bluuebunny/crossref_metadata_2025_split huggingface dataset:
095 The Brachial-Ankle Pulse Wave Velocity is a Predictive Factor for Erectile Dysfunction in Patients with Benign Prostate Hyperplasia
Authors: Amano T , Takasawa T , Shizukuda Y , Imao T 
Published: May 2022

ABSTRACT

Introduction
Phosphodiesterase (PDE) 5 inhibitors induce relaxation of endothelial cells. Tadalafil, one of PDE 5 inhibitors, has been applied for the treatments of erectile dysfunction (ED) and benign prostate hyperplasia (BPH). Under continuous treatments with PDE 5 inhibitor for BPH, it is significant to investigate the relationship between endothelial and sexual functions by comparing the brachial-ankle pulse wave velocity (baPWV).and the sexual health inventory for men (SHIM) score.

Objectives
Total 89 BPH patients who consulted our clinic with a complaint of urinary symptoms were enrolled in this prospective study. They were treated with a daily dose of 5mg tadalafil.

Methods
The Institutional Review Board (IRB) approved this clinical study and informed consents had been obtained from 89 BPH patients. Their vessels endothelial function was assessed by baPWV and erectile function was evaluated by SHIM score. International prostate symptom score (IPSS) was obtained as male lower urinary symptoms (LUTS) parameters. However, we focused on the relationship between vessels endothelial and erectile function in this sub-analysis report. Therefore, the SHIM scores were compared with baPWV and IPSS at 0, 3, 6, 12, 24, 36, 48, 60, 72 and 84 months after PDE5 inhibitor treatment.

Results
The mean age of 89 patients was 66.7 +/- 11.1 years old. Their prostate size was 29.8 +/- 21.2 ml. Initial SHIM, baPWV and IPSS score were 7.4 +/- 5.6, 1742.5 +/- 393.0 cm/sec and 17.5+/- 7.5, respectively. Before tadalafil treatment, baPWV and SHIM were significantly correlated (p=0.0025) which indicated patients with low vessels endothelial function vessels endothelial function suffered from erectile dysfunction. F4rthere06re, all the data of baPWV and SHIM including after tadalafil treatment from 3 to 84 months (n=472) were significantly co-related each other (p&lt;0.0001). On the other hand, baPWV were significantly improved from 3 to12 months after tadalafil administration, however baPWV levels returned to the baseline levels after 24 to 84 months. SHIM score was significantly improved from 3 to24 months after tadalafil administration, however SHIM levels returned to the baseline levels after 36 to 84 months.

Conclusions
Our previous paper (Aging Male 21, 2018) reported that PDE5 inhibitors improved ED, male LUTS and baPWV from 3 to 12 months. The present data also suggested that endothelial function and male LUTS strongly related to ED in BPH patients. However, baPWV and SHM score levels returned to the baseline levels after 24 and 36 months, respectively. Thus, tadalafil can delay vessels endothelial and erectile dysfunction in BPH patients. In addition, erectile dysfunction seems to be occurred after vessels endothelial dysfunction. Hence, baPWV might be a predictive factor for ED in BPH patients with tadalafil treatments.

Disclosure
Work supported by industry: no.
099 Increased Risk of Subsequent Cardiovascular Disease Among Men Aged 31-60 Years with Erectile Dysfunction
Authors: Huang I , Chen W , Huang EY , Chung H , Huang WJ 
Published: May 2022

ABSTRACT

Background
Men presenting with erectile dysfunction (ED) or coronary artery disease (CAD) can be regarded as two different manifestation of vascular occlusion incident. ED has been proven to be an independent predictor of CAD, especially young men aged 40-49 years. Although psychogenic ED is more prevalent in younger patients less than 40 years of age, but the ED presentation can also be related to vasculogenic etiology. The purpose of this study is to evaluate the subsequent CAD risk in young ED patients and also determine the relative CAD risk in ED men stratified by age.

Methods
A total of 3091 ED patients and 9273 randomly-selected controls without ED were selected from the National research database and studied retrospectively from January 1,1997 to December 31, 2007. The comparison cohort without ED was matched for age and comorbidities (diabetes, hypertension, hyperlipidemia and ischemic stroke). All subjects were followed up by the end of 2009. Cox proportional hazards regression models were used to explore the connection between ED and the development of CAD.

