bluuebunny/crossref_metadata_2025_split huggingface dataset:
242 Standardizing Sonographic Descriptors of Peyronie's Plaques
Authors: Baird B , Broderick G 
Published: May 2022

ABSTRACT

Introduction
Peyronie's Disease (PD) is characterized by a fibrous scar of the tunica albuginea. PD is typically imaged with 2D ultrasound. We propose a classification system of these ultrasound findings in the evaluation of PD.

Objective
The purpose of this study is to establish a functional, reproducible sonographic classification system for evaluating PD and to examine the relationship between PD grading and curvature, duration of PD, and vascular erectile status.

Methods
In our study, 395 patients with PD underwent intracavernous injection with an erectile agent (ICI) followed by Color Doppler Duplex Ultrasound (CDDU). All CDDU studies were performed by a single examiner and all PD grading was done by two independent reviewers using saved images. CCDU findings including peak systolic velocities (PSV) and resistive indices (RIs) were recorded. PD grades of 2D images were classified into three grades: Grade 1 acoustic shadowing without calcification; Grade 2 focal microcalcifications of the tunica, pillars, or septal fibers; Grade 3 confluent calcification of the dorsal, septal, ventral tunica albuginea.

Results
There were 250 patients classified with Grade 1 (63%) sonographic changes, 75 with Grade 2 (19%), and 70 with Grade 3 (18%). Neither median age nor body mass index (BMI) of the cohorts were significantly different: Grade 1 (59.3 yr), Grade 2 (59 yr) and Grade 3 (60.3 yr), p = 0.711; BMI 27.6, 28.2, 27.7, p = 0.813. Medical risk factors for erectile dysfunction, including hypertension, heart disease, diabetes mellitus, hyperlipidemia, smoking history, and history of prostate surgery were not statistically different for the three cohorts. Most patients had previously used PDE5-Inhibitors (293/395). History and or physical findings of Dupuytren's palmar contracture was noted in 30/395 (7.6%) of men. The median duration of PD was not significantly different in the three cohorts (12, 12, 14 months p = 0.639). Neither CDDU diagnoses (Table 1) nor curvature varied by sonographic grades (Table 2).

Conclusions
The scar resulting from PD seals together the outer longitudinal and inner circular layers of the tunica albuginea causing deformity of the erect shaft. PD plaques are usually palpable and associated with focal thickening of the tunica. On 2D ultrasound, the typical appearance is an acoustic shadow. Most of our patients presented with Grade I acoustic shadowing and no calcifications 250/395 (63%); on the other hand, 19% had acoustic plaque shadowing and additional findings of focal tunica or deep microcalcifications and 18% had confluent calcification of the dorsal, septal or ventral tunica. We propose a unique and reproducible classification system. This grading system based on grayscale ultrasound of Peyronie's plaques may serve as a paradigm for diagnosis, didactics and integrated research.

Disclosure
Work supported by industry: no, by N/A.
245 Remodeling of Extracellular Matrix Cell Elements in Peyronie's Disease Experimentally Induced by TGF-Beta and Treated with Mycophenolate Mofetil
Authors: Antoniassi T , Fácio JR F , Taboga S , Colleta S , Ruiz T 
Published: May 2022

ABSTRACT

Introduction
Peyronie´s disease(PD) is a common disease among men which causes tortuosity in the penis, making it difficult and sometimes even preventing sexual activity. PD corresponds to the presence of fibrotic disorder in the tunica albuginea of the corpus cavernosum.This disorder is characterized by excessive accumulation of collagen fibers and other components of the extracellular matrix(ECM).The metalloproteimases(MMP) are involved in the reinforcement and debilitation of many processes that influence the development of fibrosis. PD can be conducted initially with clinical treatment, but the literature does not show an adequate resolution of this condition. Mycophenolate mofetil(MMF) belongs to a class of immunosuppressants drugs and has been used to treat patients with some fibrotic disorders as retroperitoneal fibrosis. A previous study evaluating the use of Mycophenolate Mofetil showed an important improvement in the arrangement of collagen fibers after experimental induction of peyronie´s disease. This experimental model, where the penile anatomy of rats is similar to the men, promote the ability to study fibrosis at its various levels and the effects of new drug for penile rehabilitation.

