bluuebunny/crossref_metadata_2025_split huggingface dataset:
(472) The AM-EDITS: A New Tool for Evaluating the Arab Patient and Partner Satisfaction Following Penile Prosthesis Implantation
Authors: Ragheb A , Osmonov D , Abdallah M , Elmarakbi A , Massoud A , Emadeldin M , Abdelbary A 
Published: May 2023

Abstract

Introduction
The Modified Erectile Dysfunction Inventory of Treatment Satisfaction (M-EDITS) is recognized as a useful tool in English language to assess post penile prosthetic implantation (PPI) satisfaction. Nevertheless, a more global questionnaire remains to be introduced for the Arab population, where malleable PPI (MPPI) remains more popular, compared to the inflatable types. Due to the sensitivity of the topic and the conservative nature of the Middle East and North Africa (MENA) region, a scarce body of related research is available.

Objective
Our primary goal was to develop a validated Arabic version of the M-EDITS adapted to the Arabic culture and introduce it as the AM-EDITS. Our secondary goal was to utilize it to investigate the levels of Arab patient and partner satisfaction after MPPI and its sustainability during and after the first 6 months of surgery.

Methods
This was a prospective 6-month follow-up study of 120 patients undergoing MPPI at our unit by a single surgeon. Three telephone encounters were conducted for each couple at 1 month, 3 months, and 6 months postoperative (PO). For our study, we developed a validated Arabic version of the M-EDITS, coined as the AM-EDITS. The first encounter covered general patient perioperative experience, beginning from preoperative counseling till early after surgery. The second and third encounters focused on patient and partner satisfaction regarding implant utilization.

Results
The mean ages for the men and their spouses were 54.7±8.4 and 32.9±4.6 years, respectively. Over 82% of the patients in our study showed a decreased level of anxiety after preoperative counseling. 96% of the patients reported a positive experience regarding their early PO days with above half exceeding their expectations. After 3 months, 82.5% of the men were satisfied, describing their erections to be 80% close to natural. Of the 92.5% satisfied wives at 3 months, 78.5% were highly satisfied. Feeling sexually desirable by their husbands was reported in 93.4%. As opposed to the significant rise in men’s overall satisfaction and AM-EDITS index by 11.6% and 5.2 ± 0.8% (P &lt;0.001), respectively after 6 months PO, partners demonstrated a 12.4% and 5.9 ± 0.8 decline (P &lt;0.001), respectively, compared to the 3 months follow up.

Conclusions
The AM-EDITS may expand the global application of the original M-EDITS. MPPI represents a good quality of life treatment option for middle to low-income countries. Time has a positive effect on the Arab men’s PO satisfaction as opposed to their partners’. These findings should be considered during perioperative counseling of both parties to ensure sustainable satisfaction. Extended studies are necessary to confirm our findings as well as assess long-term PO satisfaction.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast
(476) Contemporary Mmanagement of Penile Foreign Body Injections
Authors: Lee W G , Merrett C , Maher E , Ralph D 
Published: May 2023

Abstract

Introduction
Foreign body injections were first used, in the form of mineral oil, in 1899 to augment men post orchidectomy for tuberculous orchitis. In the 1940s and 1950s, documented cases of purposeful penile foreign body injections started to be reported as “penile paraffinomas.” Their surgical correction is challenging due to the risk of skin necrosis and wound breakdown.

Objective
The aim of the study is to present a large case series of 31 penile paraffinomas to examine the management and complication rates in the modern era.

Methods
Retrospective review of penile paraffinomas managed at a single institution over a 15-year period (2006-2021). Patient demographics, surgical management and functional outcomes were extracted from both paper and electronic medical records.

