bluuebunny/crossref_metadata_2025_split huggingface dataset:
259 Anathema: Promoting Sexual Health and Sexual Well-Being in Patients with Colorectal Cancer
Authors: Quinta Gomes AL , Pereira R , Vasconcelos PA , Carneiro B , Nobre PJ 
Published: May 2022

ABSTRACT

Introduction
Sexual health is an important dimension of global health and is strongly related to physical and psychological health, as well as to people's perception of general well-being and quality of life. However, sexual health and sexual well-being in patients with colorectal cancer still lack a systematic and strategic management in the survival of these patients. Specialized and accessible care is of utmost importance to meet patients’ specific needs regarding sexuality and sexual health.

Objective
This presentation will focus on “Anathema: Technology for ageless sexual health”, an European project aimed to develop and implement an e-Health sexual health promotion program based on scientific evidence and designed to meet the specific needs of patients with colorectal cancer.

Methods
The project comprises different phases and its execution is based on a multimodal and participatory approach.

Results
By adopting a participatory design and a multimodal approach in the different phases of the project, Anathema is a very promising therapeutic intervention tool for promoting sexual health and to address unmet sexual needs of colorectal cancer survivors.

Conclusions
This project will make a significant contribution in addressing the sexual health and quality of life of patients with colorectal cancer.

Disclosure
Work supported by industry: no.
275 Correlation Between Libido and Testosterone: Estradiol Ratio in Men with Sexual Dysfunction
Authors: Pedrenho Neto R , dos Santos Sobreira Nunes R , C G Nascimento B. , Machado Barbosa Neto C , de Bessa Junior J , Srougi M , Carlos Nahas W 
Published: May 2022

ABSTRACT

Introduction
Sexual desire drives men to seek sexual activity, positively impacting cognitive function, emotional affective state and affecting the quality of life. This dynamic process is impacted by several factors including the cognitive, neurophysiological and affective spheres. Hormonal balance is also one of the known factors affecting libido. Our aim was to evaluate correlation between libido reduction and hormonal profile (HP), including the Testosterone(T):Estradiol(E) ratio.

Methods
Retrospective analysis of medical records of sexual medicine consultations in a tertiary care center. Patients were systematically questioned if they perceived their libido decreased using the following question (“Do you believe your libido or sexual desire has decreased in the last few months?”), and all had morning HP checked (Total and free testosterone, SHBG, E2, LH, FSH). HP was categorized into the following groups: Low T (T&lt;300ng/dl) and Normal T (T≥300ng/dl); normal T:E ratio &gt; 100 and Low T:E ratio &lt;100. All patients with hyperprolactinemia (&gt;35ng/dl) were excluded. Comparison of HP between men who referred decreased libido and those who did not was performed, and the relationship between the different parameters and sexual desire were studied by univariate and multivariate analysis.

Results
A total of 194 patients were evaluated, with a mean age of 61 ± 21 y. 188 (97%) reported being heterosexual and 154 (79%) had a steady partner. From this sample, 24% had low T levels. The percentage of patients referring decreased libido was 32.5%. In the Low T group, 67,5% reported decrease of Libido (OR 2,4; 95% IC: 1,2-4,8; p=0,01) and 67% of the Low T:E ratio group reported decrease of Libido (OR 3,7; 95% IC: 1,6-8,2; p=0,001). In multivariate analysis, after adjusting for age, we found the T:E ratio was associated with decreased of libido irrespective of T status.

Conclusion
In our sample of men seeking treatment for sexual dysfunction, low T and low T:E ratio was significantly correlated with perceived decreased libido. Recognizing the imbalance of T:E ratio can help clinicians to identify men with low sexual desire and their best management. Further studies are necessary to confirm this data and understand how treatment affects those parameters.

Disclosure
Work supported by industry: no.
005 Assessment of Combination Therapies Versus Phosphodiesterase Type 5 Inhibitor Monotherapy for Erectile Dysfunction: A Systematic Review and Meta-Analysis
Authors: Mykoniatis I. , Pyrgidis N. , Sokolakis I. , Ouranidis A. , Sountoulides P. , Haidich A. , Van Renterghem K. , Hatzichristodoulou G. , Hatzichristou D. 
Published: May 2022

ABSTRACT

Introduction
Combining two first-line treatments for erectile dysfunction (ED) or initiating other effective modalities on top of phosphodiesterase type 5 inhibitors (PDE5i) may produce beneficial outcomes.

