bluuebunny/crossref_metadata_2025_split huggingface dataset:
202 Impact of Urinary Incontinence on Sexual Function in Patients Presenting for Lower Urinary Tract Symptoms
Authors: Fallara G. , Boeri L. , Candela L. , Costa A. , Capogrosso P. , Cazzaniga W. , Schifano N. , Pozzi E. , Belladelli F. , Cignoli D. , Colandrea G. , Cornelius J. , Mattei A. , Montorsi F. , Salonia A. 
Published: May 2022

ABSTRACT

Introduction
Patients with low urinary tract symptoms (LUTS) frequently complain some sexual dysfunction and sometimes even episodes of bothersome urinary incontinence (UI).

Objective
We aimed to assess the relationship between UI (as measured with the ICIQ-UI-SF), and sexual disfunction (as measured with the IIEF), in men presenting with LUTS at a tertiary-referral centre.

Methods
In this cross-sectional study, data were retrospectively retrieved from 938 consecutive patients aged &gt;18 years seeking first medical help for self-reported LUTS (i.e., all patients had IPSS≥1). All patients had a complete clinical assessment and completed the IPSS, the ICIQ-UI-SF, the OAB-q and the IIEF questionnaires. Patients were stratified into “no UI” (ICIQ-UI-SF=0), “mild UI” (ICIQ-UI-SF=1-7), “moderate UI” (ICIQ-UI-SF=8-13) or “severe UI” (ICIQ-UI-SF=14-21). ANOVA test assessed differences in baseline characteristics among these groups. Spearman correlation test was applied to evaluate the correlation between ICIQ-UI-SF and IIEF domain scores. A linear regression analyses tested putative risk factors associated with increased ICIQ-UI-SF scores.

Result
Of 938, 589 (63%) patients had no UI, 237 (25%) had mild UI, 76 (8%) moderate UI and 36 (4%) severe UI. There were no substantial differences in total PSA levels and uroflowmetry parameters among UI groups, whereas prostate volume, IPSS and OAB-q scores were higher as UI symptoms increased (all p≤ 0.03). A negative correlation was found between IIEF-total, IIEF-Erectile Function, IIEF-Intercourse Satisfaction and IIEF-Overall Satisfaction scores and ICIQ-UI-SF scores (i.e., the worse UI symptoms, the worse the overall sexual function (rho= -0.12; p&lt;0.001), IIEF-EF (rho= -0.15; p&lt;0.001), IIEF-IS (rho = -0.1; p=0.004) and IIEF-OS (rho = -0.12; p&lt;0.001). Sexual desire and orgasmic function domains were not correlated with ICIQ-UI-SF. Finally, higher BMI (Coeff 0.12; 95% CI 0.03-0.32; p=0.011), diabetes (Coeff 1.76; 0.35-3.18; p=0.015) and presence of comorbidities (Coeff: 0.9; 0.06-0.1.74; p=0.035) were associated with higher ICIQ-UI-SF scores. Main limitations of the study were that ICIQ-UI-SF does not discriminate between urge or stress UI.

Conclusion
In patients presenting with LUTS, the presence of urinary incontinence was associated with worsening of overall sexual function (i.e., erectile function, intercourse satisfaction and overall satisfaction).

Disclosure
Work supported by industry: no.
208 Age, Testosterone Levels, and Hypogonadism-Related Symptoms Among Men with Azoospermia
Authors: Iwatsuki S. , Umemoto Y. , Takeda T. , Nozaki S. , Yasui T. 
Published: May 2022

ABSTRACT

Introduction
Considering that most men who complain of infertility are of an age traditionally defined by social and physical activity, disability in performing these activities may worsen their quality of life. Among those who complain of infertility, it is suspected that some of them have hypogonadism or symptoms intrinsic to aging; however, these associations have not been completely elucidated in current literature.

Objective
This study aimed to assess the prevalence of aging- or hypogonadism-related symptoms among men with azoospermia. We also assessed relationships between serum testosterone levels and severity of symptoms under the domains of the Aging Males' Symptoms (AMS) -scoring system.

Methods
Clinical records of 494 patients with azoospermia (106 from obstructive and 388 from nonobstructive etiologies) who underwent surgical sperm extraction at Nagoya City University were retrospectively reviewed. Correlations between age and serum total testosterone (TT) and AMS scores (total and by each of three domains) were evaluated using the Spearman's rank correlation coefficient.