Results
Median age at time of referral was 34 (IQR=10.5). Median age at time of first injection was 30 years (IQR=11.5). The substances injected were silicone (47%), paraffin (25%), mineral oils (22%), and unknown (6%). The most common presenting symptoms was pain (44%) but other reasons included concerns for cosmesis (21%) and penile tightness or phimosis (21%). Only 1 man presented with ulceration and skin necrosis. Most (97%) underwent surgical reconstruction with a median of 2 operations per man (range 1-7) and 66 operations in total. Excision with primary closure was possible in 62% of the operations with circumcision required in 18% (Table 1). Closure was by local tissue flap in 3% but split (5%) or full (5%) thickness skin grafts were sometimes required. Complications occurred in 15% (n=10) with the most common being wound breakdown (n=6) followed by skin necrosis (n=3). There was 1 scrotal haematoma that required surgical drainage (Clavien 3b). Median follow-up after the last operation was 2 months (range 0-19 months) with 70% (n=22) lost to follow-up at some point. Erectile dysfunction and loss of penile sensation were uncommon following surgery (7%, n=2 and 3%, n=1 respectively). Only 7% (n=2) of men expressed dissatisfaction with the overall result of their treatment.

Conclusions
Penile paraffinomas are rare and difficult to treat. Performing repeated staged revision surgery reduces the risk of complications by allowing time for healing between each procedure. Our complication rates are consistent with other contemporary reports. Very few men expressed dissatisfaction with their treatment despite their limited follow-up due to the severity of their presenting problem.

Disclosure
No
(478) Patient and Partner Expectations Before Inflatable Penile Implant Surgery: A Qualitative Analysis
Authors: Vaughan A , Pearlman A , Wentzell E 
Published: May 2023

Abstract

Introduction
Patient and partner expectations before inflatable penile prosthesis (IPP) surgery and satisfaction after IPP have not been well studied.

Objective
The purpose of this study is to qualitatively investigate preoperative expectations of patients and partners.

Methods
Participants included men undergoing IPP surgery for erectile dysfunction (ED) at our institution. We also included interested partners. Information was collected via preoperative telephone interview. Semantic and latent themes were identified using qualitative inductive thematic analysis.

Results
Sixteen patients and 6 partners were interviewed prior to IPP surgery. Patients reported penetrative sex as the preferred form of intercourse (100%), orgasm as the desired endpoint for both participants (86.7%), and diminished self-confidence secondary to erectile dysfunction (66.7%). Partners preferred penetrative sex (60%) and the majority denied orgasm as necessary for their satisfaction (80%). Ideally, patients desired intercourse more than three times per week (87.5%), while partners desired intercourse less than 2 times per week (80%). Most patients reported that their partner was unsatisfied with their sexual activity (93.8%), however patients and partners denied communication with their partner regarding sexual desires or satisfaction (86.7%). All patients (100%) and nearly half of partners (40%) hoped to engage in penetrative sex following IPP placement, while most partners desired restored confidence for the patient following surgery (80%).

Conclusions
Preoperative expectations differ between patients undergoing IPP surgery and their partners. Understanding the impact of these differences on postoperative satisfaction is necessary to identify favorable surgical candidates and provide appropriate preoperative counseling.

Disclosure
No
(485) Utility of Dedicated Andrology Services Among Patients at a Public Tertiary Care Hospital in a Developing Country
Authors: Hegde A , Andankar M , Pathak H 
Published: May 2023

Abstract

Introduction
Patients with andrological problems especially in developing countries do not readily seek treatment with health care professionals. Various barriers to treatment exist including cultural taboos associated with these problems. This has been an unexplored area among Indian patients especially in the public healthcare domain. Public health care set ups in India deal with a huge volume of patients and many set ups do not have dedicated andrology services to handle such patients.

Objective
To evaluate utility and satisfaction with Andrology services among patients at a public tertiary care hospital in a developing country among the out-patient population, an observational questionnaire survey was administered.

Methods
A cross sectional questionnaire survey was conducted on 350 andrology OPD patients over one year. They were given a questionaire that asked basic questions about demographics, sexual habits, education and income level at their initial visit. On follow up, questionnaire recorded the same details along with satisfaction and utility of the andology services to the public at large.

