bluuebunny/crossref_metadata_2025_split huggingface dataset:
214 European Male Aging Study Gonadal State Related to the Outcomes of Microsurgical Varicocele Repair
Authors: Komiya A , Kato M , Sazuka T , Imamura Y , Sakamoto S , Ichikawa T 
Published: May 2022

ABSTRACT

Introduction and Objective
In European Male Aging Study (EMAS), hypogonadism is classified in four groups as normal or eugonadal [total testosterone (TT) ≥10.5nmol/L and luteinizing hormone (LH) ≤9.4IU/L; N/E group], secondary hypogonadism (TT&lt;10.5nmol/L and LH ≤9.4IU/L; S/H group), primary hypogonadism (TT&lt;10.5nmol/L and LH&gt;9.4IU/L; P/H group), compensated hypogonadism (TT≥10.5nmol/L and LH&gt;9.4IU/L;C/H group). Symptoms and co-morbidities were different among groups. In the present study, incidence of EMAS hypogonadism and the relationship between gonadal state and treatment outcomes of microsurgical varicocele repair.

Patients and Methods
Enrolled were 88 patients who underwent microsurgical varicocele repair with pretreatment measurement of sex hormones. We retrospectively analyzed incidence of EMAS hypogonadism, presurgical difference in semen quality according to gonadal state, and change in semen parameters after microsurgical varicocele repair. Student T test was used to compare two groups. This study was proved by institutional review board of Chiba University (#2557).

Results
Seventy-five patients were classified as eugonadal (N/E group, 84.3%), and 13 (15.7%) were hypogonadal [8 in S/H group (9%), 0 in P/H group (0%), and 5 in C/H group (5.7%)]. Mean testicular volume was significantly higher in N/E group than in hypogonadal (S/H, P/H and C/H) groups (mean volume of the right testis 17mL vs. 12mL, p=0.0283; mean volume of the left testis, 16mL vs. 11mL, p=0.0281). Out of 54 patients with male infertility, 44 were in N/E group and 8 (15.4%) were hypogonadal and total sperm count was significantly higher in N/E group than in hypogonadal patients (10.1 × 106 vs.1.3 × 106, p=0.0033). Post-surgical semen analyses were performed after 6.4 months in average. Sperm count, sperm motility and total sperm count were significantly higher in N/E group than in hypogonadal patients (in average, 33.4 × 106/mL vs. 2.8 × 106/mL, p&lt;0.001; 41.4% vs. 22.3%, p=0.003; 116.8 × 106 vs. 7.7 × 106, p&lt;0.001, respectively). Change rate before and after surgery was significantly better in N/E group than in hypogonadal patients (sperm count, 8.1 times increase vs. 2.5 times increase in average, p=0.0242; total sperm count, 10.7 times increase vs. 2.5 times increase in average, p=0.0159).

Conclusion
Hypogonadism should be evaluated using not only testosterone level but also LH level. EMAS hypogonadal state were related to semen parameters and outcomes of microsurgical varicocelectomy.

Disclosure
Work supported by industry: no.
217 Sexual Activity of Patients Undergoing Testicular Sperm Extraction
Authors: Taniguchi H , Matsuda T , Nakaoka Y , Morimoto Y 
Published: May 2022

ABSTRACT

Introduction
For couples who wish for a baby, sexual activity (though intercourse) is the only way to conceive naturally. However, the sexual activity of men undergoing testicular sperm extraction (TESE) and factors that influence it among affected couples are not clearly understood.

Objective
To examine sexual activity among infertile men undergoing TESE and identify factors that influenced

Methods
Married Japanese male patients undergoing TESE were included. Sexual activity during the previous month was surveyed using a questionnaire, and potential predictive factors influencing sexual activity were examined.

Results
226 married men who answered a questionnaire regarding sexual frequency were reviewed retrospectively. Patients’ mean age was 35.8 ± 7.5 years (range 23–67) and that of their partners was 32.9 ± 4.5 years (range 23–44). Most couples (n = 193) were in their first marriage, and 33 were re-married. The mean marriage duration was 52.6 ± 42.2 months (range 1–192). Micro-dissection TESE and conventional TESE were performed for 152 and 74 patients, respectively. Overall, the mean sexual activity during the last month was 3.6 ± 2.6 times (range 0–15). Marriage duration was negatively correlated with the frequency of sexual activity (r = −0.23; P &lt; .01). There were no correlations between sexual activity and patients’ age, partners’ age, marriage type (first marriage/re-married), testicular volume, or serum total testosterone concentration. Regression analysis showed marriage duration (odds ratio [OR] 1.01, 95% confidence interval [CI] 1.003–1.019, P = .009) and testicular volume (OR 0.94, 95% CI 0.88–0.99, P = .033) were significant predictors of low sexual activity (0–1 times/month). There were no significant differences in sexual activity per month between patients treated with micro-TESE and c-TESE; between those in a first marriage and those re-married; and between patients with Klinefelter syndrome and patients who underwent c-TESE.

