Pub Date : 2024-03-26DOI: 10.1093/jsxmed/qdae018.022
B. C. G. Nascimento, R. Pedrenho, P. Zandoná, J. Bessa Jr, D. A. Bastos, M. D. Cordeiro, R. Coelho, W. C. Nahas, J. Hallak, J. Mulhall, C. M. Gomes
I - Testosterone recovery after different androgen deprivation therapy regimens for prostate cancer varies widely (7-96%) in the literature, with data coming mainly from retrospective studies. O - Evaluate testosterone recovery after ADT cessation prospectively. M - This secondary analysis of a neoadjuvant ADT study for high-risk prostate cancer patients collected total testosterone (TT) levels at baseline and up to 12 months post-ADT cessation. Three recovery outcomes were assessed: return to non-castrate (TT > 50 ng/dL), normal (TT ≥ 300 ng/dL), and baseline (BTB - TT ≥ baseline). A time-to-event analysis and multivariate analysis were conducted. R - 1-year follow-up data from 53 patients (60 with at least 1 follow-up data. Mean age was 64.6 (± 5.89), 28% had diabetes (DM), and 61% had hypertension (HTN). Mean TT levels were 450 ng/dL (± 170) at baseline, 112.7 ± 96.9 at 3 months, 208.5 ± 197 at 6 months, 341.8 ± 172 at 9 months, and 381.1 ± 166 at 12 months. Figure 1 shows the cumulative incidence of each outcome over time. The median time to achieve T > 50 was 5 months, for T > 300 it was 9.1 months, and for BTB it was 13.1 months. At 1 year post-ADT discontinuation, 98.1% had returned to TT > 50, 79.5% had TT > 300, and 33.9% had returned to baseline level. In a multivariate analysis including DM, HTN, age, and baseline T, only baseline T was associated with a higher chance of recovery to normality (baseline T > 450-88.5% vs. 46.9%, HR: 3.06, p < 0.05). C - In this prospective analysis, after discontinuing 3-month neoadjuvant ADT, most achieved normal T levels (80%) after 1 year, but less than half recovered to baseline levels. Cumulative Incidence of each outcome Janssen-Cilag Farmacêutica Ltda.
{"title":"(O-28) CHRONOLOGY OF ENDOGENOUS TESTOSTERONE RECOVERY AFTER DISCONTINUATION OF ANDROGEN DEPRIVATION THERAPY - RESULTS FROM A PROSPECTIVE ANALYSIS","authors":"B. C. G. Nascimento, R. Pedrenho, P. Zandoná, J. Bessa Jr, D. A. Bastos, M. D. Cordeiro, R. Coelho, W. C. Nahas, J. Hallak, J. Mulhall, C. M. Gomes","doi":"10.1093/jsxmed/qdae018.022","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae018.022","url":null,"abstract":"\u0000 \u0000 \u0000 I - Testosterone recovery after different androgen deprivation therapy regimens for prostate cancer varies widely (7-96%) in the literature, with data coming mainly from retrospective studies.\u0000 O - Evaluate testosterone recovery after ADT cessation prospectively.\u0000 M - This secondary analysis of a neoadjuvant ADT study for high-risk prostate cancer patients collected total testosterone (TT) levels at baseline and up to 12 months post-ADT cessation. Three recovery outcomes were assessed: return to non-castrate (TT > 50 ng/dL), normal (TT ≥ 300 ng/dL), and baseline (BTB - TT ≥ baseline). A time-to-event analysis and multivariate analysis were conducted.\u0000 R - 1-year follow-up data from 53 patients (60 with at least 1 follow-up data. Mean age was 64.6 (± 5.89), 28% had diabetes (DM), and 61% had hypertension (HTN). Mean TT levels were 450 ng/dL (± 170) at baseline, 112.7 ± 96.9 at 3 months, 208.5 ± 197 at 6 months, 341.8 ± 172 at 9 months, and 381.1 ± 166 at 12 months. Figure 1 shows the cumulative incidence of each outcome over time. The median time to achieve T > 50 was 5 months, for T > 300 it was 9.1 months, and for BTB it was 13.1 months. At 1 year post-ADT discontinuation, 98.1% had returned to TT > 50, 79.5% had TT > 300, and 33.9% had returned to baseline level. In a multivariate analysis including DM, HTN, age, and baseline T, only baseline T was associated with a higher chance of recovery to normality (baseline T > 450-88.5% vs. 46.9%, HR: 3.06, p < 0.05).\u0000 C - In this prospective analysis, after discontinuing 3-month neoadjuvant ADT, most achieved normal T levels (80%) after 1 year, but less than half recovered to baseline levels.\u0000 Cumulative Incidence of each outcome\u0000 \u0000 \u0000 \u0000 Janssen-Cilag Farmacêutica Ltda.\u0000","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"37 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140378188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-26DOI: 10.1093/jsxmed/qdae018.041
L. A. Santos, C. M. Braga, P. R. Contin
Sexual dysfunctions remain inadequately addressed in medical education, despite their prevalence and adverse impact on quality of life. In Brazil, there are scarce university-affiliated healthcare centers that focus on sexual health. These services play a critical role in diagnosing and managing sexual disorders and can be pivotal in the training of healthcare professionals, as well as in the advancement of research and outreach in sexual medicine. To describe the experience of establishing two sexual health centers in university-affiliated hospitals in Northeastern Brazil. This is an experiential report detailing the establishment of two distinct sexual health services. Both sexual health services started in different general hospitals in 2021, founded by a male and a female psychiatrists, authors of this paper. The initiative was prompted by the lack of dedicated sexual health services and the awareness of substantial patient distress stemming from sexual issues. Activities include patient consultations, case discussions, sexology seminars, and research project development, involving medical students and resident physicians, integrated into the psychiatry residency curriculum Referrals come mainly from other hospital specialties, but external referrals are also accepted. Collaboration with other healthcare professionals occurs through the analysis of clinical cases. The establishment of sexual health services within university-affiliated hospitals has a positive impact on patient care and contributes to the study of sexual medicine, an area often overlooked in medical education. Improvements are needed in patient recruitment, counter-referral procedures, and the systematic incorporation of medical student rotations. While these services hold promise, they require greater integration with other healthcare services and a closer collaboration with undergraduate medical education. No conflict.
