Pub Date : 2024-03-26DOI: 10.1093/jsxmed/qdae018.001
J. Moreno, M. Khera
Oral phosphodiesterase type 5 inhibitors (PDE5i) and intracavernosal injections (ICI) are effective treatments for erectile dysfunction (ED). However, the risk factors associated with the transition from oral therapy to ICI use remain less established. We aimed to identify predictive factors contributing to the progression from oral PDE5i to ICI therapy. Retrospective chart review was conducted on patients presenting with erectile dysfunction at our clinic. Patients initiating therapy before clinical documentation or without follow-up were excluded. Statistical analysis utilized chi-square test, two-tailed student's t-test, and multivariable logistic regression performed in R. Among 259 men treated for ED, 61% (158) reported subjective improvement with oral PDE5i therapy alone, while 18% (46) initiated ICI therapy. Table 1 summarizes demographic information and cardiovascular risk factors. Men progressing to ICI had higher rates of hypertension (54.3% vs. 28.4%, p=0.0015), type 2 diabetes mellitus (32.6% vs. 11.4%, p=0.0013), and a history of radical prostatectomy (26.1% vs. 3.8%, p<0.001) compared to those satisfied with oral therapy. Significant predictors for ICI progression on multivariate analysis were history of radical prostatectomy (OR 19.4, [95% CI, 1.42-678.88]) and diabetes mellitus (OR 8.6, [95% CI, 1.36-76.49]). Two patients (4.3%) experienced priapism as a complication of ICI use. Among the patients using ICI, 54% (25/46) reported satisfaction with their erections. Cardiovascular risk factors and a history of radical prostatectomy were more prevalent among patients progressing from oral therapy to ICI in our cohort. These findings may guide early counseling on ED treatment progression for patients with these predictive factors. No conflict.
{"title":"(O-01) PREDICTORS OF INTRACAVERNOSAL INJECTION THERAPY IN MEN WITH ERECTILE DYSFUNCTION","authors":"J. Moreno, M. Khera","doi":"10.1093/jsxmed/qdae018.001","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae018.001","url":null,"abstract":"\u0000 \u0000 \u0000 Oral phosphodiesterase type 5 inhibitors (PDE5i) and intracavernosal injections (ICI) are effective treatments for erectile dysfunction (ED). However, the risk factors associated with the transition from oral therapy to ICI use remain less established. We aimed to identify predictive factors contributing to the progression from oral PDE5i to ICI therapy.\u0000 \u0000 \u0000 \u0000 Retrospective chart review was conducted on patients presenting with erectile dysfunction at our clinic. Patients initiating therapy before clinical documentation or without follow-up were excluded. Statistical analysis utilized chi-square test, two-tailed student's t-test, and multivariable logistic regression performed in R.\u0000 \u0000 \u0000 \u0000 Among 259 men treated for ED, 61% (158) reported subjective improvement with oral PDE5i therapy alone, while 18% (46) initiated ICI therapy. Table 1 summarizes demographic information and cardiovascular risk factors. Men progressing to ICI had higher rates of hypertension (54.3% vs. 28.4%, p=0.0015), type 2 diabetes mellitus (32.6% vs. 11.4%, p=0.0013), and a history of radical prostatectomy (26.1% vs. 3.8%, p<0.001) compared to those satisfied with oral therapy. Significant predictors for ICI progression on multivariate analysis were history of radical prostatectomy (OR 19.4, [95% CI, 1.42-678.88]) and diabetes mellitus (OR 8.6, [95% CI, 1.36-76.49]). Two patients (4.3%) experienced priapism as a complication of ICI use. Among the patients using ICI, 54% (25/46) reported satisfaction with their erections.\u0000 \u0000 \u0000 \u0000 Cardiovascular risk factors and a history of radical prostatectomy were more prevalent among patients progressing from oral therapy to ICI in our cohort. These findings may guide early counseling on ED treatment progression for patients with these predictive factors.\u0000 \u0000 \u0000 \u0000 \u0000 No conflict.\u0000","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"109 45","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140380754","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/qdae018.005
S Garcia, C. Diaz Ritter, S. Peña Rodríguez, D. Fernandez Mantilla, F. Khoshbin
Climacturia is a frequent complication of radical prostatectomy (RP). Pelvic floor involvement and urinary sphincter functionality play a vital role in its pathophysiology. The prevalence in Colombia is unknown, and it is currently an underdiagnosed entity. This study aims to estimate the prevalence of climacturia in men undergoing RP in a fourth-level hospital in Bogota from 2018 to 2023. A descriptive cross-sectional observational study was conducted. Patients who attended postoperative control for 6 months and 1 year after a RP in the institution were included. A standardized survey was applied evaluating the presence of urine leakage during sexual arousal and/or orgasm and standardized scales of urinary incontinence and sexual function. Forty-four patients were included. The mean age of the patients was 64.7 (range: 45-81). The distribution of the surgical approach used in these patients is shown in Table 1. 56,8% (n=25) reported urine leakage during arousal. Of these patients, 43.1% (n=19) had received robot-assisted radical prostatectomy (RARP), followed by open surgery with 13,6% (n=6) of patients reporting this symptom. On the other hand, 38,6% (n=17) of patients had urine leakage during orgasm, of which the highest proportion of this symptom was open surgery. A limitation of the study was the lack of active search for this pathology in the general urological consultation and the poor response of patients to the forms. The prevalence of climacturia is high and its diagnosis has multiple limitations. In addition, other post-prostatectomy side effects were identified, such as urine leakage with arousal, whose prevalence was higher than that of climacturia and may affect the sexuality of patients. Additionally, considering these are the preliminary findings from a prospective study, a larger sample size is required to achieve more representative results. No conflict.