Conclusions
The sexual activity of patients undergoing TESE was almost the same as reported previously. Patients’ age, partners’ age, testicular volume, and serum total testosterone concentration had no correlations with the reported frequency of sexual activity.

Disclosure
Work supported by industry: no.
225 Effect of Long-Term Administration of Tadalafil on Arteriosclerosis: A Prospective Cohort Study
Authors: Hayashi K , Sasaki H , Mugita T , Tomiyama T , Koizumi S , Kurokawa I , Matsubara E , Saito K , Fuji K , Ishikawa K , Fukagai T 
Published: May 2022

ABSTRACT

Introduction
Tadalafil is a phosphodiesterase type 5 (PDE-5) inhibitor, and it is used globally as a highly effective and safe drug for the treatment of erectile dysfunction (ED) and lower urinary tract symptom (LUTS). Tadalafil relieve ED or LUTS by relaxing vascular smooth muscle and increasing blood flow to the lower urinary tract tissue. PDE is distributed in pelvic organs, including the corpus spongiosum of the penis and the urethra and prostate, as well as in the lung, heart, and vascular smooth muscle. In other words, PDE is distributed throughout the body. Thus, we hypothesized that the administration of tadalafil might reduce not only systemic arteriosclerosis but also ischemia of the lower urinary tract.

Objective
To prospectively investigate whether the long-term administration of tadalafil, which is commonly used for erectile dysfunction, could reduce arteriosclerosis.

Methods
This study included 85 patients who presented to one of three hospitals with lower urinary tract symptoms. Tadalafil was administered daily (5 mg/d), and pulse wave velocity was measured before administration and at weeks 12, 24, 36, and 48. The International Prostate Symptom Score, Overactive Bladder Symptom Score, and Erection Hardness Score were simultaneously assessed at the same time points. Further sub analyses were performed in patients with a high risk of cardiovascular events, those aged 75 years or older, and those younger than 75 years. The Wilcoxon signed rank test was used for statistical analysis.

Results
Compared with pretreatment values, the pulse wave velocity did not show any statistically significant decrease at any time point. However, the three aforementioned scores significantly improved compared. The group at high risk of cardiovascular events showed significant improvement at weeks 24 and 36, whereas the 75 years or older group showed significant improvement at only week 24.

Conclusions
The long-term administration of tadalafil (5 mg daily) reduced arteriosclerosis or inhibited its progression, and relieved dysuria and improved erectile function. In particular, the drug was revealed to be more effective in patients at a high risk of cardiovascular events and those aged 75 years or older. Hence, tadalafil may have the potential to be used as an anti-aging medicine, although further studies with longer observation periods are needed to confirm its effectiveness and safety.

Disclosure
Work supported by industry: no.
246 Peyronie's Disease - Outcomes of Collagenase Clostridium Histolyticum Injection: A Systematic Review
Authors: Mefford A , Alzweri L , Raheem O , Yafi F 
Published: May 2022

ABSTRACT

Introduction
Peyronie's Disease (PD) is a condition characterized by abnormal and excessive wound repair causing fibrous plaquing of the tunica albuginea. Intralesional (IL) therapies are for patients who prefer to avoid surgical intervention and associated adverse complications. Currently, among available IL injection therapies (Collagenase Clostridium histolyticum (CCh) (Xiaflex, Endo Pharmaceuticals, Dublin, Ireland), verapamil, IFN-a-2b, OnabotulinumtoxinA (Botox) (AbbVie, Chicago, Illinois), Hyaluronic acid). The only FDA approved intralesional treatment option is CCh, which recently expanded its indications for atypical PD.

Objective
This study aims to review recent literature pertaining to CCh and other intralesional therapies in treatment of PD.

