bluuebunny/crossref_metadata_2025_split huggingface dataset:
276 Prevalence of and Risk Factors Associated with Vaginal Lubrication Issues in Women at 6 Months Postpartum
Authors: Mbarki W , Bettaieb H , Frikha M , Abidi I , Halouani S , Boufarguine R , Oueslati H , Mbarki C 
Published: May 2022

ABSTRACT

Introduction
A woman's sexuality changes during her life and varies according to endogenous and exogenous factors. In this perspective, pregnancy and childbirth create a state of sexual dysfunction. The physiological changes that occur in the postpartum period are unique to each woman, and depend on several factors, including the mode of delivery, and the postpartum period. Postpartum vaginal dryness is a common sexual disorder, caused by modifications in vaginal lubrication mechanisms.

Objective
Studying women's sexuality after childbirth by evaluating vaginal lubrication disorders in postpartum period.

Methods
This is a prospective, cross-sectional study between November 2018 and September 2019 at obstetric and gynecologic department of Ben Arous hospital of Tunisia. 150 Women were included and were followed from the third trimester of pregnancy through 6 months after childbirth. we opted for the Female Sexual Function Index (FSFI) to evaluate sexual disorder in postpartum period.

Results
On the FSFI, the average vaginal lubrication score was 4.58 during pregnancy and 3.79 after delivery. At the time of the study, 6% of women were not sexually active during pregnancy and 2% after delivery. 53% of women who were sexually active during pregnancy reported feeling the sensation of vaginal lubrication during intercourse with varying frequency. 36% of women did not claim difficulty to acquire a satisfying level of vaginal lubrication After delivery, 39 women (26%), noted a sensation of lubrication less frequently. 84 % of women reported varying degrees of difficulty in achieving vaginal moisture during sexual intercourse after delivery (very difficult: 12%, difficult: 28%, somewhat difficult: 44%). The ability to maintain vaginal moisture during sex seems decreased after childbirth. In fact, the ability to maintain an adequate vaginal lubrification during sexual intercourse was reported on postpartum in 21 women (14%) compared to 48% during pregnancy. The factors influencing the different parameters of vaginal moisture found in our series were breastfeeding, mode of delivery and contraception.

Conclusion
In postpartum period achieving vaginal moisture and maintain of an adequate vaginal lubrification during intercourse seems to be altered. Mode of birth, breastfeeding and contraception was associated with lack of vaginal lubrication. Preparing women and their partners for this during the antenatal period and advising on simple measures, such as use of lubrication could be helpful.

Disclosure
Work supported by industry: no.
018 Physical Activity and Female Sexual Dysfunction: A Lot Helps, but Not Too Much
Authors: Maseroli E. , Rastrelli G. , Stasi V. Di , Cipriani S. , Scavello I. , Tommaso T. , Gironi V. , Castellini G. , Ricca V. , Sorbi F. , Fambrini M. , Petraglia F. , Maggi M. , Vignozzi L. 
Published: May 2022

ABSTRACT

Introduction
Research on the relationship between physical activity (PA) and female sexual dysfunction (FSD) is lacking.

Objective
To investigate the clinical, psychological, and sexual correlates of PA in women with FSD.

Methods
A non-selected series of n=322 pre- and post-menopausal patients consulting for FSD was retrospectively studied. Regular involvement in PA and its frequency (&lt;1 hour/week: sedentary, 1-3 hours/week: active, 4-6 hours/week: very active, &gt;6 hours/week: extremely active) were investigated with a specific question. FSDs, including HSDD (Hypoactive sexual desire disorder) and FGAD (Female genital arousal disorder), were diagnosed according to a structured and clinical interview. Participants underwent a physical examination and a clitoral Doppler ultrasound, and were asked to complete the Female Sexual Function Index (FSFI), Female Sexual Distress Scale-Revised (FSDS-R), Body Uneasiness Test (BUT), and Middlesex Hospital Questionnaire (MHQ).