Results
Moderate or severe (total AMS score of≥ 37) symptoms were present in 9.5% and 12.7% of patients with obstructive and nonobstructive azoospermia, respectively. Symptoms were present regardless of etiology of azoospermia. Among our study population, no significant correlation between age and TT was observed (R=-0.057, p=0.21). However, there was positive correlation between age and total (R=0.090, p&lt;0.05) or sexual (R=0.218, p&lt;0.01) scores among the AMS scale's domains. Moreover, there were negative correlations between serum TT level and total (R=-0.177, p&lt;0.01), psychological (R=-0.149, p&lt;0.01), somatic (R=-0.183, p&lt;0.01), and sexual (R=-0.097, p&lt;0.05) domain scores. Multiple comparisons using Bonferroni-Holm's correction showed statistically significant correlations between aging and sexual symptoms and between hypogonadism (decreased serum TT) and psychological or somatic domains in the AMS-scoring scale.

Conclusions
This study revealed that men with azoospermia have not only underlying deterioration in sexual symptoms with aging, but that psychological and somatic symptoms also deteriorate as a function of hypogonadism. Our results indicate that assessment, treatment, and supportive management of underlying hypogonadism-related symptoms should be considered for patients with azoospermia who are currently undergoing infertility treatment.

Disclosure
Work supported by industry: no.
218 Using Mini-Jupette Slings to Treat Post Radical Prostatectomy Urinary Incontinence: Foreplay Incontinence, Climacturia, and Stress Incontinence
Authors: Brady J , Choi E , Foley B , Wilson S , Yafi F 
Published: May 2022

ABSTRACT

Introduction and Objective
The Mini-Jupette has been successfully used concomitantly with inflatable penile prostheses (IPP) to treat erectile dysfunction (ED), climacturia and stress urinary incontinence (SUI) secondary to radical prostatectomy (RP). This is the largest single surgeon report of the original Andrianne Mini-Jupette sling and IPP placements in men with ED and climacturia, mild SUI and/or foreplay incontinence.

Methods
This was a retrospective study on a prospectively managed database of 32 patients who underwent IPP and Mini-Jupette placement using Tutoplast® cadaver pericardium graft by a single surgeon between July 2016 and February 2020. Patients were surveyed pre- and post-operatively and asked to score the severity of their foreplay incontinence (FI), climacturia, and SUI from 0 (“dry”), 1 (“1 drop”), 2 (“few drops”), 3 (“small dribble”), or 4 (“squirt of urine”). Patient surveys were compared pre- to post-operation using Fisher's exact test.

Results
Of the 32 men, 27 (84%) had FI, 26 (81%) with climacturia, and 27 (27%) with SUI (Table 1). At a mean follow-up of 17.9 months, FI (p&lt;0.001), climacturia (p&lt;0.001), and SUI (p&lt;0.001) all significantly improved (Table 2). FI improved in 78.9% (15/19) and resolved in 47.4% (9/19); climacturia improved in 82.3% (14/17) and resolved in 64.7% (11/17); SUI improved in 71.4% (15/21) and resolved in 57.1% (12/21). Sexual Health Inventory for Men (SHIM) scores significantly improved from 5.0 to 23.8 (p&lt;0.001) for the entire group. Three patients (9.4%) required an artificial urethral sphincter (AUS) for the management of persistent incontinence. One patient underwent IPP revision due to foreskin irritation and another experienced pump-related issues.

Conclusions
The Mini-Jupette in tandem with an IPP is a safe and effective treatment option for men with severe ED experiencing sexually related incontinence as well as SUI post-RP. This is the first report of IPP placement with a Mini-Jupette sling successfully treating foreplay incontinence.

Disclosure
Work supported by industry: no. A consultant, employee (part time or full time) or shareholder is among the authors (Antares Pharma, Clarus Therapeutics, Coloplast, Promescent, Viome).
224 Prevalence of Genitourinary Syndrome of Menopause in Japanese Peri- and Post-Menopausal Women: A Cross-Sectional Online Survey
Authors: Ozaki Y , Tomoe H , Kuwajima M , Ninomiya N , Sekiguchi Y , Sato Y , Nagao K , Takahashi S 
Published: May 2022

ABSTRACT

Introduction
Genitourinary syndrome of menopause (GSM) is a symptom complex that occurs secondary to vulvovaginal atrophy. It is generally accepted that GSM is more prevalent in postmenopausal women, and that it can affect their quality of life (QOL). However, there is little data regarding GSM in Japan.