Results
The mean age of the 350 men was 43.4 years; 78% were &lt;50-years-old and 70% had a low income, 60% had low education. 75% patients confessed they were reluctant to seek treatment when they had first symptoms. More than 95% of the respondents were satisfied with the andrology services and hospital environment. All patients felt a confidential environment in a dedicated OPD helped them. The fact that such services were provided at no cost was the most common reason attributed to the high satisfaction rates

Conclusions
Patients frequently consult their peer groups and the internet for information about andrology issues. We believe there should be more awareness about men’s health issues and the options available for treatment. Dedicated andrology services among others, go a long way in bridging the gap. Our study proves that when properly implemented, even in tertiary public hospitals in urban areas, utilization of the service and satisfaction rates remain high.

Disclosure
No
(490) The Ins and Outs of Peyronie’s Disease: An Evaluation of Endoscopic Associations
Authors: Batra N , Reich D , Bird V , Terry R , Yeung L , Campbell K 
Published: May 2023

Abstract

Introduction
Peyronie’s disease (PD) is a fibroproliferative disorder of the tunica albuginea of the penis. Though the etiologies and potential mechanisms for PD remain understudied, known PD risk factors include family history, Dupuytren disease, diabetes mellitus, smoking, hypertension, and penile trauma. Endoscopic procedures have also been reported as a cause of PD. Although often referenced, current literature contains little evidence describing the potential association of endoscopic procedures with the development of PD.

Objective
To evaluate the association of endoscopic procedures and patient demographics in men with the development of Peyronie’s disease

Methods
Institutional review board approval was obtained, and a retrospective review was performed at a tertiary referral center of all patients with history of urologic endoscopy who were subsequently diagnosed with PD from January 2010 to January 2022. Electronic medical records were searched for ICD-9 and ICD-10 codes to identify unique records with a diagnosis of PD. Records were also identified by CPT codes for transurethral and percutaneous urologic endoscopic procedures. Endoscopic procedures were evaluated for the type of instrumentation and divided into 4 broad categories: diagnostic cystoscopy, urethral stricture manipulation, transurethral resection, and endoscopic treatment for urinary lithiasis. Records were evaluated for time to PD diagnosis following their procedure, presence of a post-operative urethral catheter, and demographic data.

Results
A total of 19,383 unique patients with endoscopy procedures and 629 unique patients with PD diagnosis were identified. 121 patients had a diagnosis of PD and history of endoscopy, of whom 50 patients (7.9%) were confirmed to have had endoscopy prior to PD diagnosis. The median age of PD diagnosis was 62. There was no increased association between PD and endoscopy in men with a diagnosis of diabetes (p = 0.5261), hypertension (p = 0.2256), or a history of smoking (p = 0.9398). The majority of PD diagnoses (54%, 27/50) were associated with cystoscopy performed supine (48.1%, p=0.0011), in a clinic (40.7%, p = 0.0001), and with flexible instrumentation (55.6%, p&lt;0.0001). Postoperative urethral catheter use was not associated with PD (p = &lt; 0001. There was no association between the time to presentation of PD and the procedure performed (p=0.73).

Conclusions
Men with a diagnosis of PD and a history of prior urologic endoscopy are more likely to have undergone a simple, flexible cystoscopy in the clinic setting. There does not appear to be an association between the time to presentation of PD and the endoscopic procedure performed.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Endo Pharmaceuticals
(495) Does Penis Size Matter? Or, Does it Just Matter How it is Measured?
Authors: Wallace C , Snipes M , King S 
Published: May 2023

Abstract

Introduction
There is no popular standardized method for men to measure penis length with countless combinations of measuring implement, side of the penis, degree of penile stretch or erection, and most proximal point. Predictably, methods can yield drastically different results however both physicians and literature rarely elaborate on method of measurement. With how often penis length comes up in discussion in and outside of healthcare, no studies have been performed on the true variety of measurement methods and inappropriate direct comparison of studies with entirely different metrics. Besides quality of their new "erection", penis length is one of the most common concerns of patient's undergoing penile prosthesis surgery for erectile dysfunction.

Objective
To determine the various methods with which a penis can and is measured in order to better manage patients’ expectations after prosthetics surgery.

Methods
Literature review was performed to analyze variation in penile measurement techniques between scientific publications. Tiktok is a popular social media platform where users can create, share, and discover short videos and share comments related to those videos. Several videos on tiktok discussing methods to measure a penis have recently skyrocketed to popularity with as many as 10 to 15 million views and 10-20k comments. Content analysis of users who commented their techniques was performed to inform a short survey posted to tiktok asking users to vote on the most common discrepancies identified in our analysis.