Objective
To assess the efficacy and safety of different combination therapies with PDE5i compared to PDE5i monotherapy in various subgroups of patients with ED through a systematic review and meta-analysis.

Methods
We considered randomized trials on males with ED that assessed the effect of combination therapy versus PDE5i monotherapy with validated questionnaires. Studies were identified by searching Medline, Cochrane Library and Scopus databases We undertook a meta-analysis for the mean international index of erectile function (IIEF) change, and for the number of adverse events (AEs) based on different treatment modalities and subgroups of patients.

Results
We included 3,853 individuals (44 trials). Combination therapy with PDE5i, compared to PDE5i monotherapy, was associated with a mean IIEF improvement of 1.92 points (95% CI: 1.41 to 2.44, I2=82%). Adding to PDE5i: daily tadalafil, low-intensity shockwave therapy, vacuum erectile device or antioxidants resulted in a significant IIEF improvement. The latter was not observed with a-blockers. Compared to monotherapy, combination treatment improved IIEF in patients with hypogonadism, monotherapy-resistant or prostatectomy-induced ED. The treatment-related AEs did not differ between combination treatment with PDE5i and PDE5i monotherapy (OR:1.10, 95% CI: 0.66 to 1.85, I2=78%). Still, despite multiple subgroup and sensitivity analyses, the levels of heterogeneity for all outcomes remained high.

Conclusions
Combination therapy with PDE5i and antioxidants improves ED without increasing the AEs, while treatment with PDE5i and daily tadalafil, shockwaves or vacuum device seems effective, but data are scarce. Combination treatment should be initially preferred in patients with hypogonadism or prostatectomy-induced ED. Conversely, the addition of a-blockers to PDE5i does not provide additional efficacy in patients with urinary symptoms. Overall, combination therapy with PDE5i is safe and effective and should be considered as first-line treatment for refractory or difficult-to-treat cases of ED.

Disclosure
Work supported by industry: no.
038 Differences in the Gut Microbiome Composition Between Men with Peyronie's Disease and a Matched Cohort: A Pilot Study
Authors: Osman M.M. , El-Khatib F.M. , Dianatnejad S. , Nguyen J. , Choi E. , Towe M. , Yafi F.A. 
Published: May 2022

ABSTRACT

Introduction
There have been no studies to-date that have attempted to establish an association between the gut microbiome (GM) and Peyronie's disease (PD). There are numerous inflammatory diseases that are associated with both the GM and PD, making an association between the two highly likely.

Objective
To analyze stool samples from patients with PD and compare them to matched controls for differences in their GM.

Methods
We collected stool samples from 27 patients with PD and 41 control. All samples were processed by a third-party company, Viome Inc. The samples were analyzed by metatranscriptome sequencing which allows for data to show both the taxonomy of the microbiome and its KEGG orthology (KO). KO is defined as the current molecular functions and pathways that are occurring in the GM. We compared richness and prevalence of the taxa and KOs between the PD and control groups.

Results
1,477 taxa and 4,762 KOs were detected in the 68 samples. The Mann-Whitney non-parametric test showed that the richness of both the taxa and KOs were non-significantly higher in the control samples (p=0.1168 and p=0.1672), respectively. One taxon, Massilioclostridium coli, was found to be significantly higher in the control group (adjusted Benjamini-Hochberg p-value=0.044). There were, however, no significant differences in prevalence of KOs between the two groups.

Conclusions
This is the first study to look at associations between the GM and PD. We found a non-significant higher richness for both taxa and KOs in the control group. One taxon, Massilioclostridium coli, was present in significantly higher proportion in the control group (p=0.044). The clinical relevance of this finding is yet to be elucidated.

Disclosure
Work supported by industry: yes, by Viome Inc.. A consultant, employee (part time or full time) or shareholder is among the authors (Antares. Clarus. Coloplast. Promescent.).
046 A Novel Artificial Conduit for Peripheral Nerve Regeneration Rescues Erectile Function after Cavernous Nerve Injury
Authors: Kobayashi K. , Takayanagi A. , Hashimoto K. , Tanaka T. , Masumori N. 
Published: May 2022

ABSTRACT

Introduction
Postoperative erectile dysfunction after radical prostatectomy can occur due to surgical injury of the cavernous nerves, which can adversely affect quality of life.