{"title":"(O-06) PREVALENCE OF CLIMACTURIA IN POST RADICAL PROSTATECTOMY PATIENTS IN REFERRAL HOSPITAL IN BOGOTA","authors":"S Garcia, C. Diaz Ritter, S. Peña Rodríguez, D. Fernandez Mantilla, F. Khoshbin","doi":"10.1093/jsxmed/qdae018.005","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae018.005","url":null,"abstract":"\u0000 \u0000 \u0000 Climacturia is a frequent complication of radical prostatectomy (RP). Pelvic floor involvement and urinary sphincter functionality play a vital role in its pathophysiology. The prevalence in Colombia is unknown, and it is currently an underdiagnosed entity. This study aims to estimate the prevalence of climacturia in men undergoing RP in a fourth-level hospital in Bogota from 2018 to 2023.\u0000 \u0000 \u0000 \u0000 A descriptive cross-sectional observational study was conducted. Patients who attended postoperative control for 6 months and 1 year after a RP in the institution were included. A standardized survey was applied evaluating the presence of urine leakage during sexual arousal and/or orgasm and standardized scales of urinary incontinence and sexual function.\u0000 \u0000 \u0000 \u0000 Forty-four patients were included. The mean age of the patients was 64.7 (range: 45-81). The distribution of the surgical approach used in these patients is shown in Table 1. 56,8% (n=25) reported urine leakage during arousal. Of these patients, 43.1% (n=19) had received robot-assisted radical prostatectomy (RARP), followed by open surgery with 13,6% (n=6) of patients reporting this symptom. On the other hand, 38,6% (n=17) of patients had urine leakage during orgasm, of which the highest proportion of this symptom was open surgery. A limitation of the study was the lack of active search for this pathology in the general urological consultation and the poor response of patients to the forms.\u0000 \u0000 \u0000 \u0000 The prevalence of climacturia is high and its diagnosis has multiple limitations. In addition, other post-prostatectomy side effects were identified, such as urine leakage with arousal, whose prevalence was higher than that of climacturia and may affect the sexuality of patients. Additionally, considering these are the preliminary findings from a prospective study, a larger sample size is required to achieve more representative results.\u0000 \u0000 \u0000 \u0000 \u0000 No conflict.\u0000","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"118 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140379212","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/qdae018.002
J. F. Uribe
The present study wants to evaluate the frequency of sudden loss of erection in patients possibly affected by penile congenital dorsal venous leaks, using a structured questionnaire to identify the so-called wavering pattern of erection, to refine the diagnosis. and indicate the need for other diagnostic tests such as doppler ultrasound or CavernoCT to identify such leaks. In a group of 60 patients with confirmed ultrasound diagnosis of penile dorsal venous leak, a structured questionnaire of five questions was systematically administered about situations that led to loss of erection, including the following 5 items: Changes in position, external distractions, change from feet to lying down or vice versa, condom use and loss of erection during masturbation. Patients with at least four positive items were considered to comply with the so-called hesitant pattern of erection. It was found that in this group with ultrasound leaks, 81.6% of the patients fulfilled at least 4/5 items of the questionnaire and 18.3% with 3 or less. The most frequent question answered positively was “Changes of position” (91.6%), followed by “External distractions” (86.6%), third “loss of erection during masturbation” (83.4%), fourth “changes from lying to standing or vice versa” (80%) and the fifth “loss of erection with condom use” (66.6%). It is considered that the systematic performance of some key questions in patients under 40 years of age who consult for erectile dysfunction can guide an underlying diagnosis of congenital venous leaks that should be verified with adequate diagnostic images and whose use as a valid instrument requires verification additional. erectile dysfunction, vasculogenic impotence, penile diseases, penile veins. No conflict.