Results
Publications in literature range broadly in method of measuring the penis with the most significant variation due to starting measurement at the pubic bone vs mons pubis. Similarly, early analysis of tiktok comments of the top 5 most viewed videos discussing measuring techniques redemonstrates the same common discrepancies observed in literature review. This study is ongoing but we expect the results of our tiktok survey to prove that there is no common shared method that most tiktok users use to determine penile measurement. While some scientific articles do report more than one measurement of the penis, there is also no research into the accuracy and repeatability of each measurement method to patient’s experience and expectations regarding penis length.

Conclusions
A standardized method for penis measurement will unify the scientific community and patients with concerns relating to penile length whether specific to expectations after prosthesis surgery or otherwise!

Disclosure
No
(497) Is Drug Development for Female Sexual Dysfunction Dead?
Authors: Pyke R 
Published: May 2023

Abstract

Introduction
Various agents have been tested to treat female sexual dysfunction (FSD), particularly Hypoactive Sexual Desire Disorder and Female Sexual Arousal Disorder, but only two, flibanserin and bremelanotide, have met any regulatory standards (US only), and none is popular with patients or prescribers. Several more agents, e.g., sildenafil, testosterone, alprostadil, buspirone, bupropion and trazodone, have shown early promise but have not been developed further.

Objective
Evaluate whether drug development for FSD at a standstill and identify related factors.

Methods
Selective literature review using the largest, most high-quality surveys available on factors relating to the proportion of women likely to be treated for FSD and of the factors relating to convenience of the posology and the safety of agents for FSD.

Results
Surveys show that about 40% of women have sexual dysfunction, but lack of related distress and complicating factors decrease the proportion of women likely to be treated medically for primary FSD to about 0.1%. Such complicating factors include antidepressant use and chronic medical illness that prevent diagnosing primary FSD, lack of awareness, and prescriber reluctance. The posology of the available agents and their side effects may limit benefits and thus acceptance, also. Fear of regulatory rejection amid shifting standards for evaluation of efficacy and diagnostic criteria is an intangible but likely factor stalling drug development for FSD, too.

Conclusions
Major investment in developing medications for FSD may well have ended. The proportion of women with primary (stand-alone) FSD likely to be treated medically is limited to no more than 0.1% of the population because of low awareness of the diagnosis, lack of willingness to be treated, and lack of prescriber knowledge and willingness to diagnose and prescribe. Benign medications for primary FSD are not available with sufficiently robust efficacy and convenience to break down the barriers of patient and practitioner reluctance toward medical treatment. The lack of marketing success with current agents and the fear of surmounting regulatory hurdles probably have had additional chilling influences on drug development in this field. Developing agents for secondary FSD (FSD comorbid with common chronic medical conditions), e.g., HSDD and/or FSAD in women with the genitourinary syndrome of menopause, diabetes, cancer, depression, and antidepressant users, could help far more women, perhaps 10% of the female population. However, such patients should be expected to be more difficult to treat, might well require multimodal approaches using the biopsychosocial model of FSD. A combination of medication with targeted psychotherapy, couples’ therapy, and/or a mindfulness-based intervention might be necessary.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: S1 Biopharma, Sprout Pharma, Gedeon Richter.
(510) Do Patients with Peyronie’s Disease Perceive Penile Curvature Differently than the General Population?
Authors: Henry A , Lui J , Ziegelmann M , Breyer B , Smith R , Yeaman C , Kern N 
Published: May 2023

Abstract

Introduction
Perception of penile curvature (PC) varies widely, and correction of PC is in the eye of the beholder.

Objective
We sought to investigate if patients with Peyronie’s Disease (PD) had differing opinions on correction of PC compared to general andrology (AD) patients without PD and general urology (URO) patients.