{"title":"(PM-09) PIONEERING SEXUAL HEALTH SERVICES IN NORTHEAST BRAZIL: AN EXPERIENTIAL ACCOUNT","authors":"L. A. Santos, C. M. Braga, P. R. Contin","doi":"10.1093/jsxmed/qdae018.041","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae018.041","url":null,"abstract":"\u0000 \u0000 \u0000 Sexual dysfunctions remain inadequately addressed in medical education, despite their prevalence and adverse impact on quality of life. In Brazil, there are scarce university-affiliated healthcare centers that focus on sexual health. These services play a critical role in diagnosing and managing sexual disorders and can be pivotal in the training of healthcare professionals, as well as in the advancement of research and outreach in sexual medicine.\u0000 \u0000 \u0000 \u0000 To describe the experience of establishing two sexual health centers in university-affiliated hospitals in Northeastern Brazil.\u0000 \u0000 \u0000 \u0000 This is an experiential report detailing the establishment of two distinct sexual health services.\u0000 \u0000 \u0000 \u0000 Both sexual health services started in different general hospitals in 2021, founded by a male and a female psychiatrists, authors of this paper. The initiative was prompted by the lack of dedicated sexual health services and the awareness of substantial patient distress stemming from sexual issues. Activities include patient consultations, case discussions, sexology seminars, and research project development, involving medical students and resident physicians, integrated into the psychiatry residency curriculum Referrals come mainly from other hospital specialties, but external referrals are also accepted. Collaboration with other healthcare professionals occurs through the analysis of clinical cases.\u0000 \u0000 \u0000 \u0000 The establishment of sexual health services within university-affiliated hospitals has a positive impact on patient care and contributes to the study of sexual medicine, an area often overlooked in medical education. Improvements are needed in patient recruitment, counter-referral procedures, and the systematic incorporation of medical student rotations. While these services hold promise, they require greater integration with other healthcare services and a closer collaboration with undergraduate medical education.\u0000 \u0000 \u0000 \u0000 No conflict.\u0000","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140378471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-26DOI: 10.1093/jsxmed/qdae018.050
E. M. Costa, O. H. Takeda, R. Y. Fernandes, W. B. C. Branco, MVPd Cruz, A. G. Guirado, RNdF Vidal, BdO Ferreira, M. Scanavino
Investigate the feasibility of a Yoga Practice intervention (YPI) as an integrative treatment for adult men with compulsive sexual behavior disorder (CSBD) explored through the attendance and adherence treatment protocol, and the functionality of data collection mechanisms. For this study, twelve men diagnosed with CSBD and that did not present substance-use, paraphilic, psychotic, current manic or hypomanic, neurocognitive disorders, gender dysphoria, physical limitations, already practiced yoga or started psychotherapy more than six months ago were randomized in a 2-arm, double-blind clinical trial, comparing a Kundalini YPI with a supervised muscle stretching 12-week program. Participants submitted their applications online on baseline, times 1 (4 weeks), 2 (8 weeks) and time 3 (12 weeks) and the proportion of treatment and protocol adherence, teacher adherence, and allocation concealment were estimated. The age range was 24 to 47 years old. 58% were single or widower, 41% married or common-law; 75% were caucasians and 25% afro-descendants. The minimum schooling was elementary, (50% finished college). Average family income was $ 1130. There was no statistically significant association between sociodemographic and intervention groups. The patient attendance was 58%, patient adherence to the protocol 30%, professors' adherence to the protocol reached 100%, and the allocation concealment for the double-blind method ensured 100%. The answers of the self-responsive online questionnaires on psychopathologic variables reached 87% of the requested answers, and the daily practices at home 45%. Although the YPI evaluated for CSBD was acceptable and functional, this pilot indicates changes in procedures to improve attendance and adherence of patients. No conflict.
