reduced sexual desire might reflect overall anhedonia, a core symptom of MDD, which is putatively related to disturbed reward processing. Here, we aim to illuminate plausible underlying neurobiology of sexual dysfunction and in particular sexual desire in women with depression. We map associations between serotonin 4 receptor (5-HT4R) brain binding in the striatum, a key hub of the reward circuitry, and self-reported sexual function, where we focused on sexual desire, in the unmedicated depressed state. In addition, within women, we evaluate if pre-treatment sexual desire score predicted treatment outcome after eight weeks of treatment.

Methods
From the NeuroPharm study, we had access to brain scans of 5-HT4R binding and self-reports on sexual functioning (CSFQ-14 F&M) from 85 untreated MDD patients (71% women) who underwent eight weeks of antidepressant drug treatment. Whether pre-treatment sexual desire score predicted treatment outcome was evaluated using the area under the ROC curve (AUC). Treatment outcome was dichotomized as 50% or more reduction in Hamilton Depression Rating Scale 6-item (HDRS6) or not at 8 weeks clinical follow-up.

Results
We found a positive association between sexual desire and 5-HT4R binding in women (b=0.07, 95%CI [0.02:0.13], p.adj=0.024), but not in men (b=0.05, 95%CI [-0.05:0.15], p.adj=0.62). We did not find an association between overall sexual functioning and serotonin 4 receptor binding neither in women nor in men. Sexual desire at baseline did not predict treatment outcome i.e. ≥50% reduction in HDRS6 from baseline to week 8 (AUC=51.7% [36%:67%]).

Conclusions
Taken together, we find evidence for an association between low sexual desire and low striatal 5-HT4R agonist capacity in depressed women. Interestingly, this raises the question if direct 5-HT4R agonism can target reduced sexual desire in MDD.

Conflicts of Interest
Annamaria Giraldi declares that she has served as a lecturer for Eli Lilly, Pfizer, Astellas, Viatris in addition to serving as a consultant for Eli Lilly as well as being on the advisory board of Futura Medical, OvacoBio and FREYA Pharmaceuticals. Further, she states that she holds stocks in Novo Nordic. Vibe G Frokjaer declares that she has served as a consultant for H. Lundbeck and Sage Therapeutics.
(179) ARE ENDOGENOUS ANDROGENS LINKED TO FEMALE SEXUAL FUNCTION? A SYSTEMIC REVIEW AND META-ANALYSIS
Authors: Dr. Elisa Maseroli , Dr. Sarah Cipriani , Prof. Linda Vignozzi , Dr. Serena Ravelli 
Published: July 2023

Abstract

Objectives
Our aim was to answer the question: is there an association between endogenous levels of androgens and sexual function in women?

Methods
An extensive search was performed in MEDLINE, Embase and PsycInfo. Four separate meta-analyses were conducted for total T, free T, Free Androgen Index (FAI), and Dehydroepiandrosterone sulphate (DHEAS). Cohort, cross-sectional, and prospective studies were included. The effect measure was expressed as standardized mean difference (SMD).

Results
The meta-analysis on total T included 34 studies involving 3,268 women, mean age 36.5 years. In 11 studies, a significant association was found between sexual desire, measured by validated psychometric instruments, and total T (SMD = 0.59 [0.29;0.88], P &lt; 0.0001), with a moderate effect. The association with global sexual function (n = 12 studies) was also significant (SMD = 0.44 [0.21;0.67], P &lt;0.0001). Overall, total T was associated with a better sexual function (SMD = 0.55 [0.28;0.82)], P &lt; 0.0001), with similar results obtained when poor quality studies were removed. Age showed a negative relationship with the overall outcome. No differences were found when stratifying the studies according to menopausal status, type of menopause, age at menopause, use of hormonal replacement therapy, relationship status, method for T measurement, phase of the menstrual cycle or use of hormonal contraception. The meta-analysis of T derivatives (free T and FAI) also showed a significant, moderate association with sexual desire. In contrast, DHEAS seems not to exert any significant influence on desire, whilst showing a positive association with global sexual function.

Conclusions
There appears to be a moderate association between total T and sexual desire/global sexual function, which is confirmed, although weak, in studies employing liquid chromatography-mass spectrometry (LC-MS). Similar results on desire were obtained for free T and FAI. DHEAS only showed a positive association with global sexual function. More research is needed.

