bluuebunny/crossref_metadata_2025_split huggingface dataset:
(305) Impact of Melatonin Supplementation on Testosterone Levels in U.S. Adult Men
Authors: White J , Ramasamy R , Carto C 
Published: May 2023

Abstract

Introduction
Among US adults, the prevalence of melatonin supplement consumption significantly increased in the last two decades across all demographic groups. Despite scant evidence, melatonin is widely used as an over-the-counter sleep aid. Because sleep disorders are associated with testosterone deficiency, we examined the associati.n between melatonin supplementation and serum testosterone levels.

Objective
Evaluate the association between melatonin supplementation and serum testosterone levels in adult males living in the United States.

Methods
The National Health and Nutrition Examination Survey (NHANES) was used to analyze interviews, physical examinations, and laboratory tests. Data from three cycles (2011-2012, 2013-2014, and 2015-2016) was combined (appended) to study the association between melatonin usage and early morning serum total testosterone (TT) levels. Selection criteria included men aged 18 and older; exclusion criteria included the reported use of testosterone, clomiphene, or anastrozole medications or supplements in the past 30 days. Additionally, participants with missing values for age, body mass index (BMI), sleep habits, or EMSTT were excluded from the analysis. Statistical analysis was performed using SPSS v.28. Continuous variables were presented as medians and interquartile ranges [25 - 75]. To determine the association between of low EMSTT (T &lt; 300 ng/dL = low) and clinical variables, demographics characteristics, a multivariable-adjusted logistic regression analysis was performed.

Results
After selection, 7,656 participants were analyzed, of those, the median age was 47 [31 - 63] years old, the median TT level was 389.9 [289 - 513.9] ng/dL, and 27.4% of participants were found to have low TT, and 51 (0.7%) reported melatonin supplementation. Among individuals who reported melatonin intake in the past 30 days, the average intake was approximately 1 mg/day. On multivariable adjusted analysis increase age (OR = 1.019, p &lt; 0.001), and BMI (OR = 1.133, p &lt; 0.001) were associated with increased risk of low TT. However, we did not find an association with low testosterone among men who reported melatonin supplementation (p=0.898) even after analyzing for confounding variables.

Conclusions
These findings suggest that melatonin supplementation within the past 30 days was not associated with low TT levels in a nationally representative sample of men aged 18 and older. Further analyses are needed to highlight the dose-response relationship and examine the potential effects of exposure to supratherapeutic doses and chronic intake.

Disclosure
No
(313) Ethnic and Racial Distribution of Peyronie’s disease in a Hispanic Minority-Minority Community
Authors: Atuluru P , Masterson T 
Published: May 2023

Abstract

Introduction
Peyronie’s disease (PD) is a fibrotic disease of the penile corpora leading to penile curvature. PD is prevalent in up to 9% of males, but the epidemiological and demographic data of PD is not well understood. Prior studies suggest PD primarily impacts older, white, non-Hispanic males; however, this is likely due to population homogeneity in those studies. Our tertiary care center serves a unique, Hispanic minority-majority community that provides us the opportunity to assess sociodemographic and patient characteristics of PD in a heterogeneous population.

Objective
We sought to determine the sociodemographic factors as well as patient characteristics of patients with PD in our community. We hypothesize that PD is more prevalent in Hispanic males than previously reported.

Methods
We retrospectively examined a prospectively collected a database that captured all men presenting with PD from September 2018 to February 2021. At the primary visit, sociodemographic data, patient characteristics and PD disease characters were gathered. To accommodate Miami’s greater percentage of Hispanic and Black population, overall national race/ethnicity breakdowns and national PD incidence in Blacks (3-5%) and Hispanics (2-4%) was used to extrapolate what would be expected in Miami’s Hispanic minority-majority community.

Results
Our analysis included a total of 237 men who were diagnosed with Peyronie’s disease. In our clinic, 138 (58.3%) patients were Hispanic, whereas we only expected 19-36 (8-15%) to be Hispanic based on current data. Further, 26 (10.5%) were black, but we expected 10-17 (4-7%). Sociodemographic details, primary clinical characteristics and expected demographics of PD in Miami are outlined in Table 1.