{"title":"(PM-23) YOGA PRACTICE INTERVENTION AS A COMPLEMENTARY AND INTEGRATIVE TREATMENT FOR COMPULSIVE SEXUAL BEHAVIOR DISORDER: A PILOT STUDY","authors":"E. M. Costa, O. H. Takeda, R. Y. Fernandes, W. B. C. Branco, MVPd Cruz, A. G. Guirado, RNdF Vidal, BdO Ferreira, M. Scanavino","doi":"10.1093/jsxmed/qdae018.050","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae018.050","url":null,"abstract":"\u0000 \u0000 \u0000 Investigate the feasibility of a Yoga Practice intervention (YPI) as an integrative treatment for adult men with compulsive sexual behavior disorder (CSBD) explored through the attendance and adherence treatment protocol, and the functionality of data collection mechanisms.\u0000 \u0000 \u0000 \u0000 For this study, twelve men diagnosed with CSBD and that did not present substance-use, paraphilic, psychotic, current manic or hypomanic, neurocognitive disorders, gender dysphoria, physical limitations, already practiced yoga or started psychotherapy more than six months ago were randomized in a 2-arm, double-blind clinical trial, comparing a Kundalini YPI with a supervised muscle stretching 12-week program. Participants submitted their applications online on baseline, times 1 (4 weeks), 2 (8 weeks) and time 3 (12 weeks) and the proportion of treatment and protocol adherence, teacher adherence, and allocation concealment were estimated.\u0000 \u0000 \u0000 \u0000 The age range was 24 to 47 years old. 58% were single or widower, 41% married or common-law; 75% were caucasians and 25% afro-descendants. The minimum schooling was elementary, (50% finished college). Average family income was $ 1130. There was no statistically significant association between sociodemographic and intervention groups. The patient attendance was 58%, patient adherence to the protocol 30%, professors' adherence to the protocol reached 100%, and the allocation concealment for the double-blind method ensured 100%. The answers of the self-responsive online questionnaires on psychopathologic variables reached 87% of the requested answers, and the daily practices at home 45%.\u0000 \u0000 \u0000 \u0000 Although the YPI evaluated for CSBD was acceptable and functional, this pilot indicates changes in procedures to improve attendance and adherence of patients.\u0000 \u0000 \u0000 \u0000 No conflict.\u0000","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"122 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140378653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-26DOI: 10.1093/jsxmed/qdae018.006
G. M. Crelier, C. V. O. Vasconcelos, D. P. Nunes, V. A. Vidal, V. S. Diniz, J. L. Schiavini, RdTeF Filho, H. R. J. Junior, C. M. C. Lara, R. Damião
Varicocele is the most common identifiable cause of male infertility, and varicocelectomy is the most frequently performed surgery for its treatment. This condition impacts infertility cases and sperm quality. Microsurgical varicocelectomy is considered the gold standard treatment for varicocele. This retrospective cohort aims to evaluate the effects of microsurgical varicocelectomy on seminal parameters, serum testosterone, and pregnancy rate in the context of male infertility in 39 patients who underwent the procedure at a university hospital in Rio de Janeiro. This study is a retrospective cohort conducted between January 2016 and February 2023, involving 39 men who underwent subinguinal microsurgical varicocele repair in the context of marital infertility. Pre- and post-operative analyses of seminal parameters were based on the criteria of the World Health Organization from 2010. Post-operative semen analysis and serum testosterone levels were assessed 3 to 6 months after varicocelectomy. The pregnancy rate was observed through interviews until February 28, 2023. Subinguinal microsurgical varicocelectomy is associated with a significant increase in testosterone levels and an improvement in seminal parameters, all with statistical significance. Testosterone levels increased by an average of 84.2 (±14.7) ng/dl. The pregnancy rate also increased significantly, with 51.3% of couples achieving pregnancy as of the time of this study. In this patient population, infertile men with clinical varicocele who underwent subinguinal microsurgical varicocelectomy showed a significant increase in testosterone levels, improvement in seminal parameters, and a significant reduction in the proportion of azoospermia. Furthermore, there was an increase in the occurrence of pregnancy in couples with marital infertility. No conflict.