{"title":"(O-02) WAVERING PATTERN OF ERECTION AS A CLINICAL MANIFESTATION OF DORSAL VENOUS LEAKS OF THE PENIS","authors":"J. F. Uribe","doi":"10.1093/jsxmed/qdae018.002","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae018.002","url":null,"abstract":"\u0000 \u0000 \u0000 The present study wants to evaluate the frequency of sudden loss of erection in patients possibly affected by penile congenital dorsal venous leaks, using a structured questionnaire to identify the so-called wavering pattern of erection, to refine the diagnosis. and indicate the need for other diagnostic tests such as doppler ultrasound or CavernoCT to identify such leaks.\u0000 \u0000 \u0000 \u0000 In a group of 60 patients with confirmed ultrasound diagnosis of penile dorsal venous leak, a structured questionnaire of five questions was systematically administered about situations that led to loss of erection, including the following 5 items: Changes in position, external distractions, change from feet to lying down or vice versa, condom use and loss of erection during masturbation. Patients with at least four positive items were considered to comply with the so-called hesitant pattern of erection.\u0000 \u0000 \u0000 \u0000 It was found that in this group with ultrasound leaks, 81.6% of the patients fulfilled at least 4/5 items of the questionnaire and 18.3% with 3 or less. The most frequent question answered positively was “Changes of position” (91.6%), followed by “External distractions” (86.6%), third “loss of erection during masturbation” (83.4%), fourth “changes from lying to standing or vice versa” (80%) and the fifth “loss of erection with condom use” (66.6%).\u0000 \u0000 \u0000 \u0000 It is considered that the systematic performance of some key questions in patients under 40 years of age who consult for erectile dysfunction can guide an underlying diagnosis of congenital venous leaks that should be verified with adequate diagnostic images and whose use as a valid instrument requires verification additional.\u0000 \u0000 \u0000 \u0000 erectile dysfunction, vasculogenic impotence, penile diseases, penile veins.\u0000 \u0000 \u0000 \u0000 \u0000 No conflict.\u0000","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"110 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140380792","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/qdae018.020
J. B. Cabral Júnior, C. A. Souza Filho, G. J. A. Amorim, R. A. P. Oliveira, L. A. I. A. Ramos, R. C. Souza, F. J. C. Cavalcante
Intracavernous injectable therapy (IIT) has been considered a second-line therapy for the treatment of erectile dysfunction (ED) since the emergence of phosphodiesterase type 5 inhibitors (IPDE-5) for oral use in the late 1990s. The ease of access to IPDE-5, with increasingly accessible costs, in addition to the safety and efficacy with the use of these medications, caused IIT to fall into disuse for a good period. In turn, about 30% of men with ED do not respond satisfactorily to the oral use of IPDE-5, needing to resort to some other form of treatment. Patients with ED unresponsive to oral IPDE-5 were referred for IIT. Subsequently, they were submitted to a questionnaire to evaluate the results. Eight men answered the applied questionnaire. The mean age of patients was 61 years (44-75 years). All patients reported that their partner was aware of the treatment used, and 75% of patients reported the presence of some comorbidity. The response to the test was considered satisfactory in 75% of the patients, with full erection (EHS 4) in 37.5%, and partial erection with penetration (EHS 3) in 37.5%. Only one patient (12.5%) reported not having adapted to the proposed treatment, despite having a satisfactory erection. After a 12-month follow-up, only one patient (12.5%) continues to use IIT, 3 (37.5%) opted for penile prosthesis implantation, while the others chose not to adhere to any subsequent treatment. In 62.5% of patients there was no report of any side effect. Despite high rates of efficacy and satisfaction reported in the literature, our initial experience showed a low rate of adherence to IIT. The team's lack of experience and difficulty in following up patients probably contributed to these results, revealing a need for better team training and patient guidance. No conflict.