Conclusions
There is no consensus about the prevalence and demographic distribution of Peyronie’s disease. However, in our diverse community, we showed that a greater number of blacks and Hispanics than expected presented with Pyronine’s disease. This demonstrates that PD is impacting more than the previously reported non-Hispanic, white males. To reduce under-diagnosis and under-treatment, more effort should be made by clinicians to investigate, identify, and properly treat PD in minority communities.

Disclosure
No
(317) Lay People´s Myths Regarding Pedophilia and Child Sexual Abuse: A Systematic Review
Authors: Glina F , Carvalho J , Barroso R , Cardoso D 
Published: May 2023

Abstract

Introduction
The term “paedophilia erotica” was first coined in 1886 by the psychiatrist Krafft-Ebing and it was considered a “psycho-sexual perversion”. It was at the beginning of the twentieth century that the term “pedophilia” was adopted and it started to appear in medical dictionaries. Sexual abuse is legally defined as the engagement in sexual contact with a person below a specified age or who is incapable of giving consent. Both, pedophilia and Child Sexual Abuse (CSA) are worldwide phenomena requiring deep scientific knowledge in order to improve prevention strategies. Individuals’ misconceptions of pedophilia and CSA may legitimize sexual violence, which can influence prevention strategies and policies.

Objective
This review aimed to summarize existing research to help answer the question: “What are laypeople´s myths regarding pedophilia and child sexual abuse?”.

Methods
This systematic review followed the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses to identify as many relevant articles as possible. A literature search was conducted using PubMed, Web of Science, Scopus, and EBSCOhost databases for articles published before January 2022. Sixty-one articles were included in the current review.

Results
Overall, findings revealed a significant number of myths regarding pedophilia and CSA, organized into the following categories: 1) blame diffusion, 2) denial of abusiveness, 3) restrictive stereotypes, 4) victim age and consequences, 5) social stigma, 6) punitive attitudes, and 7) treatment.

Conclusions
Findings suggested that laypeople’s perceptions should be taken into account when devising prevention policies. Additionally, perceptions should also be a target of prevention since there is evidence of social stigma and prejudice involving individuals with pedophilia. Such phenomena can contribute to social, emotional, and cognitive problems, amongst said individuals as well as causing these individuals to exhibit a higher risk for abusive behavior and less help-seeking.

Disclosure
No
(325) The Role of Advanced Practice Providers Who Treat Men’s Health Urologic Conditions: An Analysis of Medicare and Commercial Claims in the United States
Authors: Raheem O , Xing M , Cooper C , Hyman M , Modi P 
Published: May 2023

Abstract

Introduction
The role of advanced practice providers (APPs) had expanded in the recent years according to the AUA. This increase of APPs had been endorsed by AUA to offset the increasing burden on the urologist workforce. Moreover, contemporary literature on the involvement of APPs in men’s-specific disease conditions is lacking.

Objective
We aim to clarify the role of APPs for publicly and privately insured patients in the treatment of mens’ urologic conditions commonly encountered in Men’s Health Clinics.

Methods
Medicare and commercial insurance claims from the Physician/Supplier Procedure Summary and IBM® MarketScan® Commercial Database, were queried for procedures submitted by APPs between 2010 and 2020. Common urologic conditions were identified using Current Procedural Terminology codes and grouped into six categories: overactive bladder (OAB), testicular hypofunction, erectile dysfunction (ED) and Peyronie’s disease (PD), benign prostatic hyperplasia (BPH), genital warts, and scrotal pain. The proportion of procedures submitted by APPs was calculated for each year and category.

Results
The proportion of claims submitted by APPs treating OAB, genital warts, and testicular hypofunction rose steadily from 2010 to 2020. Proportion of submitted service counts under OAB, genital warts and testicular hypofunction increased approximately 5, 8, and 4-fold among the privately insured compared to 3, 6, and 10-fold among the publicly insured (Figures 1 and 2). For BPH, ED and PD, and scrotal pain the proportion of APPs in both the MarketScan and Medicare groups was higher in 2020 than 2010, but with less dramatic and stable growth rates compared to other procedures. The proportions of APPs for all conditions were higher in the Medicare group compared to the MarketScan group. The Medicare data captured more year to year fluctuations in the proportion of claims submitted by APPs per condition than that of the MarketScan data.