{"title":"(O-08) IMPACT OF SUBINGUINAL MICROSURGICAL VARICOCELECTOMY ON MALE INFERTILITY: SEMINAL PARAMETERS, SERUM TESTOSTERONE, AND PREGNANCY RATE - RETROSPECTIVE COHORT AT A UNIVERSITY HOSPITAL IN RIO DE JANEIRO","authors":"G. M. Crelier, C. V. O. Vasconcelos, D. P. Nunes, V. A. Vidal, V. S. Diniz, J. L. Schiavini, RdTeF Filho, H. R. J. Junior, C. M. C. Lara, R. Damião","doi":"10.1093/jsxmed/qdae018.006","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae018.006","url":null,"abstract":"\u0000 \u0000 \u0000 Varicocele is the most common identifiable cause of male infertility, and varicocelectomy is the most frequently performed surgery for its treatment. This condition impacts infertility cases and sperm quality. Microsurgical varicocelectomy is considered the gold standard treatment for varicocele. This retrospective cohort aims to evaluate the effects of microsurgical varicocelectomy on seminal parameters, serum testosterone, and pregnancy rate in the context of male infertility in 39 patients who underwent the procedure at a university hospital in Rio de Janeiro.\u0000 \u0000 \u0000 \u0000 This study is a retrospective cohort conducted between January 2016 and February 2023, involving 39 men who underwent subinguinal microsurgical varicocele repair in the context of marital infertility. Pre- and post-operative analyses of seminal parameters were based on the criteria of the World Health Organization from 2010. Post-operative semen analysis and serum testosterone levels were assessed 3 to 6 months after varicocelectomy. The pregnancy rate was observed through interviews until February 28, 2023.\u0000 \u0000 \u0000 \u0000 Subinguinal microsurgical varicocelectomy is associated with a significant increase in testosterone levels and an improvement in seminal parameters, all with statistical significance. Testosterone levels increased by an average of 84.2 (±14.7) ng/dl. The pregnancy rate also increased significantly, with 51.3% of couples achieving pregnancy as of the time of this study.\u0000 \u0000 \u0000 \u0000 In this patient population, infertile men with clinical varicocele who underwent subinguinal microsurgical varicocelectomy showed a significant increase in testosterone levels, improvement in seminal parameters, and a significant reduction in the proportion of azoospermia. Furthermore, there was an increase in the occurrence of pregnancy in couples with marital infertility.\u0000 \u0000 \u0000 \u0000 \u0000 \u0000 \u0000 \u0000 No conflict.\u0000","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"111 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140379295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-26DOI: 10.1093/jsxmed/qdae018.045
C. de Oliveira, A. Fregonesi, L. Costa de Salles, G. Chahade Sibanto Simões, A. B. Pereira de Souza, A. Degani Ottaiano, A. Canettieri Rubez, B. Ricardo Di Domenico, F. Franco de Oliveira Júnior, A. Akel Ferruccio, R. Destro Saad
Phosphodiesterase-5 inhibitors (PDE5i) are traditionally employed for the management of erectile dysfunction and lower urinary tract symptoms. However, their role in the healing of complex penile wounds remains scarcely discussed. This study aims to describe the case of a 27-year-old man who suffered from penile strangulation, treated with sildenafil. Additionally, a literature review concerning the use of PDE5i for the treatment of complex penile injuries will be conducted. A 27-year-old man presented to the emergency room after a self-induced penile strangulation using a ring placed at the base of the penis. Extensive necrosis of the corpus cavernosum was identified through magnetic resonance imaging. Considering the psychosocial implications of penile amputation, organ preservation was chosen, and conservative treatment with sildenafil and daily local dressings was initiated. Thirty days after admission, Doppler ultrasound revealed symmetrical corpus cavernosum with normal echogenicity and usual blood flow patterns. Subsequently, the patient underwent superficial necrotic tissue debridement followed by partial skin grafting in a second stage, leading to hospital discharge after 55 days of hospitalization. PDE5 inhibitors enhance nitric oxide bioavailability, promoting vasodilation and improved tissue oxygenation, thereby facilitating various phases of the healing process. Evidence indicates their benefit in microvascular perfusion in skin and soft tissues. Reports suggest satisfactory outcomes of topical PDE5i application in radiation-induced lesions, implying their role in epidermal cell expansion, reduction of inflammatory infiltrates, enhanced vascularization, and decreased collagen deposition. This study presents a successful case of sildenafil use in treatment of a complex penile wound, shedding light on an unconventional application of PDE5i. No conflict.
{"title":"(PM-17) THE ROLE OF PHOSPHODIESTERASE-5 INHIBITORS IN THE TREATMENT OF COMPLEX PENILE WOUNDS: A CASE REPORT AND LITERATURE REVIEW","authors":"C. de Oliveira, A. Fregonesi, L. Costa de Salles, G. Chahade Sibanto Simões, A. B. Pereira de Souza, A. Degani Ottaiano, A. Canettieri Rubez, B. Ricardo Di Domenico, F. Franco de Oliveira Júnior, A. Akel Ferruccio, R. Destro Saad","doi":"10.1093/jsxmed/qdae018.045","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae018.045","url":null,"abstract":"\u0000 \u0000 \u0000 Phosphodiesterase-5 inhibitors (PDE5i) are traditionally employed for the management of erectile dysfunction and lower urinary tract symptoms. However, their role in the healing of complex penile wounds remains scarcely discussed. This study aims to describe the case of a 27-year-old man who suffered from penile strangulation, treated with sildenafil. Additionally, a literature review concerning the use of PDE5i for the treatment of complex penile injuries will be conducted.\u0000 \u0000 \u0000 \u0000 A 27-year-old man presented to the emergency room after a self-induced penile strangulation using a ring placed at the base of the penis. Extensive necrosis of the corpus cavernosum was identified through magnetic resonance imaging. Considering the psychosocial implications of penile amputation, organ preservation was chosen, and conservative treatment with sildenafil and daily local dressings was initiated. Thirty days after admission, Doppler ultrasound revealed symmetrical corpus cavernosum with normal echogenicity and usual blood flow patterns. Subsequently, the patient underwent superficial necrotic tissue debridement followed by partial skin grafting in a second stage, leading to hospital discharge after 55 days of hospitalization.\u0000 \u0000 \u0000 \u0000 PDE5 inhibitors enhance nitric oxide bioavailability, promoting vasodilation and improved tissue oxygenation, thereby facilitating various phases of the healing process. Evidence indicates their benefit in microvascular perfusion in skin and soft tissues. Reports suggest satisfactory outcomes of topical PDE5i application in radiation-induced lesions, implying their role in epidermal cell expansion, reduction of inflammatory infiltrates, enhanced vascularization, and decreased collagen deposition.\u0000 \u0000 \u0000 \u0000 This study presents a successful case of sildenafil use in treatment of a complex penile wound, shedding light on an unconventional application of PDE5i.\u0000 \u0000 \u0000 \u0000 No conflict.\u0000","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"117 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140380331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-26DOI: 10.1093/jsxmed/qdae018.010
