bluuebunny/crossref_metadata_2025_split huggingface dataset:
127 Effects of Testosterone Ointment in Japanese Men with Metabolic Syndrome
Authors: Ueshiba H 
Published: May 2022

ABSTRACT

The metabolic syndrome involves a cluster of clinical features including visceral obesity, insulin resistance, hypertension, glucose intolerance, and dyslipidemia. Recent studies have shown that low testosterone levels are significantly associated with metabolic syndrome and type 2 diabetes.
We examined the change in insulin resistance after testosterone treatment in 23 Japanese men with metabolic syndrome and low free testosterone levels. Testosterone supplements were administered by testosterone ointment (Glowmin,Daito Pharmaceutrical, Tokyo, Japan) for 3 to 6 months. Glowmin contains 10mg of testosterone per 1g of matrix. A 2-cm line of Glowmin was applied to the submandibular skin and contained a dosage of 3mg of testosterone and this was given twice a day in the morning and evening.
Fasting plasma glucose (FPG), fasting serum insulin (F-IRI), HbA1c, total cholesterol(TCHO), triglyceride(TG), HDL-C, LDL-C, free testosterone, LH, FSH, BMI and waist circumference were measured. We used homeostasis model assessment (HOMA-R) as an index of insulin resistance and investigated the change in insulin resistance and lipid profiles after testosterone treatment.
After treatment, F-IRI, HOMA-R, TCHO and LDL-C were significantly decreased from 17.3±6.2μIU/ml to 11.9±4.0μIU/ml, 4.70±1.86 to 3.09±1.20, 252±23mg/dl to 216±19mg/dl and 175±25mg/dl to 139±22mg/dl, respectively. Free testosterone was significantly increased from 5.7±1.0pg/ml to 9.1±1.4pg/ml. Other parameters were not changed significantly.
In conclusion, these results suggest that testosterone replacement therapy by testosterone ointment improves insulin resistance in Japanese men with metabolic syndrome and low free testosterone levels.

Disclosure
Work supported by industry: no.
135 A Case of Late-Onset Hypogonadism Syndrome with Rapidly Elevated Prostate Specific Antigen
Authors: Ichikawa T , Kusumi N , Tsushima T , Shiraishi H , Watari S , Sakuma T , Kubota R 
Published: May 2022

ABSTRACT

Introduction
Cases of developing prostate cancer during hormone therapy for late-onset hypogonadism syndrome are rare.

Objective
We report a case of prostate cancer that developed and died during hormone therapy for late-onset hypogonadism syndrome.

Case
A 63-year-old man was diagnosed with depression around 2010. In 2011, he visited a private urologic clinic with complaints of depression and decreased libido, and was started on androgen replacement therapy (ART) with a diagnosis of late-onset hypogonadism (LOH) syndrome. His PSA was 0.87 ng/mL in 2012, but was 3.335 ng/mL at the time of his 2017 municipal checkup. He continued to receive hormone injections every 1-2 months, but his PSA was not retested. In August 2018, he had difficulty in urination and visited his local physician, who referred him to our hospital because of a markedly elevated PSA of 213.3 ng/mL. Prostate biopsy showed adenocarcinoma, Gleason score 5+4, and CT scan showed supraclavicular, mediastinal, and retroperitoneal lymph node metastases. He underwent maximal androgen blockade therapy with castration and bicalutamide. He died after PSA failure despite chemotherapy and other treatments.

Conclusions
There is no evidence that ART, which is the main treatment for LOH syndrome, directly causes prostate cancer. In this case, a rapid increase in PSA was observed during ART treatment, which may indicate that the treatment caused latent prostate cancer to become apparent, resulting in a rapid increase in PSA. However, in this case, the detection of prostate cancer might have been delayed because PSA levels, which were required during ART treatment, were not measured regularly. In addition, the psychiatric symptoms of LOH syndrome are similar to those of depression, and it is difficult to differentiate them. When there is a history of depression, as in this case, a more careful diagnosis and treatment strategy are required.

Disclosure
Work supported by industry: no.
164 Platelet Rich Plasma as a Treatment for Erectile Dysfunction
Authors: Alkhayal S. 
Published: May 2022

ABSTRACT

Introduction
Platelet Rich Plasma (PRP) has been recently explored as a treatment for erectile dysfunction (ED). Nevertheless, standardization of technique and data on efficacy and applicability remains uncertain.

Objective
We hereby report our experience using PRP to treat erectile dysfunction in 1061 patients, over the last 6 years.

