bluuebunny/crossref_metadata_2025_split huggingface dataset:
(486) Different Methods Penile Girth Enlargement
Authors: Knigavko O , Tryfonyuk L 
Published: May 2023

Abstract

Introduction
Male dissatisfaction with the size of the penis is the most common manifestation of penile dysmorphophobia. Despite the variety of penis girth enlargement methods, a single safe technique that satisfies patients has not yet been developed.

Objective
The aim of the work was to compare the results of a combined operation to install a collagen-like matrix impregnated with autologous stem cells with simultaneous ligamentotomy to increase the circumference of the penis and Polylactic Gel injection.

Methods
In 2017-2022, penis enlargement surgeries were performed in 2 centers. In 38 patients from Ukraine and Poland, . performed the implantation of the Max Pol porous matrix, and injections of the polylactic acid gel were performed at the other Clinic. The results of penis enlargement were evaluated in the early (2 months) and long-term (36 months) terms.

Results
When using a collagen-like matrix -Scaffolf made of polymerized polylactic acid impregnated with own stem cells in 38 patients, we did not encounter complications that caused the removal of the matrix. However, 5 patients required additional polylactic acid gel injections between 6 and 36 months to optimize the shape or volume of the penis. In 4 cases (10.5%), patients underwent circumcision in the period up to 3 years, as the head did not open well due to the enlarged trunk. 34 (89.5%) patients noted an improvement in the sexual function and sexual sensations of their partner, harmonization of relationships in a couple, and 36 (94.7%) men - an increase in a sense of self-sufficiency and self-confidence. In 68 patients, Polylactic Acid Gel was used to enlarge the penis. It was injected under the skin of the penis in a volume of 15 ml per 1 procedure. As a rule, we performed 2-4 treatments (30-60 ml) with an interval of 1 month. No significant complications were noted. In 11 cases (16.4%), patients had to undergo circumcision within 3 years, due to the impossibility of retracting the foreskin. Most of patients noted an improvement in the sexual function and sexual sensations of their partner, harmonization of relationships in a couple, and 61 (91.%) men - an increase in a sense of self-sufficiency and self-confidence.

Conclusions
Thus, modern implants can improve the size and appearance of the penis, improve the quality of sexual life and the feeling of self-sufficiency in operated men. The use of a polymer matrix impregnated with one's own stem cells requires a special laboratory, more time for perioperative preparation and postoperative rehabilitation. The use of polylactic acid gel injections does not require anesthesia, operating room, is more physiological, and can be considered as the standard of safe penis enlargement. The frequency of the need for circumcision after gel injection is slightly higher at 3 years of follow-up compare with scaffold implantation, possibly due to the greater addition of penile volume.

Disclosure
No
(500) What Do Women Want? Vibrators To Be Prescribed by Their Doctors
Authors: Dubinskaya A , Shoureshi P , Eilber K 
Published: May 2023

Abstract

Introduction
Traditionally vibrator use has been a taboo topic that is rarely discussed between patient and physician. Nevertheless, the vibrator industry has flourished the past several years with vibrators now available at mainstream retailers. While these devices are readily available to the public, the role of medical professionals in regards to vibrator use and female pelvic health is not well known.

Objective
The purpose of this study was to describe the interest among women responding to a clinical trial for female sexual wellness and the use of vibrator.

Methods
We reviewed the responses to a female sexual wellness clinical trial posted on various medical platforms (clinicaltrials.gov, Medscape, Medege, Medpage). Using qualitative content analysis, we reviewed the inquiries made by women interested in participating in the study. Those women who were ineligible for the study due to their geographical location but desired to have an in depth discussion were offered telephone calls.

Results
A total of 260 emails and 12 voice mails were received from 148 women within a two-week time frame who had inquired about the female sexual wellness study and vibrators. The locations of the respondents included 31 states within the United States and Canada. The average age of the respondents was 60 years, and 62 (42%) of the women worked in the medical field (medical doctors, osteopathic doctors, and registered nurses). Five women (3.3%) received a link about the study from their male partners. The most common conditions that women were hoping to improve with vibrator use in descending order: sexual dysfunction (dyspareunia, desire/libido, orgasm), urinary incontinence, prolapse/pelvic floor, and menopause.

Conclusions
Our review demonstrated that women are interested in vibrators, particularly in a clinical trial setting, and are seeking to use them for multiple conditions including FSD and pelvic floor disorders. Clinicians should consider discussing vibrator use with patients, as it normalizes vibrator use.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Abbvie, Coloplast, Sprout Pharmaceuticals.
(503) The Impact of HEPA/Ultraviolet air recirculation system (HUAIRS) During Penile Prosthesis Surgery
Authors: Hakky T , Carrion R , Henry G 
Published: May 2023

Abstract

Introduction
Airborne bacteria are a major source of wound contamination during penile prosthesis surgery. 80% of bacteria found in the wound after surgery comes from the air. Crystalline ultraviolet C (C-UVC) filter units were designed to disinfect and recirculate the air in the operating room (OR).

