bluuebunny/crossref_metadata_2025_split huggingface dataset:
183 AdVance and AdVance XP Male Sling Comparison, an Institutional Experience
Authors: Ahmadieh K. , Parker N. , Campagna J. , Powell J. , Wolter C. 
Published: April 2022

ABSTRACT

Introduction
The AdVance male sling has been used for many years for the treatment of male stress urinary incontinence with multiple previous studies evaluating its efficacy. More recently, a new generation AdVance XP was designed with modifications in its design and surgical tools in hopes to improve patient outcomes.

Objective
The aim of our study was to provide our institution's outcomes comparing objective and patient-reported outcomes of the AdVance male sling to the AdVance XP.

Methods
All patients who have had placement of an AdVanceXP male urethral sling were retrospectively reviewed. Inclusion criteria included the necessity of one year post-operative follow up. We then identified a comparative cohort who had the most recent placement of the AdVance sling. We compared patient demographics, baseline characteristics, functional outcomes, voiding studies and complications.

Results
A total of 11 patients who received the AdVanceXP were compared to 11 patients who received the AdVance male sling. There were no statistically significant differences in baseline demographics between the two groups (Table1). When comparing the AdVance XP to Advance, there was no difference in change in average flow rate (-1.26mL/s vs -5mL/s, p=0.476) or peak flow (-5.11mL/s vs -5.73mL/s, p=.936). Patient's pre-surgical pad usage was greater in the AdVanceXP than the AdVance sling groups (2.64 vs 1.60, p=0.019). The mean decrease in pad usage was 1.95 pads in those with the AdVanceXP compared to 1.36 pads with the AdVance (p=.227). There were no statistically significant differences in operative times between the AdVanceXP and the AdVance male sling (64.5min vs 68.8min, p=.249). Both groups had one patient who had issues with post-operative pain and neither group had any patients with post-operative retention, infection or need for reoperation within one year.

Conclusions
Patient's who had placement of the AdVanceXP were found to have a greater reduction in pad usage when compared to the AdVance sling, though not reaching statistical significance.

Disclosure
No
190 Self-reported Post-vasectomy Fournier's Gangrene Complication Among Practitioners
Authors: Huynh L. , Raza S. , Deibert C. 
Published: April 2022

ABSTRACT

Introduction
While several cases of Fournier's gangrene have been reported following vasectomy, the prevalence of this complication is yet to be elucidated.

Objective
Determine the prevalence, presentation and outcome of Fournier's gangrene post-vasectomy.

Methods
We developed a brief IRB exempt survey that was disseminated by email to the 250 high volume vasectomy practitioners who are part of a global networking list-serve to gather prevalence, presentation and outcome of this debilitating complication. The data was organized and analyzed via Microsoft Forms and Excel.

Results
83/250 members responded to the survey (33%).Practitioners were: family practitioners 74.6% (62), urologists 19.2% (16), general surgeons 3.6% (3), internist 1.2% (1) and 1 Ob/Gyn. The mean self-reported number of vasectomies performed per provider was 574. 8.4% (7) of all practitioners routinely provide antibiotics prior to the procedure. The self-reported complication rate for Fournier's gangrene in this population was 6% (5). Of which majority noted the typical clinical presentation of fever (80%), pain (60%) and skin discoloration (60%). Among the practitioners who experienced Fournier's gangrene, none of them provided antibiotics prior to the procedure. However, these practitioners performed twice as many annual vasectomies than the non-Fournier's gangrene practitioner pool, 1160 versus 577, respectively. Among those with Fournier's gangrene post-vasectomy, all of them were managed with antibiotics and surgical debridement of which 60% (3) did not require ICU stay, 60%(3) had either temporary or permanent disability with only 20%(1) with complete resolution.

Conclusions
Globally, multiple specialties perform vasectomies. Fournier's gangrene is a rare yet debilitating complication that can result uncommonly after a vasectomy. The likelihood of encountering a Fournier's gangrene complication is positively associated with the number of vasectomies performed by a practitioner.