J. Moreno, M. Khera
The use of testosterone replacement therapy (TRT) in hypogonadal men with prostate cancer (PC) on active surveillance (AS) has been controversial. However, recent studies have challenged this notion, warranting further investigation. We aim to assess the impact of TRT on PC progression in hypogonadal men on AS. We conducted a retrospective chart review using data from a single hospital system between 2009 and 2022. The database included hypogonadal men with PC on AS who underwent TRT. Patients with prior PC treatment were excluded. PSA and total testosterone (TT) levels were recorded at various time points, including before and after TRT initiation. One-way ANOVA was used to analyze mean PSA and TT levels, and PC treatment progression was documented. A total of 25 men met the inclusion criteria. Mean PSA and TT levels at each time interval showed no significant difference in PSA (P = 0.283), while TT exhibited significant variation (P = 0.0052) throughout the 2-year study period. Mean TT before TRT initiation was 311.39 ng/dL, and after TRT, it increased to 773.04 ng/dL (P = 0.00011). Only one patient (4%) underwent radiation therapy for PC five years after starting TRT. Initiating TRT in hypogonadal men on AS for PC did not result in a significant change in PSA levels, despite an increase in testosterone. As our database expands, we aim to strengthen the study's statistical power. These findings contribute to the growing evidence supporting the potential viability of TRT in hypogonadal men on AS. No conflict.
在前列腺癌（PC）患者中使用睾酮替代疗法（TRT）进行主动监测（AS）一直存在争议。然而，最近的研究对这一观点提出了质疑，值得进一步研究。我们旨在评估TRT对接受AS治疗的性腺功能低下男性PC进展的影响。 我们利用一家医院系统在 2009 年至 2022 年间的数据进行了一项回顾性病历审查。数据库中包括接受TRT治疗的性腺功能减退男性AS PC患者。之前接受过 PC 治疗的患者不包括在内。在不同的时间点记录了PSA和总睾酮（TT）水平，包括开始TRT前后。采用单因素方差分析来分析 PSA 和 TT 的平均水平，并记录 PC 治疗的进展情况。 共有 25 名男性符合纳入标准。各时间间隔的 PSA 和 TT 平均水平显示，PSA 没有显著差异（P = 0.283），而 TT 在整个 2 年研究期间表现出显著差异（P = 0.0052）。TRT开始前的平均TT为311.39纳克/分升，TRT开始后则增至773.04纳克/分升（P = 0.00011）。只有一名患者（4%）在开始 TRT 五年后接受了 PC 放射治疗。 对于因 PC 而接受 AS 治疗的性腺功能低下男性，尽管睾酮有所上升，但启动 TRT 并未导致 PSA 水平发生显著变化。随着我们数据库的扩大，我们的目标是加强研究的统计能力。这些研究结果为越来越多的证据支持TRT在性腺功能低下的男性AS患者中的潜在可行性做出了贡献。 无冲突。
{"title":"(O-13) TESTOSTERONE REPLACEMENT THERAPY AND PROSTATE CANCER PROGRESSION IN HYPOGONADAL MEN ON ACTIVE SURVEILLANCE: A RETROSPECTIVE ANALYSIS","authors":"J. Moreno, M. Khera","doi":"10.1093/jsxmed/qdae018.010","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae018.010","url":null,"abstract":"\u0000 \u0000 \u0000 The use of testosterone replacement therapy (TRT) in hypogonadal men with prostate cancer (PC) on active surveillance (AS) has been controversial. However, recent studies have challenged this notion, warranting further investigation. We aim to assess the impact of TRT on PC progression in hypogonadal men on AS.\u0000 \u0000 \u0000 \u0000 We conducted a retrospective chart review using data from a single hospital system between 2009 and 2022. The database included hypogonadal men with PC on AS who underwent TRT. Patients with prior PC treatment were excluded. PSA and total testosterone (TT) levels were recorded at various time points, including before and after TRT initiation. One-way ANOVA was used to analyze mean PSA and TT levels, and PC treatment progression was documented.\u0000 \u0000 \u0000 \u0000 A total of 25 men met the inclusion criteria. Mean PSA and TT levels at each time interval showed no significant difference in PSA (P = 0.283), while TT exhibited significant variation (P = 0.0052) throughout the 2-year study period. Mean TT before TRT initiation was 311.39 ng/dL, and after TRT, it increased to 773.04 ng/dL (P = 0.00011). Only one patient (4%) underwent radiation therapy for PC five years after starting TRT.\u0000 \u0000 \u0000 \u0000 Initiating TRT in hypogonadal men on AS for PC did not result in a significant change in PSA levels, despite an increase in testosterone. As our database expands, we aim to strengthen the study's statistical power. These findings contribute to the growing evidence supporting the potential viability of TRT in hypogonadal men on AS.\u0000 \u0000 \u0000 \u0000 \u0000 No conflict.\u0000","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"105 36","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140380473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-26DOI: 10.1093/jsxmed/qdae018.021
M. Mayer, A. Gioielli, S. Valente
After conducting an exhaustive review of the literature published to date, we decided to evaluate the effects of acute exposure to autologous PRP on erectile function and assess the impact of this therapeutic strategy in patients with erectile dysfunction of mild-moderate vascular origin. All patients who participated in our study completed the IIEF 5 questionnaire prior to the procedure. autologous venous blood was extracted, the sample was processed and activated with 10% calcium chloride solution. After local anesthesia in the trunk of the penis shaft with benzocaine and xylocaine. 8 ml of PRP was applied to 9 patients, with a 25G needle, distributed in 4 applications. 2 applications in each cavernous body, one in the distal region and another in the proximal regionsThe designed protocol indicates: 4 applications spaced by 15 days. The 9 patients complied with all applications. The average age of the patients was 68.7 years (range 58-77). The IIEF-5 average prior to applications was 14.6.One month after completing the complete protocol, the IIEF-5 score showed a result of 18.9. This type of procedure, being an autologous treatment and not having relevant complications, could be a promising therapeutic strategy for patients with erectile dysfunction of mild-moderate vascular origin, as long as expectations are explained and health is addressed. integral to avoid the eventual progressive deterioration of the endothelium. No conflict.