{"title":"(O-26) INITIAL EXPERIENCE IN IMPLEMENTING AN INTRACAVERNOSAL INJECTABLE THERAPY PROGRAM FOR THE TREATMENT OF ERECTILE DYSFUNCTION IN PATIENTS AT A PUBLIC HOSPITAL","authors":"J. B. Cabral Júnior, C. A. Souza Filho, G. J. A. Amorim, R. A. P. Oliveira, L. A. I. A. Ramos, R. C. Souza, F. J. C. Cavalcante","doi":"10.1093/jsxmed/qdae018.020","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae018.020","url":null,"abstract":"\u0000 \u0000 \u0000 Intracavernous injectable therapy (IIT) has been considered a second-line therapy for the treatment of erectile dysfunction (ED) since the emergence of phosphodiesterase type 5 inhibitors (IPDE-5) for oral use in the late 1990s. The ease of access to IPDE-5, with increasingly accessible costs, in addition to the safety and efficacy with the use of these medications, caused IIT to fall into disuse for a good period. In turn, about 30% of men with ED do not respond satisfactorily to the oral use of IPDE-5, needing to resort to some other form of treatment.\u0000 \u0000 \u0000 \u0000 Patients with ED unresponsive to oral IPDE-5 were referred for IIT. Subsequently, they were submitted to a questionnaire to evaluate the results.\u0000 \u0000 \u0000 \u0000 Eight men answered the applied questionnaire. The mean age of patients was 61 years (44-75 years). All patients reported that their partner was aware of the treatment used, and 75% of patients reported the presence of some comorbidity. The response to the test was considered satisfactory in 75% of the patients, with full erection (EHS 4) in 37.5%, and partial erection with penetration (EHS 3) in 37.5%. Only one patient (12.5%) reported not having adapted to the proposed treatment, despite having a satisfactory erection. After a 12-month follow-up, only one patient (12.5%) continues to use IIT, 3 (37.5%) opted for penile prosthesis implantation, while the others chose not to adhere to any subsequent treatment. In 62.5% of patients there was no report of any side effect.\u0000 \u0000 \u0000 \u0000 Despite high rates of efficacy and satisfaction reported in the literature, our initial experience showed a low rate of adherence to IIT. The team's lack of experience and difficulty in following up patients probably contributed to these results, revealing a need for better team training and patient guidance.\u0000 \u0000 \u0000 \u0000 No conflict.\u0000","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140378365","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/qdae018.007
G. M. Crelier, R. G. Viterbo, H. A. Heleno, D. P. Nunes, J. L. Schiavini, RdTF Filho, C. M. C. Lara, H. R. J. Junior, R. Damião
Vasectomy is a widely performed male sterilization surgery with rapid recovery. In Brazil, it is carried out following legal criteria for family planning. Vasectomy reversal is a procedure with a high success rate and is considered a cost-effective option compared to other fertility techniques. The microsurgical technique, developed in 1975, is widely adopted for reconstructing the vas deferens. Vasovasostomy is the gold standard technique, using non-absorbable sutures (9-0 or 10-0). The aim of this study is to correlate the literature's results with those achieved through the microsurgical technique employed at the Pedro Ernesto University Hospital. This study was a retrospective and descriptive analysis of medical records and a review of the literature on a surgical technique. We analyzed 56 cases performed between January 2012 and December 2022 at the Pedro Ernesto University Hospital. Additionally, scientific articles published between 1999 and 2022 were collected. Surgeries were performed under general or spinal anesthesia, using a single-layer technique with Prolene 7-0 sutures. All patients underwent sperm analysis at 1, 3, and 6 months postoperatively. A total of 56 vasectomy reversals were performed in patients with an average age of 42.91 years and an average interval of 7.65 years between vasectomy and reversal. The patency rate was 82.14%, and the pregnancy rate among those who were successfully reversed was 15.22%. Reversal was more successful (87.18% patency and 25% pregnancy) in patients with an interval of less than 10 years between surgeries. The results of 56 vasectomy reversals by vasovasostomy using the modified microsurgical technique applied at the Pedro Ernesto University Hospital demonstrated satisfactory patency and pregnancy rates, closely matching those reported in the literature. The technique proved to be effective and safe, with no significant complications. No conflict.