Methods
10 ml of concentrated and activated TRU PRP using a special platelet separator was administered into the glans and penile corpora cavernosa of men with various grades of organic ED. Patients with neurogenic or psychogenic causes were excluded from the study with the aid of Duplex Doppler study. International Index of erectile function (IIEF5) questionnaire were collected before and at least 4 weeks after the procedure along with GAQ (improvement of erectile function) and SEP-3 questionnaire (achievement of satisfactory intercourse).

Results
Complete data could be obtained on 204 patients with an average age of 41.8 years (21-80) median of 40y. The mean follow up was 12 weeks (4-115) median of 6 weeks. 80% (164 patients) reported Improvement of erectile function on the GAQ. The IIEF5 increased in 77.5% (158 patients) with an average of 4.8 points (1-15) median of 4, P=&lt;0.001. 82% (130) of the improved patients achieved satisfactory intercourse according to SEP 3 questionnaire. There was no statistically significant difference with regards to Pre-treatment IIEF5, age, or comorbidities between the improved and non-improved patients. There was also no correlation between grade of Erectile dysfunction and points of improvement in IIEF5. No adverse events were reported by any patient.

Conclusions
TRU PRP Injections seem to be a safe and effective treatment modality to improve erectile function in patients with mild to severe ED. Further studies to check if additional /multiple treatments would be required to achieve better results.

Disclosure
Work supported by industry: no.
165 Pre- and Post-Injection Pain in Patients Undergoing First Intracavernosal Injection
Authors: Baird B. , Broderick G. 
Published: May 2022

ABSTRACT

Introduction
Intracavernosal injections (ICI) are a well-established treatment option with great success rates for men with erectile dysfunction. Unfortunately, the anticipation of pain with injections remains a significant barrier to the use of ICI.

Objective
This study aims to utilize a standardized verbal pain scale to examine the perception of pre- and post-injection pain in men who are undergoing their first injection with an intracavernosal erectile agent. Thus, inclusion criteria required no previous penile injection of any type, including but not limited to erectile medications and collagenase.

Methods
We determined a prospective pre-post observational study would be best to examine men undergoing their first ICI. Men who had no previous history of intracavernosal injection of any kind were asked to predict the pain associated with their first ICI with a score of zero to ten. Patients then received a 10 microgram (mcg) injection of prostaglandin E1 (PGE1). Immediately after they received their injection, they were asked to rate the pain they perceived with the injection on the same scale (0-10). The same physician administered pre- and post-injection scales in a standardized fashion.

Results
A total of 17 of men were asked to rate their pain as discussed in the Methods Section. The average age of men sampled was 61.8 years of age. On review of history, 64.7% of men were found to have used some type of PDE-5 inhibitor before visiting our clinic. The majority of men we saw had erectile dysfunction (70.6%) and/or Peyronie's Disease (58.8%). The average pre-injection prediction pain score was 5.29 +/- 1.90; the average post-injection perceived pain score was 1.21 +/- 0.81. Thus, there was an average decrease of over 4 points in predicted pain versus perceived pain. A two-sample t-test was performed; in addition, a Wilcoxson Signed Rank Test was performed. Both tests showed statistical significance in the difference between pre- and post-injection pain scores (p &lt;0.001).

Conclusions
We found that patients who are undergoing ICI for their first time have a significantly higher prediction of pain versus perception of pain after the injection. We have utilized this data in our clinic to explain to patients that while the majority of patients predict high pain scores associated with injection, the vast majority of patients report very minimal pain associated with the injection. Patients can be more open-minded to ICI therapy which could help aid them with their erectile status; this can particularly be helpful in patients who want to avoid surgery and in patients who are not good surgical candidates.

Disclosure
Work supported by industry: no, by N/A.
166 Combined Intracavernous Injection of Prostaglandin E1 and a Phosphodiesterase Type 5 Inhibitors in 5 Cases after Non-Nerve Sparing Radical Prostatectomy
Authors: Sawada N. , Aikawa J. , MItsui T. , Takeda M. 
Published: May 2022

ABSTRACT

Introduction and Objectives
Erectile dysfunction (ED) usually occurs in the surgical treatment of prostate cancer (PC). Since many patients are reluctant to discuss ED when facing PC treatment, some patients choose non-nerve sparing radical prostatectomy and later seek for ED treatment. We had 5 cases of patients who were treated with combination therapy of intracavernous injection (ICI) therapy of prostaglandin E1 (PGE1) and PDE5 inhibitors for ED after non-nerve sparing RP and retrospectively investigated the effectiveness of the combination therapy.