Methods
A cross-sectional survey was administered to adult patients in andrology and general urology clinics at 3 geographically separate institutions. Patients were grouped with having PD vs AD vs URO conditions. The survey consisted of unlabeled images of penis models with varying degrees of PC (range 10-90°). Respondents were asked to select the images they would want surgically corrected. Univariable and multivariable analyses were performed to identify demographic variables associated with willingness to consider correction.

Results
Ninety-four PD, 106 AD, and 302 URO patients were recruited. When comparing the 3 groups, besides obvious gender differences with PD patients, PD patients were less in 25-34 age range and more in 55-64 age range (p=0.01 and p=0.007). PD was less represented in Mid-Atlantic (p&lt;0.001). 8% of PD, 12% of AD, and 20% of URO patients chose not to surgically correct any degree of PC (p=0.001). Among those who endorsed willingness to surgically correct PC, the average threshold for correction was 52.5° (SD 13) for PD, 37.2° (SD 29.5) for AD, and 51.0° (SD 19.9) for URO patients. When comparing PD patients with AD patients, no difference in the decision to surgically correct was found (p=0.42). This was also found to be the case when comparing PD with URO (p=0.46) and PD+AD patients vs URO (p=0.67). On univariable analysis, among AD patients, those ages 55-64 were more willing to undergo PC correction at lower degrees of PC (p=0.03) but did not hold up on multivariable analysis (p=0.40). No other demographic factors among PD and AD groups were found to have an impact on willingness to undergo PC correction (Table 1).

Conclusions
No significant differences were seen in the decision to surgically correct PC when comparing the perspectives of patients with PD, AD, and URO. Roughly 10% of all of these patients would defer on surgical management of any degree of PC. Despite having PC, no demographic differences were seen among PD patients’ willingness to correct PC.

Disclosure
No
(526) Association of Prior COVID-19 Infection With Newly Diagnosed Erectile Dysfunction: Evaluation of 42,406 COVID-19 Recovered Men
Authors: Hebert K , Matta R , Horns J , Paudel N , Das R , Mccormick B , Myers J , Hotaling J 
Published: May 2023

Abstract

Introduction
The SARS-CoV-2 virus and associated COVID-19 infection is known to cause endothelial cell dysfunction. This has led some to hypothesize that COVID-19 infection may increase the risk of erectile dysfunction. Initial studies evaluating this association have been limited to small, single institution studies or have utilized electronic medical record databases that lack universal follow-up given they only capture follow-up care at a small proportion of health care facilities.

Objective
To assess if COVID-19 infection recovery is associated with increased rates of newly diagnosed erectile dysfunction (ED) using an insurance claims database.

Methods
Using IBM MarketScan, a commercial claims database, men with prior COVID-19 infection between January 2020 and January 2021 were identified using ICD-10 diagnosis codes. Using this cohort along with an age-matched cohort of men without prior COVID-19 infection, we assessed the incidence of newly diagnosed erectile dysfunction (ED). Men with ED secondary to prostatectomy or radiation were excluded. Covariates were assessed using a multivariable model to determine association of prior COIVD-19 infection with newly diagnosed ED.

Results
42,406 men experienced a COVID-19 infection between January 2020 and January 2021 of which 610 (1.44%) developed new onset ED within 6.5 months follow up. On multivariable analysis while controlling for diabetes, cardiovascular disease, smoking, obesity, hypogonadism, thromboembolism, and GU malignancy, prior COVID-19 infection was associated with increased risk of new onset ED (HR 1.27; 95% CI 1.1-1.5; P=0.001). COVID-19 infection carried a similar association with new onset ED as did diabetes and BMI 25-30, HR 1.3 and 1.29, respectively.

Conclusions
Prior to the widespread implementation of the COVID-19 vaccine, the incidence of newly diagnosed ED is higher in men with prior COVID-19 infection compared to age-matched controls. Prior COVID-19 infection was associated with a 27% increased likelihood of developing new-onset ED when compared to those without prior infection. Additional longitudinal studies are needed to evaluate the risk of erectile dysfunction after following asymptomatic infection and in the setting prior vaccination.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Cooper Medical, Boston Scientific, Acerus, Coloplast, Endo, Turtle Health, Maximus, FirmTech, StreamDx, Inherent Bioscience.