{"title":"(O-09) VARIATION IN MICROSURGICAL TECHNIQUE FOR VASECTOMY REVERSAL: EXPERIENCE FROM A UNIVERSITY HOSPITAL IN RIO DE JANEIRO","authors":"G. M. Crelier, R. G. Viterbo, H. A. Heleno, D. P. Nunes, J. L. Schiavini, RdTF Filho, C. M. C. Lara, H. R. J. Junior, R. Damião","doi":"10.1093/jsxmed/qdae018.007","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae018.007","url":null,"abstract":"\u0000 \u0000 \u0000 Vasectomy is a widely performed male sterilization surgery with rapid recovery. In Brazil, it is carried out following legal criteria for family planning. Vasectomy reversal is a procedure with a high success rate and is considered a cost-effective option compared to other fertility techniques. The microsurgical technique, developed in 1975, is widely adopted for reconstructing the vas deferens. Vasovasostomy is the gold standard technique, using non-absorbable sutures (9-0 or 10-0). The aim of this study is to correlate the literature's results with those achieved through the microsurgical technique employed at the Pedro Ernesto University Hospital.\u0000 \u0000 \u0000 \u0000 This study was a retrospective and descriptive analysis of medical records and a review of the literature on a surgical technique. We analyzed 56 cases performed between January 2012 and December 2022 at the Pedro Ernesto University Hospital. Additionally, scientific articles published between 1999 and 2022 were collected. Surgeries were performed under general or spinal anesthesia, using a single-layer technique with Prolene 7-0 sutures. All patients underwent sperm analysis at 1, 3, and 6 months postoperatively.\u0000 \u0000 \u0000 \u0000 A total of 56 vasectomy reversals were performed in patients with an average age of 42.91 years and an average interval of 7.65 years between vasectomy and reversal. The patency rate was 82.14%, and the pregnancy rate among those who were successfully reversed was 15.22%. Reversal was more successful (87.18% patency and 25% pregnancy) in patients with an interval of less than 10 years between surgeries.\u0000 \u0000 \u0000 \u0000 The results of 56 vasectomy reversals by vasovasostomy using the modified microsurgical technique applied at the Pedro Ernesto University Hospital demonstrated satisfactory patency and pregnancy rates, closely matching those reported in the literature. The technique proved to be effective and safe, with no significant complications.\u0000 \u0000 \u0000 \u0000 No conflict.\u0000","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"121 29","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140379004","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/qdae018.039
M. L. Ribeiro, A. Naccarato, M. E. Negreiros, M. E. Barbuio, I. Silva, W. E. Matheus
Sexual dysfunction, present in 43% of women and 31% of men, is the result of several pathological conditions and must be properly investigated and treated. About 50 to 72% of physicians experience difficulty and do not regularly investigate their patients' sexual health. The study investigates the teaching and approach to sexual health in the medical graduation at the Faculty of Medical Sciences of the State University of Campinas, in order to detect gaps that justify the difficulty in discussing this aspect. Descriptive and transversal study is in progress, including medical students that are above 18 years old and are in the fifth or sixth year of their graduation. Anonymously and after reading the Informed Consent Form, the online questionnaire, composed of questions related to the theoretical and practical approaches in sexuality and the knowledge that they have been receiving in medical school, can be answered. The online questionnaire was answered by 64 students in the fifth and sixth year of graduation (1.6% and 98.4%, respectively). 43.5% denied being effectively prepared and confident, 35.5% are uncertain and only 21% feel prepared to discuss the subject with their patients. The main theme approached involves mostly the female sexuality, being the reproductive focus (85.2%), abortion (85.2%) and sexual violence (83.6%) the most discussed subjects. Only 4 students indicate that they understand male dysfunctions. A minority of participants (21.9%) felt safe to address sexual issues with their patients. Most of the students do not feel comfortable or confident and lack specific knowledge and skills to deal with questions related to sexuality. More time should be dedicated to education, theoretical and practical classes, concerning human sexuality and its cultural, societal, and health aspects in the graduation during medical school. No conflict.