Material and Methods
The mean age when the patients had RP was 65.4 years. Following the 2016 National Comprehensive Cancer Network (NCCN) risk classification guidelines, 2 patients had high risk, and 3 had intermediate risk. The mean period up to the introduction of ICI from the date of RP was 40.2 months (12-120 months). All patients were given PDE5 inhibitors 3-4 weeks prior to ICI therapy. Erection was evaluated by the induction of ICI of 20 μg of prostaglandin E1 (PGE1), using Erection Hardness Score of 1 to 4; a score of 3 or 4 was classified as successful. Self-injection regimen was introduced by the physicians after the evaluation, and a total of 5 patients were tested.

Results
The response was Grade 1 in 1 patient, Grade 3 in 3 cases, Grade 4 in 1 case. The effectiveness rate was 80%. Penile self-injection therapy was adopted by 4 patients, and IIEF-5 and SHIM score improved from 5.3 to 17.5 and 4.3 to 14.8, respectively. No drug adverse effect was observed in the 4 cases.

Conclusions
Combination of ICI therapy and PDE5 inhibitors can be a candidate for ED patients who unluckily chose non-nerve sparing radical prostatectomy when treated prostate carcinoma.

Disclosure
Work supported by industry: no.
170 Low Intensity Extracorporeal Shockwave Therapy Improved the Resistance Index of Cavernosal Artery in Venous Occlusive Erectile Dysfunction
Authors: Chang H. , Chung T. , Chang I. , Chiang I. , Liu S. 
Published: May 2022

ABSTRACT

Introduction
Veno-occlusive dysfunction has become a recognized cause of organic impotence. No effective management can improve venous occlusion. Although Low intensity extracorporeal shockwave therapy (LiESWT) has been an effective treatment for arteriogenic erectile dysfunction (ED) for years, we still did not know the effects for venous occlusive function.

Objective
This study aimed to measure the change of resistance index of cavernosal artery in patients with venous occlusive ED after LiESWT.

Methods
Totally 65 patients with ED were enrolled in our study. LiESWT with one treatment session per week for six consecutive weeks were introduced to our patients and then we recorded patient's resistance index (RI) before and after the LiESWT with penile doppler ultrasound.

Results
The RI (Mean±SEM) did not increase significantly after LiESWT (0.85±0.01 vs 0.86±0.01, p=0.395). However, those patients with pre-LiESWT RI lower than 0.85 who were more likely to have veno-occlusive ED showed significant increase of RI after the LiESWT in comparison to those with pre LiESWT RI higher than 0.85 (% Change of RI after LiESWT: 4.34±1.47 vs before LiESWT: -0.89±0.99, p&lt;0.05).

Conclusions
Most of the previous studies focus the effect of LiESWT on PSV and erectile function score which was thought to be the major parameter of erectile function especially in arteriogenic ED. However, RI as an important parameter which indicated the venous leakage problem in ED also improved after the LiESWT in people with low RI. Our result shows the potential of LiESWT in repairing the tissue and decreasing the venous leakage in patients with venous occlusive ED.

Disclosure
Work supported by industry: no.
176 Is Immediate Preoperative Blood Glucose or Hemoglobin A1c a Risk Factor for Infection Following Penile Prosthesis Placement? A Systematic Review of Literature
Authors: Huynh L. , Huang E. , Choi E. , Yafi F. 
Published: May 2022

ABSTRACT

Introduction
Diabetes mellitus is historically associated with increased risk of surgical site infection, but its role in increasing infection following penile prosthesis implantation is controversial.

Objective
The present systematic review seeks to assess whether preoperative hemoglobin a1c (HbA1c) or serum glucose are independent predictors of infection following PP implantation in diabetic men.

Methods
A stepwise literature search of MEDLINE database resulted in 192 articles regarding PP and DM. Of the 16 articles including either HbA1c and/or serum glucose in diabetic men with and without infection, studies utilizing only healthy controls and non-human subjects were excluded, resulting in 9 studies.

Results
Eight and three studies assessing HbA1c and serum glucose (n¼3,516 patients), respectively, and meeting inclusion criteria were included. Three studies indicated HbA1c as a significant indicator of PP infection, all of which included both diabetic and healthy controls; the remaining five included only diabetic patients and found no associations between HbA1c and infection. One study reported serum glucose to be significantly higher in those with PP infection, but included a significant number of patients with uncontrolled DM. Of note, since the year 2000, following advent of antibiotic-impregnated prosthesis and the no-touch surgical technique, studies have found no association between HbA1c or serum glucose with risk of infection. Furthermore, these studies reported significantly lower (&lt;4%) infection rate in diabetic patients undergoing PP implantation.