Objectives
The aim of this research is to investigate the alterations in the elements of extracelular matrix promoted by the antifibrotic action of Mycophenolate Mofetil in rats with TGF-Beta induced peyronie-s disease

Methods
Thirty male Wistar rats will be used,divided into 6 groups.Group 1- control group. Group 2 - rats that will receive injection of saline in the tunica albuginea. Group 3- rats that will receive only injection of TGF-beta. Group 4- rats that will receive TGF-beta and will be treated with MMF during 7 daysy. Group 5- rats that will receive TGF-beta and will be treated with MMF por 30 days. Group 6- rats that will receive only MMF. All rats‘penises will be collected after euthanasia for histochimical assesmente of collagen fibers with picrossirius and immunohistochewmistry of metalloproteinases(MMP2, MMP3 and MMP9). Five random fields from the region of the tunica albuginea will bew captured for each penile sample with Olyvia software and measurements will be performed with ImageJ software of the elements of the extracellular matrix. To compare groups will be used the paired sample T test. Data will be checked for normality using th kolmogorov-Smirnov test. When non-parametric, the Kruskal-Wallis test followed by Dunn´s test will be used.Differences will be considered statiscally significant when p&lt;0,05.This experimente was approved and will be conducted according to the ethics committee rules on the use of animals.

Hypothesis
MMF promotes na improvement in fibrotic disorder preventing peyronie´s disease.

Disclosure
Work supported by industry: no.
256 The Burden of Female Sexual Dysfunction in Basrah-Iraq: The First Preliminary Report
Authors: Odhaib S , Mansour A , Altemimi M , Alidrisi H , Abdulrazzaq Z , Mohammed A , AlWaeli D , Alibrahim N 
Published: May 2022

ABSTRACT

Introduction
Help-seeking behavior in women with female sexual dysfunction (FSD) from conservative communities is affected by cultural and religious factors.

Objective
To evaluate psychosexual, social, physical, and biochemical factors which impact FSD in premenopausal women from Basrah.

Methods
This was a cross-sectional observational study in a tertiary endocrine center on 673 reproductive-aged premenopausal women with sexually-related complaints for more than 6 months during (Sep 2018-Jan 2021). Relevant history and examination were done in the initial visit using non-judgmental patient-centered integrative approach, with ubiquity statement followed by a closed-ended question, and then an open-ended follow-up. FSD diagnosis was done (n=219).
A couple-interview session was scheduled, involved intimacy assessment through series of questions, then we used Female Sexual Function Index (FSFI) and Decreased Sexual Desire Screener (DSDS), to diagnose generalized and secondary acquired hypoactive sexual desire disorder (HSDD), and related sexual disorder.
The gonadotropins, androgens, thyroid, adrenal, ovarian, and pituitary function, along with insulin resistance, glycemic and lipid level were assessed. The final number of the women in the study was 166 women. We used Pearson's correlational analysis to confirm the significance correlations between FSD and different parameters. We used Mann-Whitney U test in subgroup analysis HSDD subtypes.

Results
FSD prevalence was 24.67% with mean duration (8±2 months). Intercourse frequency prior to complaint onset (3±1 times weekly), compared to (2±1 times monthly) in the latest month before consultation. All FSFI domains scores were reduced. DSDS diagnosed generalized and secondary acquired-HSDD in 31 and 57 women, respectively. Hormonal investigation did not aid FSD diagnosis. Pearson's correlational analysis did not show any significant correlation between the test variables and FSD.

Conclusions
No significant correlation between FSD and any psychosexual, physical, and biochemical parameter could be seen. Longitudinal multicenter larger scale studies are needed.

Disclosure
Work supported by industry: no.
262 High Inguinal Microsurgical Denervation of the Spermatic Cord for Chronic Scrotal Content Pain for Pediatric Patients
Authors: Shiraishi K , Matsuyama H 
Published: May 2022

ABSTRACT

Introduction
Microsurgical denervation of the spermatic cord (MDSC) has been demonstrated to be an effective treatment for men with chronic scrotal content pain (CSCP) in adult but not for pediatric patients.

Objective
The purpose of this study was to investigate the effectiveness and safety, including testicular development, of MDSC for pediatric patients less than 15 years old.