{"title":"(PM-07) EVALUATION OF SEXUAL HEALTH EDUCATION IN THE FACULTY OF MEDICAL SCIENCES OF THE UNIVERSITY OF CAMPINAS: SEXUAL COMMUNICATION IN PATIENT-DOCTOR RELATIONSHIP APPROACH","authors":"M. L. Ribeiro, A. Naccarato, M. E. Negreiros, M. E. Barbuio, I. Silva, W. E. Matheus","doi":"10.1093/jsxmed/qdae018.039","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae018.039","url":null,"abstract":"\u0000 \u0000 \u0000 Sexual dysfunction, present in 43% of women and 31% of men, is the result of several pathological conditions and must be properly investigated and treated. About 50 to 72% of physicians experience difficulty and do not regularly investigate their patients' sexual health.\u0000 The study investigates the teaching and approach to sexual health in the medical graduation at the Faculty of Medical Sciences of the State University of Campinas, in order to detect gaps that justify the difficulty in discussing this aspect.\u0000 \u0000 \u0000 \u0000 Descriptive and transversal study is in progress, including medical students that are above 18 years old and are in the fifth or sixth year of their graduation. Anonymously and after reading the Informed Consent Form, the online questionnaire, composed of questions related to the theoretical and practical approaches in sexuality and the knowledge that they have been receiving in medical school, can be answered.\u0000 \u0000 \u0000 \u0000 The online questionnaire was answered by 64 students in the fifth and sixth year of graduation (1.6% and 98.4%, respectively). 43.5% denied being effectively prepared and confident, 35.5% are uncertain and only 21% feel prepared to discuss the subject with their patients.\u0000 The main theme approached involves mostly the female sexuality, being the reproductive focus (85.2%), abortion (85.2%) and sexual violence (83.6%) the most discussed subjects. Only 4 students indicate that they understand male dysfunctions. A minority of participants (21.9%) felt safe to address sexual issues with their patients.\u0000 \u0000 \u0000 \u0000 Most of the students do not feel comfortable or confident and lack specific knowledge and skills to deal with questions related to sexuality.\u0000 More time should be dedicated to education, theoretical and practical classes, concerning human sexuality and its cultural, societal, and health aspects in the graduation during medical school.\u0000 \u0000 \u0000 \u0000 No conflict.\u0000","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"113 36","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140379243","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/qdae018.040
E. Rodrigues, A. Naccarato, I. Silva, D. Sabbag, F. Denardi, U. Ferreira, W. E. Matheus
Evaluate the impact of physical activity on Quality of Life and Sexual Function in patients with prostate cancer who underwent treatment – surgical or radiotherapy, or who are under active surveillance. 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), FACT-P, IIFE-5 short form, Physical Activity Worksheet, measurement of Heart Rate (HR) and Blood Pressure (BP) to be filled during the month. Data will be collected in 2 initial sessions, after receiving the diagnose or during treatment or active surveillance. The patients will receive physical activity guidance each week, for three months. During this period, individuals will be monitored weekly when a partial evaluation of the results obtained will be carried out. At the end of the 12 sessions, patients will be interviewed again, using same instruments, to assess possible changes in quality of life. At the moment we are almost completing the 12 sessions, with 14 filled. The mean age is 65.5% years old, 90% had radical prostatectomy, 55% has minor income. The patients reported an improvement in their quality of life, in the execution of their recurrent activities, less body aches, a feeling of well being after the walk and during the day, and more disposition for the experienced activities. Confidence in achieving and maintaining an erection, changed from low to moderate. It is expected to establish the relationship between the improvement of quality of life and physical activity in an educational group. After analyzing the results, it is expected to have information that will contribute to the treatment of men with prostate cancer. The results will be presented at National and/or International Congresses, and subsequently published in Scientific Journals. No conflict.
{"title":"(PM-08) PHYSICAL ACTIVITY IN PATIENTS WITH PROSTATE CANCER: THE IMPACT ON QUALITY OF LIFE AND SEXUAL LIFE","authors":"E. Rodrigues, A. Naccarato, I. Silva, D. Sabbag, F. Denardi, U. Ferreira, W. E. Matheus","doi":"10.1093/jsxmed/qdae018.040","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae018.040","url":null,"abstract":"\u0000 \u0000 \u0000 Evaluate the impact of physical activity on Quality of Life and Sexual Function in patients with prostate cancer who underwent treatment – surgical or radiotherapy, or who are under active surveillance.\u0000 \u0000 \u0000 \u0000 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), FACT-P, IIFE-5 short form, Physical Activity Worksheet, measurement of Heart Rate (HR) and Blood Pressure (BP) to be filled during the month. Data will be collected in 2 initial sessions, after receiving the diagnose or during treatment or active surveillance. The patients will receive physical activity guidance each week, for three months. During this period, individuals will be monitored weekly when a partial evaluation of the results obtained will be carried out.