Results
The ED patients have a greater chance of developing cardiovascular disease compared to controls (460/3091, 14.9% vs. 1021/9273, 11.0%, p-values &lt; 0.0001). Cox proportional hazards regression suggested ED increases the risk of CAD development (HR 1.37, 95% CI [1.22-1.53], p&lt;0.0001). Results stratified by 10-year age decades demonstrate ED men aged 31-40 years, 41-50 years, and 51-60 years pose greater risk of developing CAD comparing to the controls (HR 1.61, 95% CI [1.04-2.52], p=0.03; HR 1.79, 95% CI [1.38-2.32], p&lt; 0.0001; HR 1.68, 95% CI [1.35-2.09], p&lt; 0.0001, respectively). On the contrary, the incident cardiac events were not increased in ED men aged 21-30 years, 61-70 years and 71-80 years comparing to the controls (HR 1.77, 95% CI [0.50-6.29], p=0.38; HR 1.17, 95% CI [0.95-1.44], p=0.15; HR 0.88, 95% CI [0.65-1.19], p=0.40, respectively).

Conclusion
Erectile dysfunction is a harbinger of cardiovascular clinical events in men aged 31-60 years. Erectile dysfunction should prompt investigation and close follow up for further cardiac events.

Disclosure
Work supported by industry: no.
104 The Relationship Between Site-Specific Prostate Surface Dose in Cases of Iodine-125 Prostate Brachytherapy and Erectile Dysfunction
Authors: Ishii S , Takata R , Kikuchi K , Itoh A , Tsuyukubo T , Tamura D , Ikarashi D , Maekawa S , Matsuura T , Kato R , Kato Y , Kanehira M , Sugimura J , Abe T , Nakamura R , Obara W 
Published: May 2022

ABSTRACT

Objective
To conduct detailed measurements of site-specific radiation doses in 36 sections plotted on the surface of the prostate after brachytherapy (BT), to conduct a comprehensive analysis of the regions associated with erectile dysfunction (ED).

Subjects and methods
The subjects were 81 patients selected from among patients who underwent BT between 2004 and 2016 because they were able to complete the International Index of Erectile Function (IIEF)-6 questionnaire pre-treatment and 12 months post-treatment. Post-planning was done by inputting CT images made over a four-week period after treatment into a radiotherapy planning system, dividing the surface of the prostate into 36 equal sections, and measuring the D90 radiation dose (Gy) at each site. The soft tissue surrounding the corpus cavernosum was set as the ROI for the uretheral bulb spongy tissue, and the radiation dose to this region was similarly calculated.

Results
We selected 56 of the 81 patients who did not have ED or who had mild ED prior to treatment. 23 patients who scored 22 or higher on the IIEF-6 at 12 months post-treatment were assigned to the non-ED group, and 11 patients who scored under 11 were assigned to the ED group. Statistical inter-group comparison of the site-specific radiation doses indicated that the doses were significantly higher in the ED group in the following sections: Center of right lobe at 3 o'clock, center of left lobe at 2-4 o'clock, apex of left lobe at 2-4 o'clock. No significant difference in radiation dose was found for the corpus cavernosum.

Conclusion
In the group of patients with high radiation doses to the middle and apex at 2 – 4 o'clock the IIEF-6 score was significantly lower at 12 months post-treatment. This suggests that excessive radiation exposure to these sections may have an effect on post-BT ED.

Disclosure
Work supported by industry: no.
105 Combine Treatment of Veno-Occlusive ED Withveno-Occlusive Surgery, Injections of Stem Cells and VEGF
Authors: Knigavko O , Gramatiuk S 
Published: May 2022

ABSTRACT

Introduction
The venous leakage is one of the most often reason of erectile dysfunction (ED) in young and middle age men. The main reason of veno-occlusive ED (VOED) is the insufficiency venous obstruction in corpora cavernosa under tunica albuginea that is why all types of veno-occlusive operations have particular and short term effect up to renovation of venous leakage in half year. Conservative treatment of VOED with PDE-5 has a low effectiveness. Evermore young patients deny Penile prosthesis implantation for psychological reason.

Objective
We want to stimulate growth of endothelial valves under tunica albuginea with injections autological mesenchymal stem cells and autological VEGF (Vascular endothelial growth factor) and combine it with veno-occlusive surgery.