Conclusions
APPs play a critical role in urologic care and can help address impending physician workforce shortages in urology, specifically in men’s health. The role of APPs in men’s urologic health, particularly OAB, testicular hypofunction, and genital warts, is increasing for both privately and publicly insured patient populations. Further research on implementation and utilization of APPs, as well as the health outcomes of such workforce modifications, is warranted.

Disclosure
No
(345) The Pathophysiology of Peyronie’s Disease Following Radical Prostatectomy
Authors: Megson M , Shaw G , Cellek S , Ralph D 
Published: May 2023

Abstract

Introduction
Peyronie’s disease (PD) is defined as a fibrotic disease of the penis resulting in plaque formation and abnormal penile curvature. In the general population the incidence of PD is 0.7%, however, this increases to 16% after radical prostatectomy (RP).

Objective
Our aim is to document the incidence of PD after radical prostatectomy seen in our hospital.

Methods
A prospective and a retrospective audit recruiting men undergoing RP. Both documented demographics, operative details and PD risk factors. The retrospective audit has reviewed men undergoing a RP in 2018. After identification the patients were contacted to clarify any development of curvature after RP. The prospective audit has reviewed men prior to their RP with an IIEF, PD questionnaires and examinations for existing plaques. Then again at 6 weeks, 3 months and 6 months post-operatively.

Results
For the retrospective audit; 511 men were identified, of which 194 were recruited. Of these 16% (n=31) described a new curvature. 7 were Non-Nerve Sparing (NNS), 11 Unilateral Nerve-Sparing (UNS) and 13 Bilateral Nerve-Sparing (BNS). These had a mean curvature of 20 degrees (SD=8). For the prospective audit; 524 men have joined the study of which 267 have had their 6-month review. 47% (n=126) of those reaching 6 months post-op had a new plaque. 29 were NNS, 39 UNS (14 intra-facial: extra-facial and 25 inter-facial: extra-facial) and 58 BNS (30 intra-facial: intra-facial), 18 intra-facial: inter-facial and 10 inter-facial: inter-facial).

Conclusions
These are ongoing audits which still require further investigation. However, a larger proportion of men than thought develop a new plaque. The retrospective study collaborates the previous indicated 16% of new PD diagnoses after RP.

Disclosure
No
(351) Cross Cultural Adaptation and Psychometric Validation of The Arizona Sexual Experiences Scale (ASEX) into Bangla
Authors: Mian D M S , Qusar M M A S , Hossain R , Chowdhury T , Roy K 
Published: May 2023

Abstract

Introduction
Sexual Dysfunction affecting all age groups. We need standard tool for proper assessment and management of patient with Sexual Dysfunctions. However, there is severe scarcity of validated tool in Bangla to assess Sexual Dysfunctions in our cultural context. The Arizona Sexual Experience Scale is widely used validated tool to screen and assess severity of Sexual Dysfunctions for clinical management and research.

Objective
To develop a culturally adapted and validated Bangla version of The Arizona Sexual Experience Scale (ASEX) to assess Sexual Dysfunctions.

Methods
This was a cross sectional validation study conducted from June, 2019 to Mar, 2021. After receiving the approval from original author of The Arizona Sexual Experience Scale (ASEX), it was forward and backward translated followed by the expert committee review the initial Bangla version of the scale was developed. Afterward this scale was applied on 56 patients with Sexual Dysfunctions and evaluated validity (Content validity, Face validity and Construct validity) and reliability (Internal consistency). Data analysis performed by Statistical Package for Social Science (SPSS) version- 24.

Results
The Bangla Arizona Sexual Experience Scale (ASEX) showed very good psychometric property with a Cronbach’s alpha value of 0.756. The Factor analysis based one the Eigen value revealed the Bangla version has one component.