\u0000 At the end of the 12 sessions, patients will be interviewed again, using same instruments, to assess possible changes in quality of life.\u0000 \u0000 \u0000 \u0000 At the moment we are almost completing the 12 sessions, with 14 filled. The mean age is 65.5% years old, 90% had radical prostatectomy, 55% has minor income. The patients reported an improvement in their quality of life, in the execution of their recurrent activities, less body aches, a feeling of well being after the walk and during the day, and more disposition for the experienced activities. Confidence in achieving and maintaining an erection, changed from low to moderate.\u0000 \u0000 \u0000 \u0000 It is expected to establish the relationship between the improvement of quality of life and physical activity in an educational group. After analyzing the results, it is expected to have information that will contribute to the treatment of men with prostate cancer. The results will be presented at National and/or International Congresses, and subsequently published in Scientific Journals.\u0000 \u0000 \u0000 \u0000 No conflict.\u0000","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"120 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140380227","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 : 2024-03-01DOI: 10.1093/jsxmed/qdae002.059
G. Yin, J. Ock, J. Suh, M. Kwon, A. Limanjaya, J Ryu
Diabetes mellitus (DM), a primary cause of erectile dysfunction (ED), is a pancreatic β-cell dysfunction that leads to insulin deficiency and resistance, resulting in microvascular complications. Argonaute 2 (Ago2), a catalytic engine in mammalian RNA interference, is involved in neurovascular regeneration under inflammatory conditions. In the present study, we aimed to determine whether an exogenous injection of Ago2 proteins can improve erectile function in STZ-induced type-1 diabetic mice and explore the specific mechanisms of Ago2 in the process. Eight-week-old male C57BL/6 mice were used for in vivo study. The detailed mechanisms were evaluated in age-matched control or STZ-induced type-1 diabetic mice. Mouse cavernous endothelial cells and human umbilical vein endothelial cells were used for in vitro study. The function of Ago2 in high-glucose condition was evaluated by tube formation assay, migration assay, immunofluorescence stain and western blot experiments. We report that Ago2 administration can effectively improve penile erection by enhancing cavernous endothelial cell angiogenesis and survival under diabetic conditions. We found that although Ago2 is highly expressed around blood vessels and nerves, it is significantly reduced in the penis tissue of diabetic mice. Exogenous administration of the Ago2 protein restored erectile function in diabetic mice by reducing reactive oxygen species production-signaling pathways (inducing eNOS Ser1177/NF-κB Ser536 signaling) and improving cavernous endothelial angiogenesis, migration, and cell survival. Our study provides new evidence that Ago2 mediation may be a promising therapeutic strategy and a new approach for diabetic ED treatment. Our study provides new insights into Ago2 function and may represent a new therapeutic approach for ED and other vascular and neurological diseases. No.
{"title":"(064) Argonaute 2 Restores Erectile Function by Enhancing Angiogenesis and Reducing Reactive Oxygen Species Production in Streptozotocin (STZ)-Induced Type-1 Diabetic Mice","authors":"G. Yin, J. Ock, J. Suh, M. Kwon, A. Limanjaya, J Ryu","doi":"10.1093/jsxmed/qdae002.059","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae002.059","url":null,"abstract":"\u0000 \u0000 \u0000 Diabetes mellitus (DM), a primary cause of erectile dysfunction (ED), is a pancreatic β-cell dysfunction that leads to insulin deficiency and resistance, resulting in microvascular complications. Argonaute 2 (Ago2), a catalytic engine in mammalian RNA interference, is involved in neurovascular regeneration under inflammatory conditions.\u0000 \u0000 \u0000 \u0000 In the present study, we aimed to determine whether an exogenous injection of Ago2 proteins can improve erectile function in STZ-induced type-1 diabetic mice and explore the specific mechanisms of Ago2 in the process.\u0000 \u0000 \u0000 \u0000 Eight-week-old male C57BL/6 mice were used for in vivo study. The detailed mechanisms were evaluated in age-matched control or STZ-induced type-1 diabetic mice. Mouse cavernous endothelial cells and human umbilical vein endothelial cells were used for in vitro study. The function of Ago2 in high-glucose condition was evaluated by tube formation assay, migration assay, immunofluorescence stain and western blot experiments.\u0000 \u0000 \u0000 \u0000 We report that Ago2 administration can effectively improve penile erection by enhancing cavernous endothelial cell angiogenesis and survival under diabetic conditions. We found that although Ago2 is highly expressed around blood vessels and nerves, it is significantly reduced in the penis tissue of diabetic mice. Exogenous administration of the Ago2 protein restored erectile function in diabetic mice by reducing reactive oxygen species production-signaling pathways (inducing eNOS Ser1177/NF-κB Ser536 signaling) and improving cavernous endothelial angiogenesis, migration, and cell survival. Our study provides new evidence that Ago2 mediation may be a promising therapeutic strategy and a new approach for diabetic ED treatment.\u0000 \u0000 \u0000 \u0000 Our study provides new insights into Ago2 function and may represent a new therapeutic approach for ED and other vascular and neurological diseases.\u0000 \u0000 \u0000 \u0000 No.\u0000","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"10 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140083453","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 : 2024-03-01DOI: 10.1093/jsxmed/qdae002.026