Materials and Methods
On the basis of the Kharkiv Regional Clinical Centre of Urology and Nephrology, Andrology deratment in 2012-2021 we carried out comprehensive examination and treatment of 174 patients with VOED. Most of them 142 (81.6%) have left side or bilateral varicocele. The average patient age is 36.5 +4.1 years. Patients with prostatitis or depression/anxiety were excluded from the investigation or treated previously. We provided embolization of deep dorsal and Santorini plexus veins for patients with distal form of VOED throw deep dorsal vein –46 patients -Group 1.We performed ligation of deep dorsal and penile veins with Marmar surgery from peno-pubical incision for proximal form of VOED – 68 patients – Group 2, And we made both methods together for 62 patients –Group 3 with combination of proximal and distal leak. Patients with only surgical methods created subgroup A – 105 men. For improving of veno-occlusive mechanism for 69 patients (subgroup B) we injected to each corpus cavernosa 1 mln of autological endothelial stem cells 5 times (2 times before and 3 times after surgery) each 1.5-2 months and we performed 15 microinjections of VEGF each 10 days. During occlusive operations we injected to ligated veins (deep dorsal and big penile veins) 2 mln of autological fibroblastic stem cells in retrograde direction. Then we compared short (2 months) and long term (10 months) result.

Results
The efficacy of surgical treatment according to subjective data (questionnaires on IIEF-5) in 2 months was almost equal (16.7±3.1 and 16.9±3.0), but in 10 months significantly higher in SubGroup B(14.3±3.2 and 19.6±3.4). According to objective data in 10 months adding microinjections of autological stem cells and VEGF to surgery significantly improves Erectile function (absence of venous leakage on Doppler Penile US with bemix) 56.4% - subgroup A and 91.4% - subgroup B.

Conclusions
Half year injections of autological stem cells and VEGF improve of veno-occlusive mechanism and increases effectiveness and long term result of veno-occlusive operations for treatment of VOED.
Cavernosografy of combine form of VOED

Disclosure
Work supported by industry: no.
124 Prognostic Value of High-Sensitivity Modified Glasgow Prognostic Score in Castration-Resistant Prostate Cancer Patients Who Received Docetaxel
Authors: Sakamoto S , Ando K , Imamura Y , Kato M , Komiya A , Ichikawa T 
Published: May 2022

ABSTRACT

Introduction
The Glasgow prognostic score, a marker of systemic inflammation, is associated with clinical outcomes in different cancers including prostate cancer. However, there is no evidence for the relationship between the high-sensitivity modified Glasgow prognostic score (Hs-mGPS) in prostate cancer and its prognosis.

Objective
This study aimed to investigate the prognostic significance of Hs-mGPS in castration-resistant prostate cancer (CRPC) treated with docetaxel.

Methods
We retrospectively analyzed clinical datasets from 131 CRPC patients who received docetaxel treatment at Chiba University Hospital and a related hospital. Clinical factors including Hs-mGPS before docetaxel treatment were evaluated according to overall survival.

Results
The numbers of patients with Hs-mGPS of 0, 1, and 2 were 88, 30, and 13, respectively. The median prostate-specific antigen (PSA) level was 28.9 ng/mL. The median testosterone level was 13.0 ng/dL. The percentages of bone and visceral metastases were 80.8% and 10.2%, respectively. For overall survival, Hs-mGPS ≥ 1 (hazard ratio of 2.41; p = 0.0048), testosterone ≥ 13.0 ng/dL (hazard ratio of 2.23; p = 0.0117), and PSA ≥ 28.9 ng/mL (hazard ratio of 2.36; p = 0.0097) were significant poor prognostic factors in the multivariate analysis. The results of the two-group analysis showed that a higher Hs-mGPS was associated with high PSA, alkaline phosphatase, and testosterone levels. The median testosterone levels for Hs-mGPS of 0, 1, and 2 were 9.0, 16.5, and 23.0, respectively. Based on the multivariate analysis, we created a combined score with three prognostic factors: Hs-mGPS, testosterone, and PSA. The low-risk group (score of 0-1) showed a significantly longer overall survival compared to the intermediate-risk (score of 2-3) and high-risk (score of 4) groups (p &lt; 0.0001).

Conclusion
Our results demonstrated that an elevated Hs-mGPS was an independent prognostic factor in CRPC patients treated with docetaxel therapy. Risk classification based on Hs-mGPS, testosterone, and PSA may be useful in predicting the prognosis of CRPC patients.