Conclusions
Data exploring HbA1c and serum glucose on PP infection were heterogeneous in time period, study design, and patient populations. Only three (33%) and one (11%) of the studies reported p HbA1c and serum glucose levels to be predictive of PP infection, respectively. However, studies following the year 2000 and restricted to only diabetic patients did not find HbA1c nor blood glucose to be accurate predictors of PP infection.

Disclosure
Work supported by industry: no.
206 Psychoeducational Group of Men with Prostate Cancer
Authors: Silva I. , Naccarato A. , Denardi F. , Ferreira U. , Matheus W. 
Published: May 2022

ABSTRACT

The incidence of cancer in the world population in 2002 was estimated at 11 million new cases, while in 2020 this estimate is approximately 20 million. Cancer is a global public health problem.
Prostate cancer (PCa) is a multifocal disease, with a wide clinical variety among patients. The male survivor of PCa has unique chronic side effects compared to other cancer survivors, with challenges in achieving physical and social well-being, and satisfaction with life in general.
This study aims to evaluate the impact of psychotherapy, in an open group, on Health-Related Quality of Life (HRQOL) and Sexuality in patients with PC who underwent treatment – ​​surgery, radiotherapy or who are under supervised follow-up.
Data is been collected through an initial interview (Identification, Anamnesis, Health Anamnesis, Degree of Satisfaction with Life and Sexuality, Affective-Emotional Assessment and Treatment Data), SF-36 and IIEF-5 short form questionnaire, in patients who are diagnosed, who have undergone treatment - surgery, radiotherapy or supervised monitoring - or who are being monitored at the clinic, and reapplication in the last semester of operation of the group. Each session will be answered 5 questions related to the perception of the previous session.
The group is available for 2 years, once a week, and the patient will attend 12 sessions. The sessions last 90 minutes, conducted by the same psychologist.
The research is been developed considering the ethical principles of secrecy, privacy, confidentiality and non-identification of the interviewees' data.
The study does not pose risks to the subjects and invasive techniques of the body or psychological suffering will not be used. Before starting the process, the Informed Consent Form (TCLE) is been delivered, as well as the provision of all details regarding the research. It is also explained that participation is voluntary and that the participant can leave the research at any time, without prejudice to their treatment and monitoring.
Only patients who meet all these criteria will be included, after signing the informed consent.

Disclosure
Work supported by industry: no.
207 Sexual Activity of Aged Japanese Women Who Visited a Female Urological Outpatient Clinic
Authors: Masuo Y. , Taniguchi H. , Taguchi M. , Mishima T. , Matsuda T. , Kinoshita H. 
Published: May 2022

ABSTRACT

Introduction
The previous reports according to sexual activity of aged woman is limited. Sexual activity of aged women would be related to QOL of them. Recently, sexual dysfunction of aged women recognized as Female Sexual Dysfunction (FSD).

Objective
To clarify the sexual activity of aged Japanese women, sexual activity of the female patients who visited a female urological outpatient clinic was investigated.

Methods
Between June 2010 and August 2018, 404 aged female patients who visit our female urological outpatient clinic and answered the King's Health Questionnaire (KHQ) were enrolled in this study. The main chief complaint of these patients was pelvic organ prolapse. Self-reported data of KHQ, question number 5a and 5b which ask the patients about the relationship between urine voiding and sexual activity were reviewed retrospectively. Associations between sexual activity (as reported in the questionnaire) and patients’ background, partners status, and change of sexual activity after treatment for pelvic organ prolapse were analyzed.

Results
The mean age of the patients was 71.0 years, with 80.9% in their 60s and 70s. Sexual intercourse was practiced by 19.7% (n = 77) of all patients with 40.0% in their under 50s, 27.9% in their under 60s, 15.2% in their 70s, and 0% in their 80s. 31.2% (n = 119/381) of patients had their partners. Among the patients with a partner, the percentage who practiced sexual intercourse was 58.0% of all patients with 65.4% and 55.6% of women in their 60s and 70s, respectively. Among the patients who had sexual intercourse, 64.9% had chief complains of pelvic organ prolapse. 71% of patients who had sexual intercourse received surgery and 91% of them was tension-free vaginal mesh (TVM). After the surgery 63.8% of patients continued sexual activity.