{"title":"(O-27) PRELIMINARY DATA ON THE USE OF PLATELET-RICH PLASMA IN PENIS FOR ERECTILE DYSFUNCTION OF VASCULAR ORIGIN","authors":"M. Mayer, A. Gioielli, S. Valente","doi":"10.1093/jsxmed/qdae018.021","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae018.021","url":null,"abstract":"\u0000 \u0000 \u0000 After conducting an exhaustive review of the literature published to date, we decided to evaluate the effects of acute exposure to autologous PRP on erectile function and assess the impact of this therapeutic strategy in patients with erectile dysfunction of mild-moderate vascular origin.\u0000 \u0000 \u0000 \u0000 All patients who participated in our study completed the IIEF 5 questionnaire prior to the procedure.\u0000 \u0000 \u0000 \u0000 autologous venous blood was extracted, the sample was processed and activated with 10% calcium chloride solution. After local anesthesia in the trunk of the penis shaft with benzocaine and xylocaine. 8 ml of PRP was applied to 9 patients, with a 25G needle, distributed in 4 applications. 2 applications in each cavernous body, one in the distal region and another in the proximal regionsThe designed protocol indicates: 4 applications spaced by 15 days. The 9 patients complied with all applications.\u0000 \u0000 \u0000 \u0000 The average age of the patients was 68.7 years (range 58-77). The IIEF-5 average prior to applications was 14.6.One month after completing the complete protocol, the IIEF-5 score showed a result of 18.9.\u0000 \u0000 \u0000 \u0000 This type of procedure, being an autologous treatment and not having relevant complications, could be a promising therapeutic strategy for patients with erectile dysfunction of mild-moderate vascular origin, as long as expectations are explained and health is addressed. integral to avoid the eventual progressive deterioration of the endothelium.\u0000 \u0000 \u0000 \u0000 No conflict.\u0000","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"113 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140380508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-26DOI: 10.1093/jsxmed/qdae018.047
B. O Ferreira, B. J Teixeira, L. Talib, M. T Scanavino
Hypersexuality or Compulsive Sexual Behavior Disorder (CSBD) is characterized by a spectrum of sexual behaviors and fantasies marked by compulsion, obsession, and impulsivity. The pathophysiology of CSBD remains poorly understood despite the arousing of articles exploring the potential biomarkers associated with hypersexuality. We aimed to review the literature regarding the investigation on CSBD pathophysiology from a neuroimaging, neuroendocrine and molecular perspective. We raised papers related on neuroimaging, neuroendocrine and molecular biomarkers investigated in individuals that reached diagnosis of CSBD or similar, written in English language in the last 10 years, through PubMed, Scopus, and Web of Science with biomarkers and compulsive sexual behavior/hypersexuality key terms. Neuroimaging studies revealed the activation of the anterior cingulate cortex, ventral striatum, and amygdala, in individuals with CSBD. Neuroendocrine markers revealed abnormalities in the hypothalamic-pituitary-adrenal (HPA) axis, including elevated adrenocorticotropic hormone (ACTH) levels and non-suppression of dexamethasone. Findings concerning the hypothalamic-pituitary-gonadal (HPG) axis, responsible for sexual function regulation, varied among CSBD individuals, including testosterone and luteinizing hormone (LH) levels. Oxytocin levels have been noted to rise in CSBD individuals and subsequently decrease following psychotherapy. Genetic and epigenetic markers associated with CSBD suggest involvement of addiction-related genes and epigenetic modifications near the corticotropin-releasing hormone (CRH) gene. Most of the findings point to HPA axis alterations. Molecular analysis is in the beginning, as well as more research on the HPG axis is needed. The exploration of CSBD biomarkers potentially will provide insights into its pathophysiology, diagnosis, and treatment. FAPESP.