Conclusions
The study commented the Bangla version of the ASEX (ASEX- Bangla) can be used for assessment of Sexual Dysfunctions in Bangladesh and it will help in further management of the sexual dysfunction in the country and will also help in future research in this area.

Disclosure
No
(365) Contraceptive Refusal
Authors: Choucroun D 
Published: May 2023

Abstract

Introduction
In France in 2019 the level of abortion is the highest for thirty years. Between 2010 and 2013, the use of oral contraception fell from 50% to 41% to reach 32% in 2018 (Women aged 15 to 49) Hormone phobia is often cited when the woman refuses œstrogen-progestins, but use of the morning after pill continues with one million "levonorgestrel 1,5 mg" sold each year in France. Remember this after morning pill contains 15 times more levonorgestrel than the pill. The situation is therefore more complex, and we need to understand the multiples factor that contribute to non-use medical contraception

Objective
Understand the possible causes of contraceptiv refusal in France We want to expose how the obligation of medical prescription to obtain oral contraception build a negativ representation of the pill by cognitiv distorsion.

Methods
We have etablished a statistical inventory concerning the evolution of the use of hormonal contraception in France since the contraceptive crisis in 2012 and put into perspective the number of abortions performed in France We carried out a review of literature by introducing in Pub Med the keywords "contraception over-the-counter" for a period of 5 years until 06/2022 the information obtained was confronted with the study of the effects of new information and communication techniques on perceptions and on constructions of mental representations

Results
The literature review from 06/2017 to 06/2022 reports that dispensing of contraception over-the-counter would promote its use, reduces the interruption of treatment,,would reduce the risk of unwanted pregnancies and would support the empowerment of women and girls. At the same time, in the "ATAWAD" era, anytime-anywhere- any device, the non accessibility to an object confers a representation and an imaginary of a dangerous product. This mechanism may be involved in contraceptiv refusal.

Conclusions
People who want to use contraception face many barriers: time, transport, cost, stigma, moral and even religious prejudices of prescribers. We recall that since 2012 the American College of Obstetricians and Gynecologists recommends that contraceptives must be available over-the-counter, This is already the case in several states. in 2017 in France the Family Planning has supported a petition to obtain hormonal contraception without prescription and we want this to become possible.

Disclosure
No
(381) Comparing Erectile Dysfunction (ED) Outcomes Following Priapism as an Adverse Effect of Intracavernosal Injectable Medications to Priapism due to Recreational use of Intracavernosal Injectable
Authors: Masterson J , Choi E , Zhao H , Kim H , Anger J 
Published: May 2023

Abstract

Introduction
Ischemic priapism is a urologic emergency which results in permanent erectile dysfunction if not managed immediately. We previously identified a large portion of ischemic priapism cases presenting to our institution caused by recreational use of intracavernosal injectable medications (ICI) for which patients did not have a prescription.

Objective
In the present study we identified a nearly equal number of men who presented with ischemic priapism as an adverse effect of ICI for which they did have a prescription. Our goal was to compare erectile function outcomes between these two populations in follow up.

Methods
Men presenting for ischemic priapism as an adverse effect of prescription ICI from January 2010 to December 2018 were contacted by mail, then via telephone. Standardized questions were asked of all participants on the topic of erectile dysfunction (five-item international index of erectile function (IIEF-5)). IIEF-5 results were compared to our previously described population of men with ischemic priapism caused by recreational use of ICI using the Student’s T-test of means.

Results
13 men aged 23 – 68 (mean 51.9) were recruited. Ten men (77%) were white; the remaining three (23%) were black. All men confirmed diagnosis of ED prior to their priapism episodes and all men had their own prescription for ICI from a urologist. Seven men (54%) required phenylephrine irrigation, five (38%) achieved detumescence with cavernosal aspiration and saline irrigation alone, one (8%) required a distal shunt. Mean IIEF-5 for the population at time of phone interview was 12.5 (□ 7.4) signifying mild-moderate ED, which was not significantly different from the mean IIEF-5 of our priapism population due to recreational use of ICI (13.3 □ 4.0; p = 0.87; table 1).