Results
Mean age was 45.1±12.9, mean body mass index was 25.24±6.34 kg/m2 and 46.3% (n=149) of women were post-menopausal. At multivariate analysis, women engaging in PA (67.4%, n = 217) scored significantly higher in several FSFI domains - including desire, arousal and lubrication (see Table 1) - and showed lower sexual distress and lower resistance of clitoral arteries, as compared to sedentary women. A significant, inverse association between PA and HSDD was observed (see Table 1). In the same adjusted model, the association between PA and the vascular resistance of clitoral arteries, expressed by clitoral PI, retained statistical significance. Mediation analysis demonstrated that the negative association between PA and HSDD was partly mediated by body image concerns (BUT Global severity index), psychopathological symptoms (MHQ total score) and sexual distress (FSDS-R score). These latter two factors also partly mediated the association between PA and a reduced risk of FGAD, whilst a lower BMI was a full mediator in the relationship between PA and FGAD. Finally, extreme PA was associated with significantly worse scores in several psychosexual parameters (i,e, sexual satisfaction – see Figure 1) and histrionic/hysterical symptoms), even compared to a sedentary lifestyle.

Conclusions
In women with FSD, PA was associated with better sexual function and clitoral vascularization, lower sexual distress and reduced odds of HSDD and FGAD; the benefits of PA on sexuality were mediated by both psychological and organic determinants; excessive PA was related with a poor overall sexual function and with a low sexual satisfaction. Women consulting for FSD may gain benefits from regular PA; however, physicians should remain alert to the downsides of excessive exercise.

Disclosure
Work supported by industry: no.
025 Pathway Enrichment Analysis of Microarray Data from Human Penis of Diabetic and Peyronie's Patients, in Comparison with Diabetic Rat Erectile Dysfunction Models
Authors: Searl T. , Ohlander S. , McVary K. , Podlasek C. 
Published: May 2022

ABSTRACT

Introduction
Erectile dysfunction (ED) is a debilitating medical condition in which current treatments are minimally effective in diabetic patients due to neuropathy of the cavernous nerve, a peripheral nerve that innervates the penis. Loss of innervation causes apoptosis of penile smooth muscle, remodeling of corpora cavernosa (penile erectile tissue) morphology, and ED.

Objective
In this study, microarray and pathway analysis were used to obtain a global understanding of how signaling mechanisms are altered in diabetic patients and animal models as ED develops, in order to identify novel targets for disease management, and points of intervention for clinical therapy development.

Methods
Human corpora cavernosal tissue was obtained from diabetic (n=4) and Peyronie's (control, n=3) patients that were undergoing prosthesis implant to treat ED. Rat tissue was obtained from BB/WOR diabetic (n=5) and diabetes resistant (n=5) rats. RNA was extracted using TRIzol, DNase treated, and purified by Qiagen mini kit. Microarray was performed using the Human Gene 2.0 ST Array. 1) Alterations in patient and diabetic rat pathway signaling were examined using several analytical tools (ShinyGO, Metascape, WebGestalt, STRING) and databases, 2) Strengths/weaknesses of the different pathway analysis tools were compared, and 3) Comparison of human and rat (BB/WOR and Streptozotocin) pathway analysis was performed. Two technical replicates were performed. P value (FDR) &lt; 0.15 was used as threshold for differential expression. FDR&lt;0.05 was considered significant.

Results
Microarray identified 182 differentially expressed protein-coding genes. Pathway analysis revealed similar enrichments with different analytical tools. Down regulated pathways include development, tubular structure, sprouting, cell death, ischemia, angiogenesis, transcription, second messengers, and stem cell differentiation. ED patients, who have diabetes, incur significant loss of normal regulatory processes required for repair and replacement of injured corpora cavernosal tissue. Combined with loss of apoptotic regulatory mechanisms, this results in significant architectural remodeling of the corpora cavernosa, and loss of regenerative capacity in the penis.

Conclusions
Penis from diabetic ED patients lacks capacity for maintenance of corpora cavernosal architecture and regeneration, which are critical points for intervention for therapy development. The analysis of tissue specific gene expression profiles provides a means of understanding drivers of disease and identifying novel pathways for clinical intervention. This first report of microarray and pathway analysis in human corpora cavernosa, is critical for identification of novel pathways pertinent to ED and for validating animal models.

Disclosure
Work supported by industry: no.
027 Recovery of Erectile Dysfunction after Administration of Hydrogen Sulfide Donor Sodium Hydrogen Sulfide and Transplantation Of Adipose-Derived Stem Cells in Rats with Bilateral Cavernous Nerve Injury
Authors: Asker H. , Sezen S.F. , Yilmaz-Oral D. , Turkcan D. , Elçi M.P. , Kirlangic O.F. , Gur S. 
Published: May 2022

ABSTRACT

Introduction
Radical prostatectomy causes nerve injury-related erectile dysfunction (ED), which results in a poor response to phosphodiesterase 5 inhibitors. Hydrogen sulfide (H2S), an endogenous gasotransmitter, is produced by cystathionine-β-synthase (CBS), cystathionine-γ-lyase (CSE) and 3-mercaptopyruvate sulfurtransferase (3-MST) and participates in erectile physiology. Adipose-derived stem cells (ADSCs) represent a promising cell source for cell replacement therapy in several degenerative diseases because of its self-renewal properties and multi-differentiation potential with low immunogenicity.