{"title":"(PM-19) INSIGHTS INTO THE PATHOPHYSIOLOGY OF HYPERSEXUALITY: A COMPREHENSIVE LITERATURE EXPLORATION","authors":"B. O Ferreira, B. J Teixeira, L. Talib, M. T Scanavino","doi":"10.1093/jsxmed/qdae018.047","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae018.047","url":null,"abstract":"\u0000 \u0000 \u0000 Hypersexuality or Compulsive Sexual Behavior Disorder (CSBD) is characterized by a spectrum of sexual behaviors and fantasies marked by compulsion, obsession, and impulsivity. The pathophysiology of CSBD remains poorly understood despite the arousing of articles exploring the potential biomarkers associated with hypersexuality.\u0000 \u0000 \u0000 \u0000 We aimed to review the literature regarding the investigation on CSBD pathophysiology from a neuroimaging, neuroendocrine and molecular perspective.\u0000 \u0000 \u0000 \u0000 We raised papers related on neuroimaging, neuroendocrine and molecular biomarkers investigated in individuals that reached diagnosis of CSBD or similar, written in English language in the last 10 years, through PubMed, Scopus, and Web of Science with biomarkers and compulsive sexual behavior/hypersexuality key terms.\u0000 \u0000 \u0000 \u0000 Neuroimaging studies revealed the activation of the anterior cingulate cortex, ventral striatum, and amygdala, in individuals with CSBD. Neuroendocrine markers revealed abnormalities in the hypothalamic-pituitary-adrenal (HPA) axis, including elevated adrenocorticotropic hormone (ACTH) levels and non-suppression of dexamethasone. Findings concerning the hypothalamic-pituitary-gonadal (HPG) axis, responsible for sexual function regulation, varied among CSBD individuals, including testosterone and luteinizing hormone (LH) levels. Oxytocin levels have been noted to rise in CSBD individuals and subsequently decrease following psychotherapy. Genetic and epigenetic markers associated with CSBD suggest involvement of addiction-related genes and epigenetic modifications near the corticotropin-releasing hormone (CRH) gene.\u0000 \u0000 \u0000 \u0000 Most of the findings point to HPA axis alterations. Molecular analysis is in the beginning, as well as more research on the HPG axis is needed. The exploration of CSBD biomarkers potentially will provide insights into its pathophysiology, diagnosis, and treatment.\u0000 \u0000 \u0000 \u0000 FAPESP.\u0000","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"110 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140380803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-26DOI: 10.1093/jsxmed/qdae018.037
V. Boraschi Gomes, T. Fernandes Torres, D. Merino, M. Castiglione, R. Pavione Rodrigues Pereira, C. Tanaka
Sexual dysfunction is an alteration in one or more components of the sexual response cycle and dyspareunia is the dysfunction in which the woman experiences pain before, during or after vaginal penetration, which impairs quality of life and relationship with the couple. Physiotherapy uses several techniques to address this dysfunction, including pelvic floor muscle training (PFMT) and perineal massage (PM), but studies on the actual effects of these techniques and the resolution of dyspareunia are still scarce. Therefore, the objective of this study is to identify the evidence on the use of PFMT and MP techniques in the treatment of women with dyspareunia. Research carried out in the PEDro, Pubmed and MEDLINE databases. Articles of the type were included: clinical trials, meta-analysis and systematic reviews, published in English and Portuguese; in the period from 2013 to 2023; who addressed TMAP and MP techniques in the treatment of dyspareunia. Those who did not meet the inclusion criteria were excluded. In total, 525 articles were identified, but only 9 studies were selected for this review as they met the inclusion criteria. Most of the results showed significant responses to treatment with the use of PFMT and MP, and even the studies in which they did not obtain significance did not rule out the possibility of these techniques, since they do not present side effects and have good potential. to improve. Many studies have low methodological quality. It was observed in the literature that PFMT and MP have good responses in the treatment of dyspareunia, but there is not enough support in the literature to demonstrate their effectiveness. It is necessary to develop future studies with better methodological quality for more solid scientific evidence. No conflict.