Objective
We evaluated the treatment effects of a novel artificial conduit for peripheral nerve regeneration (Nerbridge), which is commercially available, on erectile dysfunction in a cavernous nerve injury model.

Methods
Male Sprague-Dawley rats were used this study. The rat cavernous nerve was resected bilaterally. We interposed a nerve gap with the artificial conduit as a treatment group. After resecting the rat cavernous nerve, we did not do any treatment in an untreated group. Sham-operated rats were used as a control group. We measured the intracavernous pressure (ICP) and arterial pressure (AP) at 8 weeks after surgery in these 3 groups.

Results
In the untreated group, ICP/AP was significantly decreased compared to that in the control group (mean ICP/AP: 0.138 vs. 0.566, respectively; p&lt;0.05). On the other hand, ICP/AP in the treated group (mean: 0.284) was not significantly decreased compared to that in the control group.

Conclusions
The commercially available artificial conduit may prevent the decrease in erectile function after cavernous nerve injury.

Disclosure
Work supported by industry: no.
051 Redo Surgery Improves Sexual Function in Patients with Sequelae of Failed Hypospadias Repair
Authors: Gamidov S. , Shatylko T. , Gasanov N. , Dusmukhamedov R. , Mammaev R. 
Published: May 2022

ABSTRACT

Introduction
Despite major improvements in management of congenital abnormalities of male external genitalia, non-pediatric urologists still encounter late complications of failed hypospadias repair. Such patients represent a complex group burdened with lower urinary tract symptoms, subfertility and sexual dysfunction. Psychological problems related to appearance of external genitalia are also common. It is currently unknown whether redo surgery improves sexual well-being in adults with sequelae of failed hypospadias repair.

Objective
To evaluate improvement in sexual function in patients with late complications of hypospadias repair.

Methods
We performed an analysis of symptoms related to sexual dysfunction in 112 patients with late complications of hypospadias repair who were admitted to our department for redo surgery. Average age of patients at admission was 32.1 years (min-max: 18-62). All patients consented to interview, completion of questionnaires, endocrine evaluation and penile doppler ultrasound when indicated. We compared prevalence of specific sexual symptoms before and after redo surgery using McNemar's test.

Results
Prevalence of erectile dysfunction following redo surgery decreased from 40.2% to 23.2% (p &lt; 0.0001). Prevalence of low libido decreased from 59.8% to 30.3% (p &lt; 0.0001). Asthenic ejaculation also became less frequent; initially it was present in 63.4% patients, and after surgery it was present only in 24.1% (p &lt; 0.0001). Incidence of painful ejaculation decreased from 10.7% to 0.9% (p = 0.0026). Redo surgery didn't have positive or negative impact on premature ejaculation, delayed ejaculation, anejaculation and orgasmic dysfunction.

Conclusion
Redo surgery for complications of hypospadias repair seems to positively impact libido and erectile function, probably through improvement of body image and alleviation of psychogenic factors for erectile dysfunction. However, most ejaculation-related disorders, except asthenic ejaculation and painful ejaculation, remain unaffected.

Disclosure
Work supported by industry: no.
052 Sexual Aspects of Patients after Treatment of Penile Cancer: Reports of Patients Accompanied at Urology Oncology Service of a Public Hospital
Authors: Silva I. , Naccarato A. , Denardi F. , Ferreira U. , Matheus W. 
Published: May 2022