Objective
The current study was to evaluate the effects of H2S donor, sodium hydrogen sulfide (NaHS), and transplantation of ADSCs per se and their combination treatment on bilateral cavernous nerve injury (BCNI)-induced erectile dysfunction (ED).

Methods
A total of 35 Sprague-Dawley rats were divided into 5 groups, including sham-operated (Sham), BCNI (4-wk), BCNI treated with NaHS (5.6 mg/kg/day, i.p.), BCNI treated with ADSCs (1x106 cells by intracavernosal injection) and BCNI treated with NaHS and ADSCs groups. Rats in the ADSCs treatment groups were subjected to intracavernosal injection after BCNI. Erectile function was evaluated by the ratio of intracavernous pressure (ICP)/mean arterial pressure (MAP) and total ICP. The relaxant and contractile responses of corpus cavernosum (CC) were measured from in vitro studies. Protein expression and localization of nitric oxide synthases (NOS) and H2S synthesis enzymes were analyzed by Western blotting and immunohistochemistry. The smooth muscle/collagen ratio was determined using Masson trichrome staining.

Results
Rats with BCNI displayed significantly reduced ICP/MAP and total ICP (p&lt;0.001 vs controls) when were partially restored by NaHS and ADSCs treatments alone. Interestingly, combined treatment completely enhanced decreased in vivo erectile responses (p&lt;0.001 vs the NC group). Relaxation responses to acetylcholine and electrical field stimulation (EFS) as well as contractile responses to phenylephrine and EFS in the CN group were less than in controls (p&lt; 0.05), which was normalized after all treatments groups. The combined treatment modulated changes of protein expressions and reduced ratio of smooth muscle to collagen in rats with BCNI.

Conclusions
The current data indicated that the combination treatment with NaHS and ADSCs is more successful than monotherapies in reversing BCNI-induced ED. H2S and cell-based therapy most probably may have a synergistic effect on erectile function via controlling molecular regulation and morphological penile alterations, which supports combined treatment for expanding clinical outcomes radical prostatectomy-induced ED.

Disclosure
Work supported by industry: no.
028 Hydrogen Sulfide has a Role as an Endogenous Relaxation Factor in the Rat Prostate
Authors: Shimizu T. , Zou S. , Shimizu S. , Aratake T. , Higashi Y. , Yamamoto M. , Saito M. 
Published: May 2022

ABSTRACT

Introduction
Hydrogen sulfide (H2S) is the third endogenous gasotransmitter besides carbon monoxide and nitric oxide, and has a wide range of physiological functions such as neuromodulation, vasorelaxation and cytoprotection. Although in human prostate cancer cells, NaHS (a H2S donor) treatment was reported to inhibit proliferation and to elevate secretory function, physiological functions of H2S in the prostate tissue had not been investigated yet. Endogenous H2S is biosynthesized from L-cysteine by cystathionine β-synthase (CBS) and cystathionine γ-lyase (CSE). In addition, 3-mercaptopyruvate sulfurtransferase (MPST) synthesizes H2S from 3-mercaptopyruvate (3MP), which is produced from L-cysteine by cysteine aminotransferase (CAT) (CAT/MPST pathway). Recently, a new pathway for endogenous H2S biosynthesis is reported; D-cysteine is metabolized by D-amino acid oxidase (DAO) to 3MP, which is a substrate for MPST to synthesize H2S.

Objective
We investigated (1) tissue distribution of CBS, CSE, MPST, CAT and DAO, (2) endogenous H2S levels, and (3) effects of NaHS on contractility in the rat prostate.

Methods
Dorsolateral and ventral prostate (PR-D and PR-V), liver and cerebellum (L and C) were prepared from male Wistar rats (300-400 g) sacrificed with an overdose of sodium pentobarbital (80 mg/kg, ip). (1) Tissue distributions of 5 enzymes were investigated by real-time PCR, western blot and immunohistochemistry. L and C were used for positive controls. (2) H2S contents in the prostate tissues were measured by methylene blue method. (3) By using 1 x 5 mm strips of the prostate tissues, effects of NaHS (1 x 10-9 to 3 x 10-4 M) were evaluated on pre-contracted prostate strips by noradrenaline (10-5 M). Prostate strips were pretreated with propranolol (10-6 M) 30 min before the pre-contraction.