Objective
We assess the particle-reducing capacity of C-UVC units in a highly controlled operating room setting in the office and surgery center during penile prosthesis surgery.

Methods
A particle counter was deployed in a positive-pressure operating room and a standard office HVAC system to measure total and viable particle counts (TPC). A HEPA/Ultraviolet air recirculation system (HUAIRS) was purchased and placed into the ORs in both locations. Weekly particle count experiments were performed for 6 months in both office OR and surgery center OR settings. A C-UVC unit was kept 4 meters from the door in both settings and the particle counter was used near the operative field.

Results
After 6 months of weekly office-based procedure collection of data using a particle counter an 83.4% particle reduction was seen at the 5 micron level. Initially, reads were 14,143 particles and after implementation of the HUAIRS, a total particle count was 2,299 during office penile prosthesis. In the OR at the surgery center, the same weekly data collection was employed. The initial 5 micron particle count dropped 81.74% from 6,143 particles to 1,122 once the HUAIRS system was employed.

Conclusions
C-UVC units have shown to be capable of significantly reducing TPC in the office and operating room setting. Reducing airborne particles using C-UVC units may reduce infection rates following penile prosthesis surgery.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast.
(506) Histology Appears to Reveal Good Sealing of the Human, Porcine and Dog Vasectomy Specimens using the Vasectomy Sealing Procedure
Authors: Henry G , Hakky T , Griggs R , Nighan W , Fuselier A , Jones L 
Published: May 2023

Abstract

Introduction
The Sealed Vasectomy Procedure (SVP) is a new bipolar radiofrequency sealing tool for transdermal vasectomy in hopes of making the procedure a faster, simpler, and safer office procedure. Testing has been successful in rabbits with excellent wound healing, complete vas occlusion on histology, and no sperm in post-procedural semen analysis. The study data was presented last year as a video submission and subsequently won the AUA 2022’s “Best Video” of the andrology / infertility / sexual dysfunction session. Further studies in larger animals were indicated and FDA approval is needed before its application in humans. The issue of “does the SVP effectively seal the vas deferens in animals larger than a rabbit and in humans?” is a critical one for treating physicians.

Objective
Evaluate the effectiveness of the SVP in sealing the vas deferens in animals larger than a rabbit and in humans.

Methods
Animal (rabbit) studies have been previously described. We performed microscopic evaluation of the vas deferens tissues from canines treated with the SVP at either 40 or 60 watts, euthanized at 14 days post-treatment under the conditions of this study. Human vas deferens specimens after removal from the patient were then immediately treated with SVP tool on benchtop. Porcine vas deferens samples were procured and underwent benchtop testing. Specimens were sent for pathologic evaluation by a third-party professional vendor [Crisp County Regional Medical Center in Cordele, Georgia].

Results
4 canine, 6 human, and 26 porcine vas deferens were included in SVP testing. Human, porcine, and canine specimens demonstrated tissue coagulation and fibrosis in the treated vasa deferentia. (See Figure 1 Human and 2 Canine)

Conclusions
SVP is a potentially exciting novel vasectomy procedure that appears to provide good sealing of the vas deferens in the canine animal model and on benchtop for the human and porcine vas deferens. FDA approval is still needed before use in humans.

Disclosure
Yes, this is sponsored by industry/sponsor: Signati Medical

Clarification
Industry initiated, executed and funded study
Any of the authors act as a consultant, employee or shareholder of an industry for: Signati Medical.
(514) Are Intracorporal Injections Associated with Difficult Placement of Inflatable Penile Prosthesis Placement?
Authors: Charles D , Mohankumar K , Waldcoh B , Kasson M , Dietrich P , Guise A 
Published: May 2023

Abstract

Introduction
Inflatable penile prosthesis (IPP) is the gold-standard treatment for erectile dysfunction that is refractory to pharmacologic therapies. While complications occur in 1-10% of patients, there remains a paucity of data regarding the impact of intracorporal injections (ICI) on a more difficult IPP placement.

Objective
We sought to demonstrate correlation between prior ICI and increased difficult with IPP placement. We hope to use our data to help guide future pre-procedural planning as well as patient counseling.

Methods
The records of patients who underwent IPP placement via single surgeon between 2016 – 2021 were retrospectively reviewed. Baseline patient demographics in addition to history of priapism, shunt, presence of Peyronie’s disease (PD), ICI use and duration, and intraoperative details including need for multiple corporal dilations and corporal scarring were gathered. Exclusion criteria included patients with re-operative/revision IPPs, patients with 2-piece IPPs, and patients with semi-rigid IPPs. The associations were calculated using Chi-squared analysis and logistic regression.