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.
(53) INVESTIGATION ON A TREATMENT OPTION FOR CERVICAL CANCER CAUSED BY PERSISTING HPV16 INFECTIONS: PHASE 1 DOSE-ESCALATION STUDY OF IMMUNOTHERAPY WITH DELNSE6E7 IN HPV-16 INFECTED WOMEN WITH NORMAL CYTOLOGY, CIN1 OR CIN2
Authors: Michaela Bayerle-Eder , Carola Fuchs , Michael Wolzt 
Published: July 2023

Abstract

Objectives
Assessment

Methods
randomised, double-blind, 1:3 placebo-controlled, phase 1 dose-escalation study in up to 36 subjects.

Results
24 otherwise healthy women with persistent HPV 16 infections were randomised, one was excluded and 17 patients have completed the study. 6 patients are currently in the treatment phase of the clinical trial. The study is still ongoing and open for recruitment. Preliminary results will be presented at the ESSM 2023.

Conclusions
Introduction/Conclusion:
Human papillomavirus (HPV) infection is the most common viral infection of the reproductive tract. Most sexually active individuals are exposed trough lifetime, but 90% of HPV infections usually recover within a few months. A small proportion of infections with high-risk types of HPV virus subtypes can persist and progress to cancer.
Thus persistent HPV16 infection cause 55 % of cervical cancer world-wide, which is most often diagnosed between 35 and 44 years.
Regardless of HPV vaccination status there is no treatment for persistent HPV16 infections, which causes not only a physiological but also a psychological burden.
Immune therapy with delNSE6E7, which has been effective against papilloma virus induced cancer in horses may offer future treatment options for persisting HPV16 infections preventing development of cervical, oropharyngeal or anal cancer in humans.

Conflicts of Interest
Michaela Bayerle-Eder is involved in patient recruitment for BlueSkyGmbH, which developed delNSE6E7.
(186) VAGINAL CHANGES, SEXUAL FUNCTIONING AND DISTRESS OF WOMEN WITH LOCALLY ADVANCED CERVICAL CANCER TREATED IN THE EMBRACE VAGINAL MORBIDITY SUBSTUDY
Authors: Isabelle Suvaal , Dr. Kathrin Kirchheiner , Prof. Remi A Nout , Dr. Alina E Sturdza , Prof. Erik Van Limbergen , Dr. Jacob C Lindegaard , Prof. Hein Putter , Dr. Ina M Jürgenliemk-Schulz , Prof. Cyrus Chargari , Dr. Kari Tanderup , Prof. Richard Pötter , Prof. Carien L Creutzberg , Dr. Moniek M ter Kuile 
Published: July 2023

Abstract

Objectives
The EMBRACE-vaginal morbidity substudy prospectively evaluated physician-assessed vaginal changes and patient-reported-outcomes (PRO) on vaginal and sexual functioning problems, and sexual distress in the first 2-years after radio(chemo)therapy with image-guided adaptive brachytherapy for locally advanced cervical cancer.

Methods
Eligible patients had FIGO 2009 stage IB1-IIIB cervical cancer with no or only limited (&lt;5mm) vaginal involvement. Comprehensive assessment of vaginal changes was done before treatment, at 4-6 weeks and 3, 6, 12 and 24 months thereafter and graded using CTCAE. PRO were assessed at the same timepoints using validated Quality of Life and sexual questionnaires. Statistical methods included Generalized Linear Mixed Model analysis and Spearman’s rho correlation coefficients.

Results
113 eligible patients were included. Over time, mostly mild (grade 1) vaginal changes were reported in 10.8-36.8% of the participants. At 24 months, 46.7% reported not being sexually active, mostly because of losing interest in sex or lacking a partner. Among the 41-53 sexually active women, 43.2-51.3% reported vaginal functioning problems starting at 4-6 weeks and more severe sexual problems and distress were reported by 5-15% of them. Physician-assessed vaginal changes and PRO sexual satisfaction differed significantly (p≤.05) between baseline and first follow-up, without further changes over time. No or only small associations between vaginal changes and vaginal functioning problems and sexual distress were found.