Results
(1) CBS, MPST and CAT were detected in the prostate. Expression levels of CBS in the PR-D were lower than those in the PR-V, and the levels of MPST in the PR-D were higher than those in the PR-V. In expression levels of CAT, there was no significant difference between two prostate tissues. On the other hand, CSE or DAO was not detected in these tissues. Immunoreactvities of these enzymes were mainly detected in the prostate glandular epithelium. (2) H2S was detected in the prostate tissues. (3) NaHS dose-dependently induced relaxation of pre-contracted PR-D and PR-V strips. There were no significant differences of the EC50 values or relaxation rate against the pre-contractions between two prostate tissues.

Conclusion
H2S synthesized by CBS- and CAT/MPST-mediated pathways has a role as an endogenous relaxation factor in the rat prostate. Therefore, endogenous H2S might open new avenues of therapeutic interventions for benign prostatic hyperplasia.

Disclosure
Work supported by industry: no.
033 Shaeer's Punch Technique: Trans-Corporeal Peyronie's Plaque Surgery and Penile Prosthesis Implantation
Authors: Shaeer O. 
Published: May 2022

ABSTRACT

Introduction
Penile prosthesis implantation in cases of severe Peyronie's disease may require plaque excision/incision and grafting, that may require mobilization of the neurovascular bundle (NVB) or urethra, posing the risks of penile hyposensitivity or urethral injury, and is time consuming, possibly increasing infection risk.

Objective
Evaluating trans-corporeal debulking of Peyronie's plaques by “Shaeer's Punch Technique”.

Methods
Penile prosthesis implantation and Punch technique (PPI-Punch) was performed for 26 patients. Following corporotomy and dilatation, Peyronie's plaques were punched-out from within the corpora cavernosa using the punch forceps then a penile prosthesis implanted. Comparison to a matching retrospective group of 18 patients operated upon by plaque excision-grafting and penile prosthesis implantation was performed. Outcomes were in terms of straightness of the erect penis, complication, satisfaction with length on a 5-point scale , the International Index of Erectile Function-5 (IIEF), and the Erectile Dysfunction Inventory of Treatment Satisfaction questionnaire (EDITS).

Results
Average pre-operative curvature angle was 58.1 ± 11.7 in the Punch group and 58 ± 14.8 in the excision-grafting group, p=0.99. Following surgery, all patients had a straight penis. No tunical perforations, urethral injuries or extrusions were noted. Average additional operative time for Punch technique ranged from 5 to 10 minutes (7.3 ± 1.7), in contrast to the excision-grafting group where plaque surgery duration was 50.8 minutes ± 11.1, an 85% difference, p &lt; 0.0001. Septal plaques in the latter group could not be removed. In the PPI-Punch group, penile sensitivity was preserved in all patients, compared to the excision/grafting group with 7/18 patients reporting hyposthesia of the glans. Infection occurred in 1/26 patients in the PPI-Puch group, compared to 2/18 patients in the excision/grafting group. Satisfaction with length on a 5-point scale was 3.8 ± 0.9 in the punch group, versus 3.1 ± 1.1 in the excision-grafting group, p=0.009..

Conclusions
Shaeer's Punch Technique is a minimally invasive procedure for trans-corporeal excavation of Peyronie's plaques prior to penile prosthesis implantation. There is no need for mobilization of the neurovascular bundle or spongiosum, hence low or no risk for nerve or urethral injury and brief plaque surgery time.

Disclosure
Work supported by industry: no. A consultant, employee (part time or full time) or shareholder is among the authors (Coloplast, BSC, Rigicon).
039 Effect of Retinoid Loaded Hyaluronic Acid Nanomicelle on Vaginal Epithelium in Mouse Menopausal Model
Authors: Park K. , Chung H.S. , Lee H. , Kim T. 
Published: May 2022

ABSTRACT

Objective
This study aimed to develop hyaluronic acid-based retinoic acid-containing stimulation-sensitive vaginal nanoparticles and investigate the effects of newly developed vaginal nanoparticles on the regeneration of vaginal epithelial layers and aquaporin 3 expressions in the menopausal animal model.