Results
There were 96 patients that met inclusion criteria, with average age of 62 years. Half (48/96) had history of ICI use, with mean duration of 17.25 months (range 1-65). ICI was not associated with corporal scarring (p=0.51) or need for multiple dilations during IPP placement (p=0.46). Duration of ICI (comparing subgroups of &lt; 20 months and &gt;20 months) was not significantly different with respect to corporal scarring (p=0.343) or need for multiple dilations (p=0.839). History of priapism or shunt was not associated with corporal scarring (p=0.251). Patients with PD were more likely to require multiple dilations (p=0.033).

Conclusions
History of ICI and its duration were not associated with corporal scarring and increased intraoperative difficulty. Patients with a history of Peyronie’s disease were more likely to require multiple dilations. Other studied factors including ICI duration of &gt;20 months, history of priapism, and history of shunt are NOT associated with corporal scarring or need for multiple dilations.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific
(515) A Call to Contraception: Overturn of ROE v. WADE Catalyzes Rise in U.S. Vasectomy Consultations
Authors: Lindsey J , Torres-Anguiano J R , Donato J , Campbell K , Lipshultz L , Kassab J 
Published: May 2023

Abstract

Introduction
On June 24, 2022, the U.S. Supreme Court’s landmark decision on DOBBS v. JACKSON WOMEN'S HEALTH ORGANIZATION leaves abortion rights or restrictions to be defined at the state level. The following week several news outlets reported that urologists across the country are experiencing significant increases in clinical encounters for individuals interested in undergoing a vasectomy.

Objective
To explore the impact of changes to federal protection of abortion rights on the number of individuals seeking vasectomies at two high-impact academic centers and their correlation with Google Web searches.

Methods
A cross-sectional analysis of Google web searches from 1/1/2004-6/30/2022 was performed for the key term ‘vasectomy’ utilizing Google Trends®. One primary outcome was relative search interest in the key term ‘vasectomy’ prior and after the overturn of ROE v. WADE. We calculated the coefficients of determination for the linear search trend of this term. In parallel, cross-sectional analyses were performed utilizing databases from the electronic medical records of two high-impact university hospitals (‘Hospital-1’ and ‘Hospital-2’). in the U.S. focusing on patient encounters for vasectomy consultation coded as ‘vasectomy / vasectomy consult / vasectomy planning/ vasectomy education.’ The observation interval included 06/01/2022 - 06/30/2022. Correlation coefficients were calculated using SPSS.

Results
Web searches for the term ‘vasectomy’ increased 3.6 times the average number of searches for ‘vasectomy’ during the week following the U.S. Supreme Court’s decision on abortion, and it marked the most the term had ever been searched since Google began tracking its searches in 2004. Similarly, office visits for vasectomy consultations for Hospital-1 and Hospital-2 increased by factors of 2.4 and 6.0, respectively. Internet searches for ‘vasectomy’ and the number of clinic vasectomy consultations demonstrated correlation values of r = 0.96 and r = 0.89 for Hospital-1 and Hospital-2, respectively.

Conclusions
Online search interest as well as clinical encounters for vasectomy consultation have increased over the past 30 days coincidentally with - and perhaps as a consequence of - the overturn of ROE v. WADE. Our study has demonstrated marked correlation between the increase in Google searches and office visits for vasectomy consultation. This may mark a watershed moment in the adoption of vasectomy for male contraception.

Disclosure
No
(516) Maximizing Penile Prosthesis Length: Our Technique and Outcomes
Authors: Razdan S , Siegal A , Valenzuela R 
Published: May 2023

Abstract

Introduction
The most common cause of patient regret after penile prosthesis surgery is penile shortening, which has been reported in up to 70% of patients postoperatively.

Objective
We sought to query a national database on average prosthesis length and describe our techniques to maximize cylinder sizes.

Methods
We performed a retrospective review of the Coloplast database of 3-piece penile prosthesis cases performed over the span of 1 year nationally and by a single high volume surgeon and compared average cylinder lengths.

Results
Between July 1, 2021 and June 27, 2022, 145 three piece penile prosthesis surgeries were performed at our institution. All were performed via a scrotal incision. Nationally, 32.8% were performed infrapubic while 58.1% were performed scrotal. The most prevalent cylinder length in our series was 22cm, compared to the most prevalent nationally of 20cm. (Table 1). Our technique to maximize cylinder length involves circumferential mobilization of the corporal bodies and corporal tissue sparing. After initial scrotal incision and dissection to the level of the penile compartment, circumferential mobilization of the corporal bodies is carried out. In addition, the ventral corporal dartos layer is meticulously peeled away. Corporal tissue sparing is carried out by employing 9” Metzenbaum scissors rather than sequential dilators for corporal tunneling. (Image 1). The benefit of this approach is the ability to create a dorsal compartment to the level of the triangular ligament of the glans, thereby extending the space to the level of the midglans. This maneuver minimizes placement of the prosthesis anteriorly at the level of the fossa navicularis and prevents floppy glans that would otherwise compromise maximum cylinder length.