Disclosure
No
194 Environmental Toxicants and Male Sexual Dysfunctions
Authors: Ferry K. , Alzweri L. , Burnett A. 
Published: April 2022

ABSTRACT

Introduction
Understanding how substances in the environment impact sexual function is a broad and ever-expanding field. While some toxicants are well understood to disrupt the male sexual response cycle or impact the ejaculation pathway, other are just being understood.

Objective
We reviewed current articles detailing how heavy metals, industrial chemicals, pesticides, lifestyle and behaviors, climate, and radiation affect the male sexual function and the suspected mechanisms these toxicants have as sexual function disruptors.

Methods
We used SCOPUS and PubMed to review literature from 2016-2020 pertaining to the topics of environmental toxicants including those relating to heavy metals, industrial chemicals, pesticides, life style and behavioral exposures, climate, and radiation. Studies were also included if the paper included research on the toxicant specified and the authors hypothesized on the pathophysiological effect the toxin had on the male sexual response cycle. Studies were also included if the research demonstrated that the toxicant was shown to have no impact on male sexual health or a mixed conclusion.

Results
A total of 109 papers were collected and 79 were analyzed in this review. While every one of these categories had articles that were inconclusive or did not find that the toxicants had a significant effect on male sexual function, the majority of studies showed that heavy metals, industrial chemicals, pesticides, and climate had a positive correlation between male sexual dysfunction and exposure to these toxicants. Lifestyle and behaviors showed a positive correlation, but the studies done on bicycling and diet were not as numerous as in the other categories. Radiation was the only category that did not have a definitive answer for whether it causes male sexual dysfunction or not. Our study identified that heavy metals, industrial chemicals, and pesticides effected the hormones involved in sexual function and decreased the quality of sperm in those studied. Sperm quality was also decreased in those exposed to climate and radiation. Impairment and injury to sexual organs caused by the toxicants were observed in both the industrial chemical and climate category. The increased risks these toxicants impose on male sexual function is shown in table 1.

Conclusions
These results show that the field of research devoted to understanding the connection between many of these agents and male sexual function has grown in recent years, but still needs focus and attention brought to it.

Disclosure
No
208 Misrepresentation of Female Sexual Behavior in Pornography
Authors: Dubinskaya A , Dallas K , Scott V , Anger J , Eilber K 
Published: April 2022

ABSTRACT

Introduction
Female sexual wellness is a highly complex condition that builds not only on biological factors, but also on social norms, background, religion, education, and social media. One source where both women and men learn about sexual behavior, interactions, and expectations is pornography. This resource has become widely available to anyone with access to the internet. While pornography is a way of expanding sexual horizons, like any media it may misrepresent more common behaviors and expectations for both genders. The impact of pornography on male attitudes towards sex and women in general has previously been described. This not only harming males, but it also potentially has negative effects on female sexual wellness as well.

Objective
The purpose of this review is to evaluate how women's sexuality is portrayed in the most commonly viewed pornography videos in order to understand its role in female sexual health.

Methods
Videos from the category “most viewed videos” based on internet ratings were viewed. We analyzed the content and female and male sexual behaviors.

Results
We reviewed the 25 most viewed videos by the general public from the five most popular free pornography websites. The two most commonly viewed contexts were sexual encounters between step relatives (16%) and during casting sessions (16%). With the majority of videos having two participants (92%), two videos included three and five participants. Overall, only 9 (36%) videos demonstrated at least one female orgasm with 5 (20 %) videos showing clitoral stimulation before reaching orgasm. Only 4 (16%) videos did not demonstrate male orgasm. Similarly, only 8 (32%) videos pictured a female as the recipient of oral sex, whereas all but 3 (12%) videos showed the male as the recipient. Only in one (4%) video did a woman have more than one orgasm. Anal sex was represented in 4 (16%) of videos, with novelty toy uses in one (4%) video.