Methods
A systematic search of literature using exclusively PubMed was performed. There were no specific inclusion or exclusion criteria, however a preference was placed on recent and high impact articles. The review represents many types of studies including randomized control trials, meta-analyses, as well as phase 2 and 3 clinical trials. The use of CCh was compared to other IL therapies and evaluated for efficacy. This included Lastly, CCh use in atypical Peyronie's Disease was assessed for rate of success and complication.

Results
Recent literature supports the notion that CCh is the most superior IL treatment for typical and atypical PD patients. The capstone CCh study was the IMPRESS trial that showed a 34% reduction in curvature with a mean -17.0 ± 14.8 angle reduction with IL CCh, while men in the placebo saw an average 18.2% decrease in penile bend with a mean -9.3 ± 13.6 degree of change per person (p&lt;0.0001). A shortened protocol for IL CCh treatment offered a 31.4% reduction in curvature while decreasing cost and office visits, potentially increasing patient compliance. Lastly, the literature shows CCh is used most commonly in atypical cases with about 64.8% of patients being treated with CCh – this is probably because of the high efficacy and superb safety profile that it offers. The most serious complications associated with CCh including urethral injury, corporal rupture and penile fracture are rare in all types of PD.

Conclusion
Since the approval of CCh by the FDA in 2013, it has been a staple in the treatment of PD, and here we report the continued success and superiority of this therapy. CCh is an effective, minimally invasive therapeutic option in most PD populations, however recent changes have made CCh unavailable for commercial use out of the United States, thus impacting many patients who have previous benefited from it.

Disclosure
Work supported by industry: no.
251 Adults Apply Different Criteria for Virginity Loss Depending on the Context of the Judged Behavior
Authors: Komlenac N , Herzig R , Pittl M , Perkhofer S , Tucek G , Hochleitner M 
Published: May 2022

ABSTRACT

Introduction
Health care practitioners may rely on abstract concepts such as “virginity loss” when assessing emerging adults’ sexual history. Additionally, virginity loss can be an important life event or “a turning point” in a person's sexual life. Sometimes, virginity loss has social implications and can be associated with potential social status changes. Therefore, it is important to understand emerging adults’ definitions of “virginity loss”.

Objective
The current study analyzed whether emerging adults apply different criteria for virginity loss depending on the context of the judged behavior.

Methods
The online study included 987 persons (75% women/25% men; M age = 23.7, SD = 3.8) from German-speaking countries. Each participant was assigned one of 16 vignette conditions. Each vignette described a situation in which two persons engage in intimate partnered behavior. The main character's gender, sexual orientation, the partner's gender and the commitment of the two persons to each other were manipulated. Participants had to indicate whether 13 intimate partnered behaviors qualified as virginity loss in the given context. Multinomial logistic regression models were calculated for the analysis.

Results
Almost all participants agreed that penile-vaginal intercourse constituted loss of virginity. However, other intimate partnered behaviors were more likely judged to constitute loss of virginity only when the two partners had the same gender. For instance, penile-anal intercourse was often perceived as virginity loss only when two men engaged in this intimate partnered behavior.

Conclusion
Emerging adults do not agree on whether intimate partnered behaviors other than penile-vaginal and penile-anal intercourse between two men constitute virginity loss. Even though participants seem to apply different standards for virginity loss definitions depending on the gender of the involved partners, they mostly judge close physical partnered behaviors as virginity loss when the behavior is or resembles penile-vaginal intercourse. Thus, participants seem to base their virginity loss definitions on heteronormative beliefs. The devaluation and non-acceptance of close physical partnered behaviors that do not resemble penile-vaginal intercourse as constituting virginity loss may lead some emerging adults to feel pressured to engage in non-preferred close physical partnered behaviors in order to not be denied social implications or social status changes that may result from virginity loss. For health care practitioners it is recommended to use descriptions of concrete behavior and not rely on abstract concepts such as “virginity” when taking a patient's sexual history.

Disclosure
Work supported by industry: no.
260 A New Paradigm in the Treatment of Compulsive Sexual Behaviours
Authors: Neves S 
Published: May 2022

ABSTRACT

Introduction
Compulsive sexual behaviours have been misunderstood for years using the controversial conceptualisation of ‘sex addiction’, a disorder that had not been clinically endorsed. In 2018, the ICD-11 has agreed on a clinical definition of compulsive sexual behaviour disorder (CSBD) with diagnostic criteria.