ABSTRACT

The penile cancer is a rare neoplasia affecting mostly the lower income and scholarship socioeconomic levels. Patients with penile cancer live for several months with the symptoms before seeking a urologist. The delay of seeking medical assistance is mainly due to the fact that own recognition of having a serious disease, fear of treatment and surgery. Delayed treatment affects the severity of prognostic and quality of life of patients. For the advanced stages, penectomy is still the best available treatment.
This study aims to comprehend the meaning of the experience of patients with penile cancer who underwent partial or total penectomy.
The medical records of patients who were surgically treated due to this neoplasia were reviewed in the hospital database. After reviewing the data, the researchers contacted the patients and offered the interview with the psychology group of the Oncology Urology outpatient clinic. On the scheduled return day, patients met with the psychologist, which applied semi-structured interviews seeking the meaning of the lived experience.
After conducting the interview, the literal transcription and subsequent synthesis of what was transcribed was carried out. From the collected data, two more syntheses will be made in search of the units of meaning and then analysis of the collected speeches, seeking to understand the meaning of the lived experience. After completion of the process, the syntheses will be submitted to 2 independent psychologist colleagues for a better understanding of the described phenomena. Were interviewed 7 men who had penile cancer and underwent treatment, with total or partial penectomy. The average age among survey participants is 57,3 years. Of the interviewed patients, 4 are married, 2 are single but in a relationship, and 1 is divorced. All patients reported unfavorable sociocultural and socioeconomic aspects, lacking basic information on self-care and on who cared for them.
The research was developed considering the ethics principles of confidentiality and privacy. This study does not offer any physical or psychological risk for the participants. Prior to the interview the “Termo de Consentimento Livre e Esclarecido (TCLE)” was provided, as well as every detail of the research. It is also explained that participation is voluntary and that the participant can leave the research at any time, without causing harm to their treatment and monitoring.
The results are in a qualitative analysis. There are indications of significant themes, such as heredity, fear, faith, acceptance, care, neglect and suffering.

Disclosure
Work supported by industry: no.
057 Ceiling Effect of Clomiphene Citrate on Testosterone to Estradiol Ratio in Eugonadal Infertile Men
Authors: Liao Y. , Chang H. 
Published: May 2022

ABSTRACT

Introduction
Study has shown that the Testosterone to Estradiol ratio (T/E2 ratio) has more impact over semen quality and sexual desire than Testosterone does alone. Clomiphene Citrate is a Selective Estrogen Receptor Modulator that had long been used as an empirical option in the management of idiopathic oligozoospermia. Clomiphene may change the Hypothalamus-Pituitary-Gonad axis and result in the T/E2 ratio alteration. There were no reliable data about the T/E2 ratio change after Clomiphene use in eugonadism.

Objective
The aim of this preliminary study was to determine whether clomiphene citrate has an effect on T/E2 ratio in infertile patient with eugonadism.

Methods
This study included a total of 24 male patients who was diagnosed as idiopathic infertility with Eugonadism. They all take Clomiphene Citrate (25mg/day) as empirical treatment. Blood test including Testosterone, estradiol, prolactin, LH and FSH were done before and 4 weeks after Clomiphene use. Paired T test was used to evaluate the significance of the hormone level change.

Results
For all the patients, the T/E2 ratio did not show significantly increase after Clomiphene use. In the subgroup analysis, if the T/E2 ratio less than 0.2, clomiphene can yield a significant increase of T/E2 ratio, not vice versa.

Conclusions
In conclusion, Clomiphene citrate may significantly increase Testosterone to Estradiol Ratio in eugonadal men under the premise of its ceiling effect (T/E2 ratio &lt;0.20), providing us a possible guidance to the use of Clomiphene in this group of patients.

Disclosure
Work supported by industry: no.
061 The Study of the Effectiveness of Topical Testosterone and Estrogen for Urinary Tract Symptoms of GSM
Authors: Ninomiya N. , Sekiguchi Y. 
Published: May 2022

ABSTRACT

Introduction
Genitourinary Syndrome of Menopause (GSM) causes atrophic changes in the vulva and vagina due to a decrease in the amount of sex hormones with aging, causing unpleasant physical symptoms in the genital area. GSM symptoms are vulvar mucosa atrophy findings, vaginal dryness, lack of moisture during sexual intercourse, dyspareunia, frequent urination and urgency of urination, etc. Routine moisturizer use is recommended to prevent the progression of GSM symptoms, but the effect is insufficient from the perspective of mucosal improvement. In Europe and the United States, testosterone treatment is approved in addition to estrogen for GSM treatment, but it has not yet been approved in Japan. And its effect on GSM symptoms in Japanese women has not been investigated.

Objective
The aim of this study is to examine the efficacy and safety of topical treatment with testosterone and estrogen for GSM.