Conclusions
The most viewed videos on popular pornography sites did not represent the most common sexual scenarios as these were between step relatives and during casting sessions. Pornography demonstrates preference for male-centered pleasure. Although the majority of women climax with clitoral stimulation, this was not represented by popular pornography sites. Inaccurate portrayal of female sexuality can contribute to sexual performance anxiety, unfulfilled expectations among both partners, and sexual dysfunction. More research is needed to determine the best referral websites representing more realistic female sexual behavior.

Disclosure
No
209 Hormonal Imbalances Association to Persistent Genital Arousal Disorder in Females
Authors: Tannenbaum J , Greenberg J , Raheem O , Hellstrom W 
Published: April 2022

ABSTRACT

Introduction
The etiology of the uncommon presentation of persistent genital arousal disorder (PGAD) can provide an insight into the hormonal imbalances that effect sexual function and dysfunction in females. We examine, review, and analyze the correlation of the known cases of PGAD that involved hormonal imbalances with a focus on hormone imbalances (HI) from a urological perspective.

Objective
To review the literature regarding hormonal imbalances in females with PGAD with a focus on HI.

Methods
A literature review of articles and clinical studies was performed to define the diagnosis, etiology, and treatment outcomes of PGAD. Search terms included hormone imbalances and/or, persistent genital arousal disorder, diagnosis of persistent genital arousal disorder, defining persistent genital arousal disorder, as well as treatment of persistent genital arousal disorder.

Results
We found the of onset of PGAD on average was 49.2± 13.1 years with the average length of symptoms 4.7± 11.2 years. The common etiology of cases presented as hormonal imbalances with most individuals experiencing this as their only etiology. Overall, individuals who underwent treatment had a 72.2% rate of symptoms being resolved. The treatments administered involved pharmacological, clinical intervention, diet modification, and hypnotherapy. Clinical intervention was used the less than pharmacological treatment but was more successful.

Conclusions
There was a high frequency of PGAD presentation and treatment involving dopamine medications such as selective serotonin receptor inhibitors (SSRI). When evaluating for this rare disease it is important to keep in consideration the effect of hormone imbalances. Further studies are needed to get a more thorough understanding of the effects of dopamine may have on sexual dysfunction disorders such as PGAD.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast and Boston Scientific
210 A Review of Sexual Function Following Genital Burns: An Understudied, Morbid, and Rare Condition
Authors: Ferry K , Alzweri L 
Published: April 2022

ABSTRACT

Introduction
Genital burns are rare but devastating injury that can impart long term physical and emotional distress to patients. Most victims of genital burns are male patients while the highest prevalence occurs during 0-12 years of age. While the techniques to either conservatively or surgically repair genital burns have been detailed, to our knowledge there have not been a retrospective review following up on the sexual function of these patients after their reconstruction.

Objective
We aim to call attention to articles that analyze sexual function after genital burns and identify the lack of research in this subject.

Methods
We conducted a retrospective analysis by searching through PubMed for key words including “Genital burns, male female, genital, burns” and excluding the word “burning” as it commonly describes a symptom rather than the injury. We selected papers that described techniques for how they treated genital burns regardless of whether they followed the sexual function of the patient after treatment. We found 31 papers that fit our criteria with many of the papers focusing on surgical intervention. These 31 papers were analyzed and categorized on whether they analyzed sexual function. For the purpose of this review, sexual function was divided into the broad categories of aesthetic, function, sensation, psychological, and reproduction.

Results
Of the 31 papers reviewed, there were 8 studies that assessed aesthetic satisfaction, 7 that assessed function, 9 that assessed sensation, 1 that assess psychological impact, 3 that assess reproduction capabilities, and 13 studies did not address any of these categories in their findings (table 1). Papers that studied surgical interventions for genital burns in any capacity were more likely to also study sexual function as opposed to studies that focused on conservative management. Some gaps in the literature that we noted were that while the papers acutely followed up in sexual function, we could find no incidence of a long-term retrospective review on sexual function after repair.