Conclusion
A patient survey revealed the sexual activity of a Japanese older female population who visited a urological outpatient clinic with the chief complaint of pelvic organ prolapse.

Disclosure
Work supported by industry: no.
211 Pathological Analysis of Spermatic Dysfunction in Testicular Ischemia-Reperfusion Injury
Authors: Hirata K , Ohira S , Tone S , Nakatsuka T , Morinaka H , Takasaki H , Sugiyama S , Shimizu S , Nagai A 
Published: May 2022

ABSTRACT

Introduction & Objectives
Testicular ischemia represented by torsion needs emergency surgery to reperfuse testicular blood flow. However, spermatic dysfunction is often led despite appropriate treatment. Pathology of spermatic dysfunction following testicular ischemia-reperfusion injury (IRI) is still unclear. In previous research, Inflammation and excessive oxidative stress were thought to be involved in tissue dysfunction following IRI. We hypothesized that inflammation and excessive oxidative stress plays key role in spermatic dysfunction following testicular IRI. We investigated relevance between Inflammation / excessive oxidative stress and spermatic dysfunction using testicular IRI model mice.

Materials & Methods
Ten to fifteen weeks old, C57BL/6 male were used through the study. Unilateral (left side) testicular vessels were clamped and de-clamped 1 hour later. Testicular blood flow was resumed. Sham operation mice were set as control. Bilateral testes were removed at 0(during ischemia), 1, 3, 5 weeks after modeling testicular IRI mice. Inflammation and oxidative stress changes in bilateral testis were investigated using histological, biochemical and immunohistochemical analysis. Spermatic changes extracted from the epididymal cauda were investigated using computer aided sperm analysis (CASA).

Results
Histological analysis using HE and Masson-Trichrome (MT) stain showed invasion of inflammatory cells and destruction of tissue structure from week 1. Inflammatory analysis using comprehensive protein assay and immunofluorescent stain showed increased expression of cytokines (IL-2, IL-3, IL-17A, IL-23), chemokines (CCL2, CCL5, CXCL1, CX3CL1), testes were showed from week1. Oxidative stress and cell death analysis using representative candidates (8-OHdG, ROS) showed increased expression of representative candidates from week0. Spermatic analysis showed that obvious decreased spermatic concentration and motility were showed from week 1. In contralateral testes, slow decreased spermatic concentration and motility was showed from week 1.

Conclusions
Spermatic dysfunction following testicular-ischemia reperfusion injury was induced in inflammatory and excessive oxidative stress changes. Inflammatory and excessive oxidative stress changes might be a novel regulatory factor for spermatic dysfunction following testicular ischemia-reperfusion injury.

Disclosure
Work supported by industry: no.
236 Evaluation of Sexual Function after Dutasteride Treatment in Patients with Once Negative Prostate Biopsy and Benign Prostate Hyperplasia.
Authors: Taniguchi H , Inoue T , Kawa G , Murota T , Tsukino H , Yoshimura K , Kamoto T , Ogawa O , Matsuda T , Kinoshita H 
Published: May 2022

ABSTRACT

Introduction
5α-reduced inhibitors (5ARIs) are usually administered to patients with benign prostatic hyperplasia, however, whether 5ARIs affect sexual function remains a controversial issue for both patients and urologists.

Objective
In this study, we evaluated the impact of dutasteride treatment for erectile function in patients with once-negative prostate biopsy and benign prostate hyperplasia.

Methods
81 patients with benign prostate hyperplasia were enrolled in a one-arm prospective study. They were administrated 0.5 mg/day of dutasteride for 12 months. Patient characteristics, change of IPSS and IIEF-15 scores at baseline and 12 months after dutasteride administration were examined.

Results
The mean ± SD age of the patients was 69.4 ± 4.9 years and the prostate volume was 56.6 ± 21.3 mL, respectively. The mean ± SD prostate volume and PSA levels were decreased 25.0% and 50.9%, respectively, after 12 months of dutasteride administration. IPSS total, voiding subscore, storage subscore, and QOL score significantly improved after 12 months of dutasteride administration. No significant change was observed in any of the IIEF scores after 12 months. There was no decrease in EF severity.

Conclusion
Twelve months administration of dutasteride for patients with BPH improved urinary function and did not increase the risk of sexual dysfunction.

Disclosure
Work supported by industry: no.