Objective
The aim of this survey was (i) to determine the prevalence of vulvovaginal symptoms of GSM among Japanese peri- and post-menopausal women and (ii) to examine whether sexual activity affected the prevalence of GSM.

Methods
We conducted an online survey of 4,134 Japanese women aged 40 – 79 years in the general population. In this primary study, we focused on vulvovaginal symptoms of GSM. GSM was defined as a condition characterized by presenting at least one vaginal symptom such as vulva dryness, vulva hurting, dryness during sexual activity, and dyspareunia using the vulvovaginal symptoms questionnaire. The correlations between age, sexual activity, and GSM were analyzed.

Results
The prevalence of GSM was 11.6%. The respondents who reported GSM were more likely to be younger. The most common symptom was vulva dryness (6.0%). Only 22.0% of respondents were currently sexually active. Sexual activity was significantly correlated with GSM (P&lt;0.01). The participants aged their 40s – 60s who had sexual activity showed an age-dependent increase in the prevalence of GSM such as vulva dryness and hurting. The respondents aged their 70s who were sexually active reported less dyspareunia than the other ages.

Conclusions
The vulvovaginal symptoms of GSM were not found with high frequency in Japanese peri- and post-menopausal women. This primary study was conducted in limited areas of GSM. We are planning to analyze the features of GSM including urinary symptoms and QOL more comprehensively with our whole database.

Disclosure
Work supported by industry: yes, by KOBAYASHI Pharmaceutical Company Limited. A consultant, employee (part time or full time) or shareholder is among the authors (KOBAYASHI Pharmaceutical Company Limited).
233 Association Between Physical Activity and Sexual Dysfunctions in Medical Students from Southern Brazil
Authors: Tronco G , Castralli H , Salatino L , Motta G , Zancan M 
Published: May 2022

ABSTRACT

Introduction
Physical activity is likely to be associated with sexual activity, being a modifiable risk factor to female sexual dysfunction. This condition is a highly prevalent medical issue, affecting 41% of reproductive-age women worldwide. In a study by Cabral et al., the presence of a sexual dysfunction, measured by the Female Sexual Function Index (FSFI), was found in 67% of the sample and associated with a sedentary lifestyle. In another study, menopausal women have a better body image when they exercise regularly, improving their self-esteem, emotion expression, and maintaining an adequate BMI. Despite the importance of sexuality disorders and physical activity to the quality of life and health of women, studies that evaluate the relationship between these aspects in young women are scarce.

Objective
This research aims to analyze the association between physical activity and sexual dysfunctions in a female population of medical students.

Method
Cross-sectional study developed with young female adults that answered an online survey with 34 questions covering sociodemographic, behavioral and sexuality aspects. The validated Portuguese version of the Female Sexual Function Index questionnaire (FSFI-6) was applied, which is composed of six questions scored from 0 to 5, addressing the main sexual domains: desire, arousal, lubrication, orgasm, satisfaction and pain. A total FSFI-6 score ≤ 19 was considered a positive screening for female sexual dysfunction. The practice of physical activity was divided into: not practice, practice 1 or 2 times, 3 or 5 times and 6 or more times. We used the Kruskall-Wallis statistical test for quantitative analysis.

Results
Of the 169 participants, 29% (n = 49) reported not practicing physical activity during the week, while 24.9% (n=42) practiced it 1 or 2 times, 36.7% (n=62) 3 or 5 times and 9.5% (n=16) 6 or more times. The FSFI-6 analysis revealed an association between 6 or more times of physical activity and better scores in desire (p=0,10), excitation (p=0,12), orgasm (p=0,015), satisfaction (p=0,01) and total scores (p=0,001). Also, there is an association between 3 and 5 times of physical activity and better scores in desire (p=0,011), satisfaction (p=0,019) as well as in the total FSFI-6 distribution (p=0,001). They were all compared with no physical activity.

Conclusion
We found an association between a sedentary lifestyle and worst scores in desire, excitation, orgasm, satisfaction and the total of FSFI-6 distribution. Therefore, there is a lower risk of presenting sexual dysfunctions when the woman is physically active.