Conclusions
Men who present with ischemic priapism as an adverse effect of prescription ICI appear to have similar functional outcomes compared to men with ischemic priapism due to recreational use of ICI as assessed by IIEF-5. This could also be interpreted as a better functional outcome considering that this population had pre-existing ED prior to their priapism episode and therefore did not lose erectile function. The adverse effect population also appears to require a shunt in the treatment of their priapism less frequently than the recreational ICI population.

Disclosure
No
(405) Penile Prosthesis Implantation and Peyronie's Disease: How to Approach the Residual Curvature – A Detailed Demonstration of Moulding Technique and Grafting Procedure
Authors: Chiriaco G , Maher E , Lee W G , Ralph D 
Published: May 2023

Abstract

Introduction
Insertion of a penile prosthesis is the treatment of choice in men with Peyronie’s disease and concomitant erectile dysfunction. The aim of surgery is to straighten the penis and allow adequate rigidity for sexual intercourse. A conundrum arises when there is residual curvature during device testing.

Objective
This video highlights strategies that will aid the implanter when faced with these intraoperative challenges.

Methods
This video illustrates three different scenarios and suggests strategies that can be used when there is a residual penile curvature following inflatable penile prosthesis insertion: 1) Manual moulding – In this scenario, a persistent left lateral curvature is successfully straightened by moulding the plaque following device insertion. The cylinders are fully inflated and the tubes to the pump are double clamped. One hand is positioned distal to the apex of the curvature while the other is proximal. The penis is manipulated in the opposite direction to the curvature. 2) Residual curvature after manual moulding – The plaque can be incised at the point of maximal curvature and grafted If there is a significant persistent curvature (&gt;30 degrees) following moulding. A fibrin sealant patch was used in this patient and it offers a quick and effective choice for grafting the tunical defect. 3) Upfront plaque incision and grafting - Some patients are not suitable for moulding following penile prosthesis insertion. Examples include ventral penile curvature and ossified plaques. In this patient with a ventral curvature, the plaque was incised and the tunical defect grafted with bovine pericardial graft prior to corporal dilatation.

Results
All three patients had an uneventful post-operative outcome. They were encouraged to cycle the device from 3 weeks and allowed to commence sexual intercourse after 6 weeks post-surgery.

Conclusions
Manual moulding is a safe and effective first line option for residual penile curvature following inflatable penile prosthesis insertion. Plaque incision and grafting can be considered if moulding fails or where manual moulding is contraindicated. There are several choices for graft material including fibrin sealant patch or bovine pericardium.

Disclosure
No
(413) Obturator Fenestration Technique for the Woody Indurated Penis
Authors: Suarez-Sarmiento A , Ghomeshi A , Castillo M P , Levit B , Perito P 
Published: May 2023

Abstract

Introduction
Performing penile implant surgery can be challenging especially in the presence of a woody indurated penis (e.g. post priapism, post infection, prolonged h/o ICI, etc.) The loss of corporal smooth muscle cells and excess of collagen deposition caused by corporal fibrosis can create challenges and increase risk of perforation, crossover and certainly infection. Clinically, these fibrotic corpora make placement of a penile prosthesis a difficult surgical procedure.

Objective
We demonstrate how the Obturator Fenestration Technique facilitates placement of a penile implant in the woody indurated penis.

Methods
48 y/o male w/ Hx of a 3-day Priapism treated with a shunt at the time. Patient was not offered a penile implant until 8 months following event. At the time of penile implant surgery the urologist placed a malleable halfway up on the right corpora and did not attempt the other side and case was aborted. Physical examination revealed diffusely woody indurated corporeal tissue throughout the left corpora and distally on the right corpora

Results
Penile implant was successfully implanted using the obturator fenestration technique in the woody indurated penis in the patient with a previously failed attempt at implantation.

Conclusions
The use of the Obturator Fenestration Technique can help facilitate increasingly complex cases This can help reduce unnecessary complications and repeat revision surgery. However, there is a learning curve while using the Obturator Fenestration Technique and should not be performed by a novice surgeon We hope to improve our techniques and surgical approaches to improve surgical times and post-operative outcomes for the woody indurated penis

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast, Boston Scientific