Conclusions
Relatively mild vaginal changes were reported after image-guided radio(chemo)therapy and brachytherapy according to EMBRACE-protocol. Although vaginal and sexual functioning problems and sexual distress were frequently reported, the rate of more substantial problems and distress was relatively low. These results are favorable compared to previous data, potentially due to the combination of tumors with limited vaginal involvement, EMBRACE-specific treatment optimization and rehabilitation recommendations. The lack of association between vaginal changes, vaginal functioning problems and sexual distress shows that sexual functioning is more complex than vaginal morbidity alone.

Conflicts of Interest
The authors declare that they have no competing interests. The EMBRACE vaginal morbidity substudy was supported by Elekta AB and Varian Medical system through unrestricted research grants and study sponsoring through the Medical University of Vienna.
(72) IMPACT OF COVID-19 PANDEMIC ON VIOLENCE AGAINST WOMEN IN THE REPUBLIC OF ARMENIA
Authors: Satenik Sahakyan , Ruzanna Azatyan , Arsen Grigoryan , Prof. Aram Hakobyan 
Published: July 2023

Abstract

Objectives
The purpose of this study was to identify potential incidents of female violence during the COVID-19 pandemic as well as the prevalence of female violence in the Republic of Armenia

Methods
Women in Armenia who are at least 18 years old and have lived there for at least six months prior to the COVID-19 pandemic are included in the study. From November 30 to December 14 2021, an online and paper version of a 16-item survey was sent out. The questionnaire assessed emotional, physical, sexual abuse, mood disturbances 6 months before and during COVID-19 self-isolation measures in Armenia.

Results
353 adult Armenian women participated in the study. Before COVID-19 sexual abuse was reported by 3% of study participants. These women were abused once in 1.5% of cases and multiple times in 1.5% as well. During COVID-19 pandemic participants reported sexual abuse in 6.1% (8) of cases, with 2.3% being abused once and 3.8% being abused multiple times. Differences between these two periods were significant (p&lt;0.05).

Conclusions
Overall, during COVID-19 self-isolation partner abuse rates were high in Armenia. Sexual abuse in a normal setting, i.e. 6 months before COVID-19 pandemic, was reported by nearly every 20th woman in our sample. During lockdown the ratio increased up to one in 9 women experiencing violent sexual behavior by partner. According to the results of the current study, the risk of intimate partner violence during the COVID-19 lockdown was influenced by social isolation, extended homestays, and heightened social and economic pressure.

Conflicts of Interest
All authors declare that they have no conflicts of interest.
(96) IMPACT OF MINDFULNESS MONOTHERAPY ON FEMALE SEXUAL DYSFUNCTION SYMPTOMS AND SEX-RELATED QUALITY OF LIFE
Authors: Izabela Jąderek , Katarzyna Obarska , Prof. Michał Lew-Starowicz 
Published: July 2023

Abstract

Objectives
The aim of the study was to assess the effect of mindfulness monotherapy on the reduction of sexual dysfunctions symptoms and sex-related quality of life, and the persistence of the effects after its completion.

Methods
We conducted four weeks mindfulness-based therapy (MBT) for two groups of heterosexual females: women with psychogenic sexual dysfunctions (WSD) and women with no sexual dysfunctions (NSD) who wanted to improve their sexual life and learn meditation. Sexual dysfunction was evaluated in clinical interview according to the DSM-5 criteria. The effects of the therapy were evaluated with Female Sexual Function Index (FSFI), Five Facet Mindfulness Questionnaire (FFMQ) and The Sexual Satisfaction Questionnaire (KSS) at baseline, one week after MBT, and follow-up after 12 weeks.

Results
93 women were recruited for the study: 53 to the WSD group, 40 to the NSD group. Participants in WSD group reported a significant increase in the level of sexual desire (p &lt;0.001), arousal (p&lt;0.001), lubrication (p=0.003), and orgasm (p=0.001) between measurements. The overall risk for sexual dysfunction (as indicated by the FSFI score) decreased compared to baseline in both treatment arms: from 90.6% at baseline to 46.7% at follow up in WSD group and from 32.5% at baseline to 6.9% at follow up in the NSD group. A significant increase in sex-related quality of life (KSS score) was observed in both study groups.

Conclusions
MBT was found effective in the treatment of sexual dysfunction and improved sexual satisfaction both among heterosexual women with or without sexual dysfunction. More research is needed to explore the potential of MBT in the treatment of sexual dysfunction in other samples (e.g., men and non-heterosexual women).

Conflicts of Interest
No conflict of interest