Conclusions
Given that many of the patients suffering from genital burns are children, it is difficult to adequately understand the long-lasting effects some of these treatments have as they mature. While it would be difficult to follow up with these patients, it is important to understand the best treatment option for patients with genital burns.

Disclosure
No
246 Effect of Prescription Drug Monitoring Programs on Testosterone Prescriptions
Authors: Mulloy E , Eisenberg M , Li S 
Published: April 2022

ABSTRACT

Introduction
Symptoms of testosterone deficiency are increasingly prevalent in the aging male population. Oftentimes, this is managed medically with exogenous testosterone supplementation. Pharmacologic testosterone is classified as a schedule III controlled substance by the Food and Drug Administration. In recent years, many states have implemented prescription drug monitoring programs (PDMP) to help track the prescribing and dispensing of controlled substances in an effort to curb the opioid epidemic. Many states also require a provider query of an online system prior to prescribing controlled medications, which has led to a reduction in opioid prescriptions.

Objectives
We sought to determine if the implementation of a state mandated query of PDMP prior to prescribing testosterone impacted provider prescribing behavior.

Methods
State PDMP requirements were determined by examining state regulatory websites. Only states who had recently implemented PDMP query mandates (since 2016) for testosterone were included. Using an insurance claims database, we evaluated all men aged 40-70 in each state who were enrolled for at least 1 year and did not move to another state during follow up. From this, a sub-cohort of men who enrolled within 3 and 6 months before and after the start date of their respective state's mandate in attempt to identify any immediate effect. Men were also stratified by race/ethnicity (White, Black, Hispanic, Asian) to observe any demographic trend. In a similar fashion, the total number of men who ever or never filled prescriptions for testosterone were identified. Rates before and after mandate implementation were compared using the generalized estimating equations test.

Results
11 states (AK, CA, FL, HI, MI, NM, NV, PA, SC, WI, WY) were identified has having recent PDMP mandates for testosterone. A total of 2,297,290 men who met enrollment criteria were identified. Rates of testosterone prescriptions varied around the country (from 5.02 to 32.80 per 1000 person years). Moreover, there were no consistent changes in the rates of testosterone prescriptions after mandate implementation, regardless of the timeframe evaluated. Testosterone prescriptions increased in a majority of the states after implementation of a PDMP mandate (6 of 11 states, p&lt;0.05) or showed no change (3 states). South Carolina and Wisconsin showed a decrease in the number of prescriptions after mandate implementation (p&lt;0.05). While differences in the rates of testosterone prescriptions existed between races, the association with PDMP mandates were similar to the statewide analyses.

Conclusion
The implementation of state mandated PDMP query prior to prescribing testosterone does not appear to have a reliable effect on testosterone prescription patterns. Men with symptomatic hypogonadism do not appear to be negatively affected by new regulatory controls largely meant to curb opioid prescriptions.

Disclosure
No
104 Reporting of Level 1 Evidence in Peyronie's Disease Publications- A Systematic Review
Authors: Bole R , Gottlich HC , Ziegelmann M , Mulhall J , Corrigan D , Levine L , Bajic P 
Published: April 2022

ABSTRACT

Introduction
Despite an increasing number of publications on Peyronie's disease (PD), evidence-based clinical decision making remains challenging due to the small number of well-designed clinical trials. The quality of available PD literature has not been assessed to date.

Objective
We sought to evaluate the quality of the methodology and reporting of systematic reviews and meta-analyses in PD literature

Methods
Study protocol registration was performed on the Open Science Framework platform. In January 2021, a systematic electronic search of the Medline/PubMed, Embase, Ovid, Scopus, Joanne Briggs Institute and Cochrane databases was performed. Search terms included “Peyronie's disease” and “systematic review OR meta-analysis OR meta analysis”. Eligibility criteria were relevance to Peyronie's disease and specification of “systematic review” or “meta-analysis” in the title or abstract. A database was created to summarize the relevant methodological and reporting criteria for each article. The outcomes included review type, authorship, journal, publication date, “A MeaSurement Tool to Assess systematic Reviews” (AMSTAR-2) score and “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” (PRISMA) score. Risk of bias was assessed using the ROBIS tool. Data were tabulated and reported as means with standard deviation, median with interquartile range (IQR) and t-testing as appropriate. Strength of association between variables was calculated using the Pearson correlation coefficient. Statistical analyses were performed on RStudio (version 1.4.1106).