Methods
A retrospective review of 10 patients who underwent MDSC was performed. A 3-cm transverse incision was made at the middle of the inguinal canal. Macroscopically identified nerves were transected, and the internal surface of the inguinal canal was ablated by bipolar cautery. Under an operating microscope, all the components of spermatic cord were transected, except for the testicular artery, lymphatics, vas system. A 0-10 visual analogue scale (VAS) was compared with pre- and post-MDSC at 12 months. Testicular volume measured by punched-out orchidometer and endocrinological examination was evaluated pre- and post-MDSC at least 12 months.

Results
The average patient age was 12.7 years (range from 10 to 15 years old). The mean duration of symptoms before surgery was 10 months. The mean operative time was 47 minutes. The mean post-VAS was significantly reduced as compared with pre-VAS (2.1 and 8.7, respectively, p&lt;0.0001).
There was no testicular atrophy or scrotal edema. Negative responses to spermatic cord block, depressive symptoms (as screened by the Beck Depression Inventory), and multiple sites of pain were predictors of MDSC failure (p&lt;0.05).

Conclusions
For both adult and pediatric patients, high inguinal MDSC for CSCP is an effective easier to perform, as it requires fewer divisions of veins and is associated with a larger diameter of the spermatic artery. It also enables complete resection of the nerves, including the nerves running outside the spermatic cord, resulting in high success rates.

Disclosure
Work supported by industry: no.
265 Postpartum Dyspareunia and Sexual Functioning: A Prospective Cohort Study
Authors: Abidi I , bettaieb H , Halouani S , Frikha M , Mbarki W , Boufarguine R , Gabsi H , Oueslati H , Mbarki C 
Published: May 2022

ABSTRACT

Introduction
Dyspareunia is a common short-term pregnancy complication. Possible risk factors for perineal pain after childbirth include perineal trauma, mode of delivery and breastfeeding.

Objective
Considering the important implications of dyspareunia on women's quality of life. Our study aims to investigate the prevalence and determinants of dyspareunia and sexual dysfunction before and after childbirth.

Methods
Between November 2018 and December 2019, 150 women in their third trimester of pregnancy were enrolled in a prospective cohort study at gynecology and obstetrics Department-Ben Arous Regional Hospital. Dyspareunia and perineal pain after childbirth were evaluated at 6 months postpartum and were assessed using validated self-report questionnaires: Female Sexual Function Index (FSFI) validated Arabic version. This questionnaire evaluates the different parameters of female sexual function, recommended by the American Foundation for Health and Sexual Function. The collected data were systematically transcribed into a database and database, and their analysis was carried out with the help of the statistical software "SPSS 21" with the use of chi-square tests, and the ANOVA method.

Results
The mean FSFI pain domain score was 3.68 after delivery. Indeed, in our study, 82% of women reported dyspareunia after delivery. Sixteen percent of women rated the degree of discomfort during penetration after delivery as high and 18 % as very high.
At six months postpartum, the degree of dyspareunia was significantly associated with the route of delivery (p = 0,005), perineal injury (p = 0,001) and breastfeeding (p = 0,026).

Conclusions
Our findings affirm that dyspareunia is a very common complaint after childbirth. Given the high prevalence and its impact on a woman's quality of life, special attention should be paid to this common complaint during the postpartum period.

Disclosure
Work supported by industry: no.
032 Sliding Technique Through a Non-Degloving Approach for Peyronie's Disease: 2-Surgeon Experience
Authors: Hernandez J. Clavell , Wang R. 
Published: May 2022

ABSTRACT

Introduction
The sliding technique (ST) has been used to restore penile size in patients with penile atrophy secondary to severe Peyronie's Disease (PD) and erectile dysfunction (ED). When combined with degloving, this procedure carries a potential risk of causing ischemia or necrosis to the glans penis.

Objective
We hereby present a detailed surgical technique of the non-degloving approach for the ST and penile prosthesis (PP) placement.

Methods
Retrospective review of databases from 2 surgeons and report patient outcomes after PP placement with sliding technique for the correction and size restoration of severe PD and ED from January 2015 to September 2019.