{"title":"(PM-05) EFFICACY OF PELVIC FLOOR MUSCLE TRAINING AND PERINEAL MASSAGE IN THE TREATMENT OF WOMEN WITH DYSPAREUNIA: NARRATIVE REVIEW OF THE LITERATURE","authors":"V. Boraschi Gomes, T. Fernandes Torres, D. Merino, M. Castiglione, R. Pavione Rodrigues Pereira, C. Tanaka","doi":"10.1093/jsxmed/qdae018.037","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae018.037","url":null,"abstract":"\u0000 \u0000 \u0000 Sexual dysfunction is an alteration in one or more components of the sexual response cycle and dyspareunia is the dysfunction in which the woman experiences pain before, during or after vaginal penetration, which impairs quality of life and relationship with the couple. Physiotherapy uses several techniques to address this dysfunction, including pelvic floor muscle training (PFMT) and perineal massage (PM), but studies on the actual effects of these techniques and the resolution of dyspareunia are still scarce. Therefore, the objective of this study is to identify the evidence on the use of PFMT and MP techniques in the treatment of women with dyspareunia.\u0000 \u0000 \u0000 \u0000 Research carried out in the PEDro, Pubmed and MEDLINE databases. Articles of the type were included: clinical trials, meta-analysis and systematic reviews, published in English and Portuguese; in the period from 2013 to 2023; who addressed TMAP and MP techniques in the treatment of dyspareunia. Those who did not meet the inclusion criteria were excluded.\u0000 \u0000 \u0000 \u0000 In total, 525 articles were identified, but only 9 studies were selected for this review as they met the inclusion criteria. Most of the results showed significant responses to treatment with the use of PFMT and MP, and even the studies in which they did not obtain significance did not rule out the possibility of these techniques, since they do not present side effects and have good potential. to improve. Many studies have low methodological quality.\u0000 \u0000 \u0000 \u0000 It was observed in the literature that PFMT and MP have good responses in the treatment of dyspareunia, but there is not enough support in the literature to demonstrate their effectiveness. It is necessary to develop future studies with better methodological quality for more solid scientific evidence.\u0000 \u0000 \u0000 \u0000 No conflict.\u0000","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"123 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140378635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-26DOI: 10.1093/jsxmed/qdae018.024
M. Abensur, N. M. Calle Roldán, K. T. Mutti, C. H. N. Abdo
Compulsive Sexual Behaviour Disorder (CSBD) is characterized in ICD-11 as a persistent inability to control intense sexual urges resulting in repetitive sexual behaviours and negative effects in personal life. Due to the limited research on CSBD´s treatment, our goal is to report a successful case of 39-year-old symptomatic male patient, treated in a structured closed online group focused on self and CSBD´s knowledge, new habits acquisition, particularities of these patients´ profile, associated with medication use. the information in this report were obtained through patient interviews, psychiatric and psychological records and literature review. The treatment took place in an outpatient service specialized in sexuality at a public institution. Following CSBD diagnosis, Paroxetine Hydrochloride (20mg/day) was prescribed with regular psychiatric follow-ups. And was referred to an online psychotherapy group consisting of 4 CSBD participants, 2 therapists, weekly 1-hour sessions held for 10 months. The therapy addressed pertinent issues to the treatment and utilized neuropsychoeducational sessions to establish new habits, along with reflective “homework” tasks. Psychotherapeutic treatment enhanced self-knowledge leading to a loss of meaning to his compulsive behaviours, therefore, a decrease in its frequency. The patient developed a healthy sexuality, free from guilt and risky behaviours, improved emotional management and diversified interests. Paroxetine Hydrochloride (20mg/day) facilitated the psychotherapy process (10 months), allowing gradual dosage reduction upon symptom alleviation. The combination of themed online group psychotherapy, a well-established group bond, neuropsychoeducation, and medication effectively addressed CSBD symptoms, enhanced emotional management, and improved quality of life. The positive outcome encourages future research into this treatment approach for CSBD. No conflict.
{"title":"(O-30) ONLINE GROUP THERAPY ASSOCIATED WITH PAROXETINE HYDROCHLORIDE FOR COMPULSIVE SEXUAL BEHAVIOR DISORDER´S TREATMENT: A CASE REPORT","authors":"M. Abensur, N. M. Calle Roldán, K. T. Mutti, C. H. N. Abdo","doi":"10.1093/jsxmed/qdae018.024","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae018.024","url":null,"abstract":"\u0000 \u0000 \u0000 Compulsive Sexual Behaviour Disorder (CSBD) is characterized in ICD-11 as a persistent inability to control intense sexual urges resulting in repetitive sexual behaviours and negative effects in personal life.\u0000 Due to the limited research on CSBD´s treatment, our goal is to report a successful case of 39-year-old symptomatic male patient, treated in a structured closed online group focused on self and CSBD´s knowledge, new habits acquisition, particularities of these patients´ profile, associated with medication use.\u0000 \u0000 \u0000 \u0000 the information in this report were obtained through patient interviews, psychiatric and psychological records and literature review.\u0000 The treatment took place in an outpatient service specialized in sexuality at a public institution. Following CSBD diagnosis, Paroxetine Hydrochloride (20mg/day) was prescribed with regular psychiatric follow-ups. And was referred to an online psychotherapy group consisting of 4 CSBD participants, 2 therapists, weekly 1-hour sessions held for 10 months. The therapy addressed pertinent issues to the treatment and utilized neuropsychoeducational sessions to establish new habits, along with reflective “homework” tasks.\u0000 \u0000 \u0000 \u0000 Psychotherapeutic treatment enhanced self-knowledge leading to a loss of meaning to his compulsive behaviours, therefore, a decrease in its frequency. The patient developed a healthy sexuality, free from guilt and risky behaviours, improved emotional management and diversified interests.\u0000 Paroxetine Hydrochloride (20mg/day) facilitated the psychotherapy process (10 months), allowing gradual dosage reduction upon symptom alleviation.\u0000 \u0000 \u0000 \u0000 The combination of themed online group psychotherapy, a well-established group bond, neuropsychoeducation, and medication effectively addressed CSBD symptoms, enhanced emotional management, and improved quality of life. The positive outcome encourages future research into this treatment approach for CSBD.\u0000 \u0000 \u0000 \u0000 No conflict.\u0000","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"10 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140378701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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