Methods
The hyaluronic acid-based retinoic acid-loaded micelle nanoparticles were developed. Female Balb/C mice (8weeks, n=30) were divided into four groups: control, bilateral ovariectomy, HA-C18 vehicle administration group, and HA-C18RA administration group. After 4 weeks of treatment, the mouse vaginal tissue was removed, and the expressions of AQP3 were determined by Western blot and immunofluorescence staining.

Results
Three drug-loaded nanoparticles were synthesized. The content of retinoic acid supported in HA-C18 RA10, HA-C18 RA20, and HA-C18 RA 30 were 3.13%, 2.52%, and 16.67%, respectively, and the retinol acid encapsulation efficiency was 95.57%, 83.92%, and 93.24%, respectively. In the experimental group, serum estrogen levels were significantly reduced compared to the control group (p &lt;0.05), and the vaginal mucosa epithelial layer was also significantly thinned. After 4 weeks of treatment, the vaginal mucosal epithelial layers were increased in the retinoic acid-loaded HAC18 administration group compared to the vehicle group. In addition, the expression of AQP3 was increased in the retinoic acid-carrying nanoparticle administration group.

Conclusions
The newly developed hyaluronic acid-based vaginal nanoparticles containing retinoic acid resulted in the recovery of the vaginal epithelial layers and also showed an increased expression of AQP3 in the vaginal epithelium. These results could contribute to developing functional vaginal lubricants/moisturizers for the treatment of women with vaginal dryness.

Disclosure
Work supported by industry: no.
042 Testosterone Improved the Erectile Dysfunction Induced by Anti-Cancer Agent Doxolubicine in Rats
Authors: Kataoka T. , Sanagawa A. , Hotta Y. , Hibi Y. , Kimura K. 
Published: May 2022

ABSTRACT

Introduction
Many chemotherapeutic agents are administered to cancer patients worldwide. We previously reported at the world meeting on Sexual Medicine 2018 that doxorubicin (DOX) increased the risk of erectile dysfunction (ED) according to our analyses of the US Food and Drug Administration (FDA) Adverse Event Reporting System (AERS) database. We also reported that DOX decreased erectile function in a study using rats. DOX also decreased rat testosterone levels. These studies suggest a need for a new treatment method for ED associated with anticancer drug treatment.

Objective
To investigate the effect of testosterone administration on DOX-induced ED in rats.

Methods
Twelve-week-old male Wistar ST rats were separated into Control, DOX, and DOX+T groups. DOX (3 mg/kg) was intravenously administered on days 1, 8, 15, and 22 in the DOX and DOX+T groups. Testosterone undecanoate (25 mg/kg) was administered to DOX+T rats on day 1. Erectile function was tested using ICP measurements, and endothelial function was tested by assessing isometric tension. Oxidative stress (NADPH oxidase), inflammation (IL-6), and smooth muscle factor (α-SMA, Cavin-1, and Cavin-2) mRNA expression levels were tested using real-time PCR.

Results
After the 4-week observation period, the ICP/MAP ratio in the DOX group (0.32 ± 0.03) was significantly decreased compared to the Control group (0.72 ± 0.05) (P &lt;0.01). The ICP/MAP ratio in the DOX + T group (0.61 ± 0.07) was increased significantly compared to the DOX group (P &lt;0.01). According to isometric tension measurements, reactivity to acetylcholine was significantly lower in the DOX group (35.0 ± 5.1%) than in the control group (77.6 ± 7.9%), whereas reactivity in the DOX + T group (69.8 ± 8.5%) was significantly improved (P &lt;0.05). NADPH oxidase-1 and IL-6 mRNA levels were increased in the DOX group compared to the Control group (P &lt;0.01), and levels were decreased relative to the DOX group in the DOX+T group. α-SMA, Cavin-1, and Cavin-2 mRNA levels were decreased in the DOX group compered to the Control group. These levels were improved in the DOX+T group.

Conclusions
We have demonstrated in rats that androgen replacement therapy may mitigate ED induced by DOX administration. We hypothesize that administration of testosterone improves smooth muscle function and vascular endothelial cell function by suppressing oxidative stress and inflammatory response in the corpus cavernosum, and maintaining normal levels of caveolin-related factors. When androgen deficiency symptoms are observed due to administration of anticancer drugs such as DOX, androgen replacement therapy is expected to be one viable treatment option. Our study sheds light on possible treatment strategies for improving quality of life for cancer survivors.

Disclosure
Work supported by industry: no.