Conclusions
Three piece penile prosthesis cylinder size can be maximized by circumferential mobilization of the corporal bodies, corporal sparing maneuvers, and the utilization of long Metzenbaum scissors for precise corporal tunneling, ensuring the distal cylinder tips are seated within the tip of the glans rather than at the coronal sulcus. This can help mitigate patient regret after prosthesis surgery.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast
(521) The Impact of Donor Robotic Partial Hepatectomy on Sexual Function in Sexually Active Men: A Prospective Cohort Study
Authors: Seyam R , Almaiman S , Mandourah H , Kattan M , Kattan S , Broering D , Altaweel W 
Published: May 2023

Abstract

Introduction
Donor robotic partial hepatectomy is evolving as a low morbidity method for liver transplantation. However, we have noticed that two of our patients complained of de novo sexual dysfunction following their surgery. Factors that may lead to the dysfunction are liver dysfunction and stress.

Objective
We set out to objectively evaluate the impact of robotic partial hepatectomy on sexual function in sexually active men.

Methods
This prospective study involved a cohort of married men with no prior sexual dysfunction who consecutively presented for a liver donation from Jan 2021 to Mar 2022. Robotic partial hepatectomy was performed using three ports and a Da Vinci XI system, and a small Pfannenstiel incision was used to deliver the specimen. We performed a preoperative assessment of sexual function using the IIEF-15 questionnaire [1], liver function using the CLDQ-29 questionnaire [2], and perceived stress PSS-14 questionnaire [3]. Lab investigations included hormonal profile, liver function, and renal function. The postoperative assessment was repeated after three months. Continuous data were compared using paired t-test. References: 1. Rosen RC, et al (1997) Urology 49:822–830 2. Younossi ZM, et al (1999) Gut 45:295–300. 3. Cohen S, et al (1983) J Health Soc Behav. 24:385-96.

Results
Twenty-eight male donors, with a median age of 31.5 SD 6.2 range 19-42 years, and BMI of 24.2 SD 4.2 range 17.9-33.1 kg were studied. At baseline, all had no sexual dysfunction, liver disease, or comorbidities. Preoperative median morning testosterone was 15.8 SD 4.1 range 10.6-26.6 nmol/L. All patients had normal hepatic and renal function. Three months postoperatively, no patient-reported sexual dysfunction. There was no significant difference in the IIEF-15 erectile function domain pre and postoperative, respectively (mean 27.2 SD 5.3 and 27.7 SD 5.4, p = 0.162). There was no significant change in the desire, orgasmic, or satisfaction domains. There was no significant change in the average CLDQ-29 score (6.9 SD 0.33 and 6.9 SD 0.33, p=0.378) or its domains of abdominal symptoms, fatigue, systemic symptoms, activity, emotional function, and worry. There was no significant change in the stress level before and after surgery, with PSS-14 total scores of 21.6 SD 6.6 and 21.5 SD 6.7, p=0.739, respectively.

Conclusions
In this small prospective cohort, we did not find a significant association between donor robotic partial hepatectomy and the development of sexual dysfunction. However, a study involving a larger number of patients may reveal more subtle changes in sexual function and underlying mechanisms.

Disclosure
No
(525) Challenges in Management of Sexual Disorders in Rwanda
Authors: Nzeyimana n I 
Published: May 2023

Abstract

Introduction
In Rwanda, it is not common to talk about sexual issues but these days there are remarkable increase in sexual disorders consultations especially in men where most are complaining of erectile dysfunction followed by ejaculatory disorders which make about 10% in public and 20% in private urological consultations. Top causes are psychogenic while organic causes include Diabetes mellitus and post chemotherapy and radiotherapy in females. Most patients present late distressed and desperate hence poor quality of life.

Objective
Highlight the challenges in management of sexual disorders in Rwanda

Methods
Narrative opinion. I will discuss in details those challenges from a perspective of a urologist interested in sexual medicine.

Results
There are neither andrologists nor specialized sexual therapist in Rwanda, hence difficulty in treating these patients. Most of patients are exposed to highly mediatized wrong information from practitioners who use herbal medicines to treat them without success in most of them. Others consult general practitioners or gynecologists who refer them to urologists. With the scarcity of urologists in the country (only 10) and lack of psychosexual therapists, limited treatment options (only some PDEIs and antidepressants available) and cultural barriers, there is a big gap in proper management of sexual disorders.

Conclusions
There is high need for capacity building of health professionals, special training of urologists, research, access to evidence-based information and management options to bridge the big gap.

Disclosure
No