Results
A total of 39 patients had significant penile atrophy and/or curvature &gt;60 degrees and underwent PP placement with grafting procedures between 2 surgeons. 11 of those patients underwent ST of which 9 had the procedure performed through a non-degloving ventral incision. Mean degree of curvature prior to ST was 62 degrees (45 to 90 degrees) Mean penile length gain was 2.47 cm (2.0 to 3.0 cm). At a mean follow up of 12.4 months (3 to 31 months) only 1 patient had residual curvature, which was minimal at 15 degrees. There were no infections or vascular complications in our series.

Conclusion
There are reports of ischemic injury in PD patients undergoing penile prothesis placement in addition to the ST with a circumcision and penile degloving. The non-degloving technique with a ventral incision provides for an alternative method to perform the ST in patients with penile atrophy secondary to severe PD and ED. This approach could theoretically minimize the risk of glans ischemia by maintaining dartos and skin continuity to the glans penis while still allowing for adequate surgical exposure.

Disclosure
Work supported by industry: no. A consultant, employee (part time or full time) or shareholder is among the authors (Jonathan Clavell Hernandez: Consultant for Coloplast and Boston Scientific, Run Wang is consultant for Boston scientific and Coloplast ).
034 Postoperative Progress of Modified Grid Incision and Sealing with Collagen Fleece for Treatment of Peyronie's Disease
Authors: Ahn S.T. , Jo S.B. , Lee D. , Han D.E. , Lee H.S. , Moon D.G. 
Published: May 2022

ABSTRACT

Introduction
Recently, there have been reports on partial plaque excision and grafting with collagen fleece technique regarding long term efficacy. However, there is still concern regarding complete regeneration of tunical defect from collagen fleece graft in terms of regenerative medicine. Previously, we introduced a less invasive modified technique by multiple grid incisions of Peyronie's plaque to minimize weakness of regenerated tunica from the collagen fleece graft and consequent veno-occlusive erectile dysfunction.

Objective
To assess the efficacy of Modified Grid Incision of plaque and sealing with Collagen Fleece through post-operative progress of 31 patients with prospective follow-up study.

Methods
From Aug 2018, 31 patients with stable Peyronie's disease (PD) were included. Surgical technique was composed 3 major steps; 1) dissection of the neurovascular bundle or urethra according to the location of plaque, 2) multiple deep grid plaque incisions for complete correction of curvature and deformity and 3) sealing with collagen fleece (TachoSil®) without suturing. Prospectively, we assessed the stretched penile length (SPL), totally straightness, penile sono, erectile function preoperatively and 6, 12, 24, 36 months postoperatively. This study was approved by the Institutional Review Board of the Korea University Hospital.

Results
Mean patient age was 58.5 years (range: 46–75). The mean curvature was 45.95 (15-90) degrees, 8 with hinge and 7with hourglass deformity. Inflatable penile prosthesis(IPP) was inserted in 4 patients and postoperative 30 months in a patient for poor erectile function. Mean follow-up was 15 months (6-36).
Daily massage softened the hard thickening of penis gradually from 3 months until 2 year. On follow-up sonography, subcutaneous thickening gradually decreased to near normal at 1 year and the breakage of tunica by grid incision reunited at postoperative 10-12 months. All patients achieved totally straightness. All patients gained preoperative length after 1.6 year. 96% of patients satisfied in GAQ at 1 year. Minor skin problem was occurred in three patients of IPP. Subcutaneous bulging hematoma was occurred in 2 patients but subsided within 3 months. In postoperative erectile function of 27 patients without IPP, spontaneous hard erection was recovered in 10 and the rest are satisfied with PED5 inhibitors.

Conclusions
Our prospective progress reports with technical modification of various plaque incisions shows that one can achieve a sufficient surgical effect without making defect of tunica albuginea. Precise understanding of the postoperative progressions are necessary for physician's confidence and encouraging the patients for successful clinical outcomes.

Disclosure
Work supported by industry: no.
053 Different Evaluation Exists Between Men with Erectile Dysfunction and Their Female Partners When Using Erectile Hardness Model: An Interesting, Observational and Cross-Sectional Field Survey
Authors: Gao J. , Zhang Y. , Li H. , Gao P. , Zhang X. 
Published: May 2022

ABSTRACT

Introduction
It is an interesting clinical phenomenon that when evaluating the erectile function of men with erectile dysfunction by couples respectively using erectile hardness model, there will exist the evaluation difference between men and their female partners. This phenomenon reflects the problem of communication and cognition between husband and wife in ED patients.