Disclosure
Work supported by industry: no.
247 Comparison of Non-Invasive Measurements of Penile Curvature in Peyronie's Disease
Authors: Pedrenho Neto R , C G Nascimento B. , Machado Barbosa Neto C , de Bessa Junior J , Srougi M , Carlos Nahas W 
Published: May 2022

ABSTRACT

Introduction
Peyronie's disease (PD) is a fibrotic disorder of the tunica albuginea, leading to penile deformities. Non-invasive estimates of penile deformities are practical, but have low accuracy when compared to objective measurements with induced erection and a goniometer. Our aim was to evaluate the agreement between different non-invasive methods of measuring penile curvature and the objective measurement.

Methods
We retrospectively reviewed medical records of patients who underwent surgery in a sexual medicine tertiary center. During the clinical visit, pre-operatively, a set of different non-invasive estimates were performed including asking the patient to explain their primary curvature with a goniometer, a drawing of the penis and a malleable implant prosthesis to be molded. Also, at home photography were required with maximal erection. The agreement of those methods and intra-operative measurement using a goniometer after saline induced erection was analyzed. A tolerable error was considered if a difference smaller than 10o or 20% of the gold standard measurement was found.

Results
The sample consisted of 69 men with a mean age of 62 ± 6 y. The direction of the curvature was dorsal in 59%, left in 35%, right in 5% and ventral in 1%. Mean curvature with of estimates with the goniometer was 57o (±31), drawing 60 o (±28), Prosthesis 60o (±25), Photography 57 o (±27), and mean intra-operative measurement was 51 o (± 24). Overall precision considering the above mentioned tolerable error definition was 45%, and the single non-invasive method with better precision was Prosthesis with 46,5% fo concordance. There was no statistical difference between them (p=0.99) for concordance and disagreement by the Dunnett's multiple comparisons test.

Conclusion
In our comparison study of 4 non-invasive curvature assessment methods, we found a low precision (approximately 45%), regardless of the chosen method. Formal curvature assessment with induced erection and a goniometer appears to be imperative.

Disclosure
Work supported by industry: no.
249 Influence of Pretreatment Sperm Cryopreservation on Psychological State of Sexual Function in Male Patients with Cancer
Authors: Takeshima T 
Published: May 2022

ABSTRACT

Introduction
With the development of cancer treatment in recent years, the prognosis of AYA (Adolescent and young adult: 15-39 years old) generation cancer survivors has significantly improved. In particular, among cancer survivors, there are no reports on how the psychological state of male sexual function is affected by whether or not fertility preservation was performed before cancer treatment.

Methods
Male patients diagnosed with malignant diseases and treated with anticancer drugs at the participating institution were asked to complete a 15-item questionnaire based on the Prostate Cancer Symptom Index and the Sexual Function Domain of the Distress Scale to assess male self-efficacy among patients who underwent pretreatment sperm cryopreservation and those who did not. The results were subjected to principal component analysis (PCA) to reduce the dimensionality, and the factors explaining the difference between the two groups were examined, and logistic regression analysis was used to examine the differences between groups.

Results
The analysis was conducted on 118 subjects in the freezable group (Group A) and 53 subjects in the non-freezable group (Group B). A complete-case analysis was conducted excluding those with missing responses. The mean age was 31.2 years in group A and 39.0 years in group B. The disease breakdown was 46.5% testicular tumor, 41.0% hematologic malignancy, and 4.7% malignant bone and soft tissue tumor in group A, and 58.5% testicular tumor, 32.0% hematological malignancies, and 1.9% malignant bone and soft tissue tumor in group B. In the principal component analysis, the first principal component was characterized as “self-evaluation of male function”, and the second principal component was characterized as “anxiety about the primary disease”. The cumulative contribution rate was 56.3% for the second principal component. Group A had tendency to have higher self-evaluation of male function and higher anxiety about the primary disease compared to Group B. Logistic regression analysis was performed with the first principal component as the explanatory variable, but no significant difference was found between the groups.

Conclusion
Patients who were able to cryopreserve their sperm tended to be more anxious about the primary disease because they had a better understanding of the disease. In addition, patients who were not able to cryopreserve sperm had tendency to have low self-evaluation of male function, suggesting that psychological support such as counseling is necessary.