Disclosure
Work supported by industry: no.
133 Outcomes of Treatment for LOH Syndrome Assessed by Free Testosterone
Authors: Kaku Y , Sato K , Ooishi A , Ishida T , Okada K , Chiba K , Fujisawa M 
Published: May 2022

ABSTRACT

Objective
Late-onset hypogonadism (LOH) is defined by reduced serum testosterone levels, and androgen replacement therapy (ART) is widely used. While serum total testosterone (TT) is used as an indicator for diagnosis and treatment for LOH in the United States and Europe, serum free testosterone (FT) is used in Japan. Patients with low FT levels (less than 8.5 pg/mL) are to be indicated for ART as LOH, and patients with moderate FT levels (between 8.5 pg/mL and 11.8 pg/mL) are also to be considered for ART as LOH borderline. In this study, we examined the outcomes of LOH and LOH borderline patients who were treated by ART.

Methods
We examined Aging Male Symptom (AMS) scale scores of LOH (n=76) and LOH borderline patients (n=16) who were treated with ART for at least 6 months at our hospital.

Results
In LOH patients, AMS score decreased from 52.1±12.3 to 41.5±12.2 (p&lt;0.05). On the other hand, in borderline cases AMS score also decreased from 55.8±10.2 to 36.5±8.45 (p&lt;0.05). There was no significant difference between two groups.

Conclusion
ART improves AMS score both in LOH and LOH borderline patients, but there were no significant differences between two groups in this study.

Disclosure
Work supported by industry: no.
138 Aging Exacerbates Hypertension Related Testicular Injury in Rats
Authors: Shimizu S , Nagao Y , Shimizu T , Higashi Y , Aratake T , Zou S , Yamamoto M , Saito M 
Published: May 2022

ABSTRACT

Introduction
The average age of paternity is rising in developed world. Hypertension is the most common chronic disease among adult males, affecting male fertility. Aging is an important risk factor for the development of atherosclerosis and hypertension. However, involvements of aging on hypertension related testicular injury are not fully clarified.

Objective
In this study, we investigated the involvements of aging on testes in spontaneously hypertensive rats (SHRs).

Methods
Male SHRs and Wistar Kyoto rats (WKYs; normotensive control) at the age of 36, 54 or 72 weeks (wk) were used (n=6, each age). At each age, body weight, testicular weight and blood pressure were measured. Serum testosterone and testicular tissue levels of malondialdehyde (MDA: a maker of lipid peroxide) were also measured by colorimetric assay and ELISA assay. Morphological changes in the testis were evaluated by hematoxylin and eosin staining. TUNEL staining was performed to quantify the apoptosis in testis.

Results
SHRs at 36, 54 o 72 wk showed a significant increase in mean blood pressure compared to WKYs at each age. SHRs at 54 or 72 but not 36 wk demonstrated a significant decrease in body weight and increase in testicular weight/body weight ratio compared to WKYs at each age. Testicular tissue levels of MDA in SHRs at all ages were significantly higher than those in WKYs at all ages. Serum testosterone in SHRs at 54 or 72 but not 36 wk was lower than that in WKYs at each age. SHRs at 54 or 72 but not 36 wk demonstrated obvious morphological changes such as thickening of blood vessel wall in testis, and seminiferous tubules with degeneration compared to the WKYs at each age. Number of TUNEL positive cells in testicular seminiferous tubules in SHRs at 36 wk was significantly greater than those in WKYs at 36 wk. While number of TUNEL positive cells in testicular seminiferous tubules in SHRs at 72 wk was significantly lower than those in WKYs at 72 wk.

Conclusion
Aged SHRs showed significant increases in oxidative damage and vacuolation in testes, and decrease in serum testosterone compared to age matched WKYs. Aging could exacerbate hypertension related testicular injury in rats.

Disclosure
Work supported by industry: no.
154 The Effect of Combination Treatment with Low-Intensity Shockwave Therapy and Tadalafil on Mild and Mild-to-Moderate Erectile Dysfunction A Double-Blind, Randomized, Placebo-Controlled Clinical Trial
Authors: Mykoniatis I. , Pyrgidis N. , Zilotis F. , Fournaraki A. , Kapoteli V. , Kalyvianakis D. , Hatzichristou D. 
Published: May 2022

ABSTRACT

Introduction
Combination of different first-line treatments for erectile dysfunction (ED) has emerged as a promising therapeutic approach.