Objective
Thanks to the ICD-11 diagnostic criteria for CSBD, it is now possible to formulate a treatment protocol that is in line with the clinical understanding of sexual compulsivity, and not based on addiction-thinking. This presentation will summarise the definition of compulsive sexual behaviours disorder (CSBD) and highlight the difference between the disorder and the various patient clinical presentations of sexual compulsivity that may not reach the disorder criteria. Based on the various clinical materials of case studies from different populations, this presentation will propose a treatment protocol based on the three-phase model according to the speaker's clinical experience, explaining the relevance of each phase, including expected outcomes.

Methods
The three-phase treatment protocol takes into account the more recent and evidence-based understanding of sexual compulsivity to address different aspects of the problems: addressing impulse control, treating compulsivity and re-integrating the meaning of sexual behaviours and eroticism. It is a treatment protocol that is flexible and compatible with established psychotherapeutic modalities and interventions.

Results
Based on the speaker's own clinical work and various case studies, a sex-positive, evidence-based treatment provides much better and permanent behavioural change than an addiction-focused treatment (or a 12-step programme mindset).

Conclusion
The conceptualisation of ‘sex addiction’ and its addiction-focused treatments are no longer appropriate with the new understanding of compulsive sexual behaviours. The ICD-11 diagnostic criteria have precipitated a paradigm shift bringing the field of sexual compulsivity into the 21st century. The contemporary clinical understanding of sexual compulsivity opens the discussion for better, less dogmatic treatments. The success of the three-phase protocol rests upon the treatment being congruent with compulsivity and well-established therapeutic modalities, rather than addiction, offering patients more choices with a pluralistic approach.

Disclosure
Work supported by industry: no.
272 The Prevalence and Combination of Gonorrhea and Chlamydia in Patients with Urethritis and Treatment Outcome
Authors: Nguyen Q , Bui Van Q , Nguyen Duy K , Nguyen Huu T , Cao Dac T , Nguyen Thi V 
Published: May 2022

ABSTRACT

Introduction
Urethritis is a common urinary tract infection, in which urethritis due to sexually transmitted infection accounts for a large proportion, especially among sexually active men. The most common causes include gonorrhea and chlamydia.

Aim
To evaluate the prevalence and combination of gonorrhea and chlamydia in patients with urethritis and treatment outcome.

Material and Methods
A retrospective study was caried out on all patients with urethritis due to gonorrhea and/or chlamydia at the Center for Andrology and Sexual Medicine (Vietnam-Germany University Hanoi, Vietnam) from January 2021 to March 2021. The patient's urethritis was confirmed by culture and Polymerase Chain Reaction (PCR) testing of fluid from the patient's penis. Patient data were collected and analyzed.

Main Outcome Measure
The number of urethritis patients were caused by gonorrhea and/or chlamydia were collected during 3 months is 54, the combination of two bacteria was 15% and overall treatment results were good.

Results
The mean age of patients was 29.56 ± 6.7 (18-54) years old. There were 17/54 (31%) patients with simple gonococcal infection, 29/54 (54%) patients were diagnosed with urethritis solely due to chlamydia, 8/54 (15%) patients had urethritis due to both gonorrhea and chlamydia. Of the 25 patients with gonococcal urethritis (mono and chlamydia co-infection): 18/25 patients (72%) were culture positive, while 7 patients (28%) were positive with gonorrhea by PCR. Antibiogram results of 18 patients diagnosed with gonorrhea showed that 18/18 patients were sensitive to spectinomycin, followed by cefoxitin (15/18 patients - accounting for 83.3%), cefotaxime (12/18 patients - accounting for 66.7%) and ceftriaxone (11 out of 18 patients -61.1%). All patients diagnosed with gonococcal urethritis alone or co-infection with chlamydia recovered after the treatment. One of 29 patients with chlamydial urethritis remained symptomatic after completion of the treatment and was tested positive for chlamydia by PCR; while 28 of 29 patients showed good results.

Conclusion
The physician should note the presence of gonorrhea and/or chlamydia and their combination in the diagnosis of urethritis. People who are diagnosed with this disease need to be treated early with the right antibiotics for a good outcome.

Disclosure
Work supported by industry: no.
273 Comparative Study of RARP and Heavy Ion Radiotherapy Sexual Functional Changes for Prostate Cancer Using the Propensity Score Matching Method
Authors: Miyazawa Y 
Published: May 2022

ABSTRACT

Introduction
We mainly perform Robotic-Assisted laparoscopic Radical Prostatectomy (RARP) and Heavy Ion Radiotherapy (HIRT) as curative treatment for prostate cancer. Several factors such as cancer control and quality of life after treatment are considered to be important, but there are few reports comparing sexual function changes before and after treatment between RARP and HIRT.