Disclosure
Work supported by industry: yes, by Ministry of Health, Labour and Welfare.
250 Psychosexual Issue Affecting Men with Klinefelter Syndrome Seeking Fertility Management
Authors: Al-Hussini M , Allchorne P , Yap T , Frodsham LC 
Published: May 2022

ABSTRACT

Introduction and Objective
Klinefelter Syndrome (KS) is the commonest hypo-androgenic chromosomal anomaly affecting fertility (1:600 men). KS frequently goes undiagnosed until middle age during fertility investigations. However, beyond fertility issues there is little known of the psychological effect of KS on these newly diagnosed men. This study aims to examine the psychosexual impact of newly diagnosed KS in couples presenting to a multidisciplinary KS clinic.

Methods
Prospectively compiled data from 18 recently diagnosed KS patients with subfertility attending a multidisciplinary KS clinic were analyzed. A baseline patient-centered psychosexual function questionnaire (NSOG) was used to identify issues with body image, sexual function and wellbeing whilst erectile dysfunction (ED) issues were specifically sought using the validated IIEF-5 questionnaire. Ethics approval was obtained.

Results
89% (17/18) of KS men rated their sex life as highly important but less than 44% rated the quality of intercourse and a similar proportion were anxious about having sexual intercourse. This was in keeping with a mean IIEF-5 score of 16 (range 24- 12) in this group indicating mild to moderate ED. 56% felt that their body could adequately work sexually but 17% felt their mood negatively affected influencing sexual performance, with only 38% satisfied in their sex life. 50% of men also reported perceived delayed ejaculation. Whilst the majority reported noticed libido issues, 5% of men reported hyperactive sexual desire which impacted on social functioning.

Conclusions
Psychosexual difficulties are common in KS patients undergoing fertility treatments and yet this aspect of their management is often neglected. Psychosexual treatment should be discussed with all KS patients as all patients reported wanting to receive help and advice on improving their sexual lives. A study is now in place to determine the longer-team outcomes of targeted psyhosexual therapy in this cohort of KS men on general wellbeing and memntal health.

Disclosure
Work supported by industry: no.
257 Breast Cancer and Sexual Dysfunction: Does Surgery Matter?
Authors: Tovim Rodrigues C , Nobre P , Quinta Gomes A 
Published: May 2022

ABSTRACT

Introduction
It is well known that breast cancer and its associated treatments have negative effects on women's physical, emotional, and overall sexual health. Studies have shown that the incidence of sexual dysfunction is significantly higher after the diagnosis and associated treatments of breast cancer. For surgical procedures, there is evidence of an increase in sexual problems 6 months after surgery. .

Objective
The aim of this review is to examine the available research on the impact of breast cancer surgery on women's sexuality.

Methods
A comprehensive search of Medline, Scopus, and Web of Science databases was conducted to find Englishlanguage articles published since January 2000. We used a list of keywords combining "breast cancer" AND "surgery" AND "sexual function" AND "sexual dysfunction".

Results
We found 1947 results, and after selecting quantitative and original articles on the effects of breast cancer surgery on female sexuality, there were 14 eligible articles. Three articles from other sources were included.
Studies comparing the sexuality of the general population with that of women who had undergone breast cancer surgery found a higher risk of sexual dysfunction in these women. When comparing different types of surgery, namely mastectomy with or without reconstruction and breast-conserving surgery, different results were obtained. Four studies found no differences in sexual function between the different types of surgery. Mastectomy without reconstruction was associated with a negative impact on sexual function in four other studies, with all sexual domains affected in some of these studies. In contrast, two studies found lower scores in women who had undergone breast-conserving surgery. Axillary lymph node removal has also been associated with genital arousal disorder. Two studies found no association between sexuality and breast cancer surgery.

Conclusions
Breast cancer and related treatments, including surgery, have a negative impact on women's sexuality. Different types of surgery appear to have different effects, with mastectomy without reconstruction associated with worse outcomes, while breast-conserving surgery was associated with lower sexual function scores in only two studies. All of these studies relied on different methods and populations with different expectations, which may explain some of the disparity in outcomes. By pointing out the surgical consequences of mastectomy preoperatively, surgeons can make patients' expectations of esthetic and functional outcomes after breast cancer surgery more realistic and help patients make better treatment decisions.

Disclosure
Work supported by industry: no.