Methods
The survey was conducted from September 2019 to September 2020. Menopausal women with atrophy of the vulvar / vaginal mucosa and either urinary tract symptoms (frequent urination, urine leakage) or vaginal symptoms (vulvar pain, dryness) or sexual function symptoms (dyspareunia) was diagnosed as GSM and was included in the study. Patients with a history of surgery within 1 year and/or those with pelvic organ prolapse were excluded.An anatomical explanation of the vulva was given to the patient using a mirror during examination. Patients used topical hormone cream once daily for 1 month on the labia minora, external urethral meatus, and vestibule. The topical hormone cream contained 0.3% testosterone, 0.008% estradiol, and 0.003% ethinyl estradiol. The daily usage was 0.5 g.The effectiveness was evaluated as follows. The attending physician evaluated the vulvar moistness and the redness on a four-point scale. A Visual Analogue Scale (VAS) was used for contact pain. The Overactive bladder symptom score (OABSS) was used to assess urinary tract symptoms. All surveys were evaluated before and 1 month after use.

Results
The survey was conducted on 30 patients aged 48 to 75 years (mean 58.3 years, median 58.5 years). The vulvar moistness was significantly improved. The redness was improved in the labia minora. No major changes were observed in vestibular region. Contact pain was significantly improved. OABSS improved significantly.Itching of the vulva was observed in 10%. Abnormal bleeding was observed in 10%. Nipple discomfort was noted in 5%. All side effects were not serious.

Conclusions
Topical testosterone and estrogen are effective for GSM symptoms in Japanese women.

Disclosure
Work supported by industry: no.
063 Testosterone (T) Recovery Profiles after Short-Term Androgen Deprivation Therapy (ADT)
Authors: Martinez J. Flores , Nascimento B. , Benfante N. , Schofield E. , Mulhall J.P. 
Published: May 2022

ABSTRACT

Introduction
ADT plays a major role in several scenarios for men with prostate cancer. T recovery after ADT cessation may be incomplete with 10% of men estimated to suffer persistent castrate levels after long-term ADT.

Objective
The objective of this study was to evaluate T recovery after short courses of ADT.

Methods
Study population included men treated with ≤6 months of ADT in association with radiation therapy (RT). Early morning T levels were collected at baseline and periodically after ADT cessation. T recovery after ADT cessation was analyzed in 2 ways: improvement to non-castrate level (T ≥50 ng/dL), and recovery to normal (T ≥ 300 ng/dL). Recovery rates and median survival time were estimated using Kaplan-Meier statistics and predictors analyzed using Cox proportional hazard ratios.

Results
88 men with a mean age of 68 ± 8 years at time of ADT were analyzed. Median duration of ADT was 3.1 months; 56% had an ADT duration between 1-3 months and 44% between 4-6 months. Mean pre-ADT T level was 390 ± 158 ng/dL. After cessation of ADT, median time to non- castrate levels was 9.3 (IQR = 6.3 – 18.5) months and 15.8 (IQR = 8.3 - 33.8) ‘months for recovery to T ≥300 ng/dL. Higher baseline T levels (T &gt; 400 ng/dL) was associated with a faster recovery to normal T level (HR = 1.80, 95% CI = 1.09 – 2.95), but not to non-castrate level. Neither age &gt; 65 years, prevalent diabetes, nor ADT duration of 4-6 months vs ≤ 3 months were significantly associated with a slower T recovery.

Conclusions
Most of our patients remained with low T levels one year after the cessation of ADT. Higher baseline T was associated with faster T recovery to normal (T ≥ 300 ng/dL).

Disclosure
Work supported by industry: no.
Dark patterns in online shopping: do they work and can nudges help mitigate impulse buying?
Authors: Sin Ray , Harris Ted , Nilsson Simon , Beck Talia 
Published: May 2022

AbstractDark patterns – design interfaces or features that subtly manipulate people in making suboptimal decisions – are ubiquitous especially in e-commerce websites. Yet, there is little research on the effectiveness of dark patterns, and even lesser studies on testing interventions that can help mitigate their influence on consumers. To that end, we conducted two experiments. The first experiment tests the effectiveness of different dark patterns within a hypothetical single product online shopping context. Results show that, indeed, dark patterns increase the purchase impulsivity across all dark patterns, relative to the control. The second experiment tests the effectiveness of three behaviorally informed interventions on four different dark patterns also in a hypothetical online shopping scenario, but this time offering multiple products instead of a single product. Between-subject analysis shows that not all interventions are equally effective, with uneven impact across dark patterns. However, within-subject results indicate that all interventions significantly reduce purchase impulsivity pre- versus post-intervention, indicating that any intervention is better than none when it comes to combating dark patterns. We then end by discussing the policy implications of our results.