Objectives
To conduct the first double-blind, randomized, placebo-controlled clinical trial to evaluate the efficacy and safety of combination therapy with low-intensity shockwave therapy (LiST) and tadalafil versus LiST and placebo in patients with mild or mild-to-moderate vasculogenic ED.

Methods
Fifty sexually active patients fulfilling the eligibility criteria were randomly assigned to six sessions of LiST twice weekly for three weeks and tadalafil once daily (n=25) or placebo (n=25) for four weeks. Patients were evaluated at one, three and six months after completion of the treatment protocol. An intension-to-treat analysis was performed. Erectile function was assessed at all time points based on the International Index of Erectile Function – Erectile Domain (IIEF-EF) and the Sexual Encounter Profile (SEP) diaries. The number of patients attaining a minimal clinically important difference (MCID) in the IIEF-EF, as well as the safety of combination therapy were also evaluated.

Results
Adjusting for the baseline values, IIEF-EF improved by 0.8 points (95%CI: -0.2-1.9, p=0.12) at one month, 1 point (95%CI: 0.1-1.9, p=0.02) at three months and 1.7 (95%CI: 0.8-2.7, p =&lt;0.001) at six months in patients treated with combination of LiST and tadalafil compared to LiST and placebo. Between the two groups, the proportion of “yes” responses to question 3 of SEP diaries improved significantly only at the 6-month evaluation, while the number of patients attaining a MCID in the IIEF-EF only at the 3-month evaluation. No adverse events were reported during the whole study period.

Conclusions
Combination of LiST twice weekly for three weeks and tadalafil 5mg once daily for four weeks may further ameliorate mild or mild-to-moderate vasculogenic ED compared to LiST monotherapy and is considered a safe treatment modality. Still, further high-quality studies are warranted to corroborate our findings.

Disclosure
Work supported by industry: no.
169 Impact of Low-Intensity Extracorporeal Shock Wave Therapy on Sexual Function after Non-Nerve-Sparing Robot-Assisted Laparoscopic Radical Prostatectomy
Authors: Inoue S. , Hayashi T. , Teishima J. 
Published: May 2022

ABSTRACT

Objective
Considering the natural course of cavernous nerve recovery following robot-assisted laparoscopic radical prostatectomy (RARP), early intervention of low-intensity extracorporeal shockwave therapy (LIESWT) would be more effective for enhancing overall recovery of potency. We analyzed longitudinally alterations in sexual function in patients after RARP, with focus on the effect of early and delayed intervention with LIESWT.

Method
This study was open-label prospective study. Four patients after RARP were enrolled into this study's protocol over a period between January and June 2017. This early intervention was performed three times a week for two weeks in admission and one time per week in our out patient clinic for six weeks. For the purpose of setting a control group, the same surgeon performed RARP on 4 patients over a period between June 2012 and December 2014. These patients received LIESWT and this delayed protocol was same as that by Vardi et al. The same surgeon performed RARP on 100 patients over a period between April 2012 and February 2015. These patients were assigned to the non-LIESWT group for setting another control group. Sexual function (SF) was assessed with the Expanded Prostate Cancer Index Composite (EPIC). A validated form of self-reported questionnaire was administered to the inpatients before RARP, and mailed to all patients receiving RARP at 3, 6, 9, and 12 months after RARP.

Results
There was no significant inter-group difference in the baseline patient characteristics and surgical outcomes. The mean duration from RARP to the start of penile rehabilitation was 6 months for patients of the delayed LIESWT group. The SF score was significantly higher at preoperative, postoperative 6 and 9 months (p=0.0024, 0.0001, and 0.0004) in the early-LIESWT group. The SF score of early-LIESWT was significantly higher than that of delayed-LIESWT at postoperative 6 and 9 months (19.7 vs. 7.4; p = 0.0153, 26.2 vs. 6.1; p = 0.0154). On the other hand, there was no significant difference in the SF score between delayed and non-LIESWT groups at all time points.

Conclusions
Our findings show that penile rehabilitation with LIESWT immediately before urethral catheter removal improved sexual function scores. Our preliminary results suggest that LIESWT could be used as a treatment option in penile rehabilitation.

Disclosure
Work supported by industry: no.