Objective
We performed retrospective study comparing the evaluation of sexual function after RARP and HIRT cases using the propensity score matching method.

Methods
127 patients treated by RARP from 2014 to 2018 and 190 patients treated by HIRT monotherapy from 2010 to 2019 were evaluated. We evaluated Expanded Prostate Cancer Index Composite (EPIC) score before and after treatment. The EPIC was compared before, 12 months, and 24 months after treatment. Propensity score matching was performed using the age at treatment, PSA value, T stage, and pretreatment EPIC comprehensive score of sexual function as covariates. A cohort of 101 patients in each group was prepared and examined.

Results
The mean ± standard deviation of each of the RARP and HIRT groups were age; 65.1 ± 5.9, 65.3 ± 6.5 years, PSA value; 6.31 ± 2.07, 6.34 ± 2.46 ng / ml, pretreatment EPIC sexual function overall score; 46.4 ± 15.6, 48.2 ± 16.2. In both groups, T1N0M0 was 16%, T2N0M0 was 83%, and T3N0M0 was 1%. The total EPIC sexual function scores before, 12 months, and 24 months after treatment were 46.4, 27.9, 28.2 in the RARP group, and 48.2, 41.4 in the HIRT group, respectively. In both groups, there was a significant decrease in score after 12 months and 24 months compared to before treatment (p &lt;0.05). At 12 and 24 months, the total EPIC sexual function score in the HIRT group was significantly higher than RARP group (p &lt;0.001).

Conclusion
In prostate cancer cases adjusted by propensity score matching, the decrease in EPIC sexual function score was significantly smaller in the HIRT group than RARP group. The results of this study seemed to be useful information for decision making with patients.

Disclosure
Work supported by industry: no.
277 Evaluation of the Sexual Desire Disorders in the Post-Partum Period
Authors: Halouani S , Bettaeib H , Mbarki W , Abidi I , Boufarguine R , Frikha M , Souayeh N , Mbarki C , Oueslati H , Gabsi H 
Published: May 2022

ABSTRACT

Introduction
A woman's sexuality changes throughout her life and varies according to endogenous and exogenous factors. In this perspective, pregnancy and childbirth create a state of sexual desire dysfunction. Eastern culture has always dissociated parents from their intimate life, making the resumption of postpartum sexuality more taboo.

Objectives
To study women's sexual desire disorders after childbirth in order to identify factors that influence it.

Methods
Prospective, cross-sectional study over 200 women followed from the third trimester of the pregnancy until the 6th month postpartum. The evaluation of sexual desire was based on the parameters of the FSFI score (Female Sexual Function Index) in Arabic version.

Results
The average age of the women in our study was 31 years with extremes ranging from 15 to 45 years. The mean parity was 2.4 with extremes ranging from 1 to 4. 94% of our patients were married. 56% of the study population delivered vaginally, of whom 6% required instrumental extraction.20% had a scheduled cesarean section, and 24% had an emergency cesarean section during labor. Over the half the population (56%) did not use any contraception after delivery. 32% opted for the combined pill, while 10% used condoms and 2% had a tubal ligation during cesarean delivery.46% of women breastfed their childs. A decrease in sexual desire has been reported in the postpartum period. At the FSFI, the mean score of the sexual desire before childbirth was 3,33. A minimum sexual desire score of 1,2 was noted in 12% of the women, and 4% of the women had a maximum sexual desire score of 6.After childbirth, the mean score was 3.25. with a minimum of 1,2 noted in 8% of women, and a maximum of 6 found in 4% of women. Regarding the frequency of sexual desire,46% of women reported having sexual desire less than half the time (38%) or almost never (8%). During pregnancy, this rate was 38%.The qualitative evaluation of sexual desire found that 46% of women reported a feeling of decreased sexual desire, whereas this disorder affected 40% of the population before delivery. On the other hand, 26% of women reported a high sexual desire. The occurrence of sexual desire and its intensity were correlated with the following parameters: marital status, breastfeeding, route of delivery and the presence of perineal lesions.

Conclusion
The postpartum period is accompanied by physical and psychological changes that affect female sexual function. A medical approach to the evaluation of sexual desire disorders must be lead in order to identify their cause's and treat them.

Disclosure
Work supported by industry: no.