Results
From 1974 to 2021, 340 articles were identified. After review 23 full length articles were included. Seventeen were systematic reviews, 4 meta-analyses and 2 were combined. Twenty-one (87.5%) articles were published after the year 2009 when the PRISMA guidelines were published. There was median 53.8% (IQR 38.2%) adherence to AMSTAR-2 criteria and 66.7% (IQR 38.9%) adherence to PRISMA criteria. The overall AMSTAR confidence rating was Critically Low in 15/23 studies, indicating more than one critical flaw. Correlation analysis revealed very high positive association between AMSTAR 2 and PRISMA adherence (+0.97). ROBIS revealed “High” concern regarding methods used to collect data and appraise 17/23 studies (73.9%), and “High” concern regarding synthesis and findings in 14/23 studies (60.9%).

Conclusions
Transparent reporting of methodology and findings in SRs and MAs is crucial to maintaining research integrity and allowing for accurate interpretation of results. Despite an increasing number of publications in PD, many of these studies fail to meet accepted methodological criteria for reporting. More high quality randomized controlled trials in PD are necessary; while systematic reviews and meta-analyses should focus on these high-quality studies with uniform use of accepted reporting guidelines.

Disclosure
No
119 Current Practices in High and Low Volume Centers Regarding Corporotomy Localization During Penoscrotal Inflatable Penile Implant Surgery
Authors: Barnard J , van Renterghem K , Jacobs B , Yafi FA , Barnard J , Osmonov D , Ralph D , Venturino L , Ziegelmann M , Wang R , Kannady C , Lentz A , Garcia EL , Adrianne R , Bettochi C , Hatzichristodoulou G , Gross M , Faix A , Otero JR , Martinez-Salamanca JI 
Published: April 2022

ABSTRACT

Introduction
Literature concerning corporotomy location in multi-component inflatable penile prosthetic surgery via a penoscrotal approach is scarce if not non-existent. However, corporotomy location represents an important issue that may influence immediate and long-term outcomes regarding patient and partner satisfaction as well as device durability.

Objective
To report practices in low- and high-volume penile implant centers regarding corporotomy location.

Methods
Data from 18 (13 European and 5 American) implant centers were collected retrospectively between September 1st, 2018 and August 31st, 2019. Variables included: intraoperative proximal and distal corpus cavernosum length measurement, total corporal length measurement, total penile implant cylinder length, and length of rear tip extenders. Additionally, patient characteristics, indication for penile implant, operative time, type of implant utilized, reservoir characteristics and short term complications were reported.

Results
809 virgin penile implant cases were included in the analysis. Mean age of participants was 61.5 +/- 9.6 years old. In total, 299 AMS 700TM (Boston Scientific) and 510 Coloplast Titan® devices were implanted. The mean proximal/distal corporal measurement ratio during corporotomy was 0.93 +/- 0.29. A statistically significant correlation between lower proximal /distal measurement ratio and higher age (p=0.0013), lower BMI (p&lt;0.0001), use of rear tip extenders (RTE) (p=0.04), lower RTE length (p&lt;0.0001) and absence of diabetes (p=0.0004) was reported. In a 3-month follow up period 49 complications and 37 revision procedures were reported.

Conclusions
This is the first study reporting and evaluating the current practices regarding corporotomy location during IPP placement in a multicenter cohort, particularly when including such a high number of patients. Nevertheless, the retrospective design limits the study outcomes. Even in experienced hands proximal length measurement in relation to distal length measurement in penoscrotal IPP surgery is in many cases sub-optimal, particularly when the tubing-cylinder connection of each device is taken into account.

Disclosure
No