Objective
To explore the influencing factors associated with this clinical phenomenon, we conducted this interesting, observational and cross-sectional field survey.

Methods
We enrolled 385 couples from the Andrology clinics of the first affiliated hospital of Anhui medical university from December 2017 to December 2018. The demographic data of couples, the medical history, sexuality and the characteristics of ED, anxiety and depression of the couples were collected through face-to-face interview and questionnaires. The couples were divided into two groups containing 238 couples and 147couples respectively. We divided couples into difference group including couples which have inconsistent evaluation results from touching the erectile hardness model and no difference group including couples which have consistent evaluation results from touching the erectile hardness model respectively.

Results
The difference group where the couples share different evaluation results reported higher erectile hardness grade from men than from their female partners (Men &gt;Female: 73.11% vs. Men &lt;Female: 26.89%).
The scores of IIEF-5 in difference group and no difference group are 13.43 ± 5.75 and 16.82 ± 8.23 respectively. The average grades evaluated from men and women in difference group are 2.79 ± 0.85 and 2.45 ± 0.63 respectively. The average grades evaluated from couples in no difference group are 3.02± 0.45.
Through statistical comparison and logistic regression analysis, duration of ED &gt;16 months, seeking treatment from female, negative communication state and depression from men are the relevant factors accounting for the different evaluation results. This phenomenon reflects the problem of communication and cognition between husband and wife in ED patients.

Conclusions
As for couples with these risk factors, we can't only focus on the oral medication which only restore the penile erectile function. More importantly, we must combine the sexual counseling and sexual knowledge education with the drug treatment. When the two treatment are tightly integrated, not only the penile erection but also the gap of couples can be restored which is the best result of the ED treatment.

Disclosure
Work supported by industry: no.
055 Effects of Testosterone Treatment on Clitoral Haemodynamics in Women with Sexual Dysfunction
Authors: Cipriani S. , Maseroli E. , Stasi V. Di , Scavello I. , Todisco T. , Rastrelli G. , Fambrini M. , Sorbi F. , Petraglia F. , Jannini E.A. , Maggi M. , Vignozzi L. 
Published: May 2022

ABSTRACT

Introduction
Preclinical studies show that, in the clitoris, testosterone (T) is necessary to maintain a functional contractile and relaxant machinery, which represents the underlying mechanism of the peripheral arousal response. Although there is clinical evidence suggesting that T treatment significantly improves multiple domains of sexual functioning, the vascularization of clitoral tissue and its regulation by sex steroids are still under-investigated.

Objective
To explore the effects of 6-month systemic T administration on clitoral color Doppler ultrasound (CDU) parameters in women with female sexual dysfunction (FSD).

Methods
81 women with FSD were retrospectively recruited. Data on CDU parameters at baseline and after 6 months with four different treatments were available and thus further longitudinally analyzed: local non-hormonal moisturizers (NH group), n=37; transdermal 2% T gel 300 mcg/day (T group), n=23; local estrogens (E group), n=12; combined therapy (T+E group), n=9. Patients underwent physical, laboratory, and genital CDU examinations at both visits and completed different validated questionnaires, including the Female Sexual Function Index (FSFI).

Results
At 6-month visit, T therapy significantly increased clitoral artery peak systolic velocity (PSV) when compared to both NH (p &lt; 0.0001) and E (p &lt; 0.0001) groups. A similar increase was found in the T + E group (p = 0.039 vs. E) (Fig.1). In addition, T treatment was associated with significantly higher FSFI desire, pain, arousal, lubrication, orgasm and total scores at 6-month visit vs. baseline. Similar findings were observed in the T + E group. No significant differences in the variations of total and high-density lipoprotein-cholesterol, triglycerides, fasting glycemia, insulin and glycated hemoglobin levels were found among the four groups. No adverse events were observed.

Conclusions
In women complaining for FSD, systemic T administration, either alone or combined with local estrogens, was associated with a positive effect on clitoral blood flow and a clinical improvement in sexual function, showing a good safety profile.

Disclosure
Work supported by industry: no.