O. Mahmoud
Gelfoam® Sterile Compressed Sponge is a hemostatic that is directly applied to bleeding surfaces. This cost-effective hemostatic agent is prepared from purified porcine skin, Gelatin granules and Water for Injection. It is water insoluble, however is completely absorbed within 4–6 weeks with minimal scar formation. Gelfoam is available sterile for intra-operative use, and is applied in a multitude of surgical specialties. In this work, we demonstrate for the first time the of Gelfoam to minimize the risk of bleeding in penile prosthesis implantation. Eight cases received a three-piece inflatable implant (Rigicon Infla10®) through a peno-scrotal incision. Following cylinder insertion, corporotomies were closed by tying the stay sutures rather than water-tight sewing. Gelfoam was soaked in antibiotic-supplemented saline. Air bubbles were squeezed out followed by soaking. Gelfoam was then applied to the corporotomies, pump space and entry rout to the reservoir space. It was secured over the corporotomies by closing a pre-fashioned layer of Buck’s fascia. A suction drain was inserted. Mummy wrap was not used. Drain output was monitored and complications recorded. In two cases, drain output was an average of 80 cc’s in the first 24 hours, then 20 cc’s in the following 24 hours. However, in 6 cases, drain output was an average of 18 cc’s in the first 24 hours, mostly sero-sanguinous, then none in the following 24 hours. No cases of hematoma formation, infection, foreign body reaction, mass formation or hypersensitivity reaction were encountered. The initial results of the current small case series demonstrate that Gelfoam is well-tolerated in penile surgeries, with possible value at minimizing post-operative bleeding, encouraging a multi-center larger study. No.
{"title":"(026) Application of Gelatin Sponge as a Hemostatic Agent in Penile Prosthesis Implantation","authors":"O. Mahmoud","doi":"10.1093/jsxmed/qdae002.026","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae002.026","url":null,"abstract":"\u0000 \u0000 \u0000 Gelfoam® Sterile Compressed Sponge is a hemostatic that is directly applied to bleeding surfaces. This cost-effective hemostatic agent is prepared from purified porcine skin, Gelatin granules and Water for Injection. It is water insoluble, however is completely absorbed within 4–6 weeks with minimal scar formation. Gelfoam is available sterile for intra-operative use, and is applied in a multitude of surgical specialties.\u0000 \u0000 \u0000 \u0000 In this work, we demonstrate for the first time the of Gelfoam to minimize the risk of bleeding in penile prosthesis implantation.\u0000 \u0000 \u0000 \u0000 Eight cases received a three-piece inflatable implant (Rigicon Infla10®) through a peno-scrotal incision. Following cylinder insertion, corporotomies were closed by tying the stay sutures rather than water-tight sewing. Gelfoam was soaked in antibiotic-supplemented saline. Air bubbles were squeezed out followed by soaking. Gelfoam was then applied to the corporotomies, pump space and entry rout to the reservoir space. It was secured over the corporotomies by closing a pre-fashioned layer of Buck’s fascia. A suction drain was inserted. Mummy wrap was not used. Drain output was monitored and complications recorded.\u0000 \u0000 \u0000 \u0000 In two cases, drain output was an average of 80 cc’s in the first 24 hours, then 20 cc’s in the following 24 hours. However, in 6 cases, drain output was an average of 18 cc’s in the first 24 hours, mostly sero-sanguinous, then none in the following 24 hours. No cases of hematoma formation, infection, foreign body reaction, mass formation or hypersensitivity reaction were encountered.\u0000 \u0000 \u0000 \u0000 The initial results of the current small case series demonstrate that Gelfoam is well-tolerated in penile surgeries, with possible value at minimizing post-operative bleeding, encouraging a multi-center larger study.\u0000 \u0000 \u0000 \u0000 No.\u0000","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"21 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140086098","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 : 2024-03-01DOI: 10.1093/jsxmed/qdae002.053
T. Kataoka, J. Hidaka, Y. Hotta, Y. Furukawa-Hibi, K. Kimura
Sleep is crucial during the developing stage of one’s life and has been associated with physical activity. However, as the number of 24-hour stores such as convenience stores and supermarkets have increased, along with increased internet usage, people have developed the habit of staying up late, resulting in sleep deprivation due to disruption in the light-dark cycle. Jet lag is widely used in animal models for inducing irregular circadian rhythms. Chronic jet lagged model animals are known to develop a variety of disorders. To investigate the influences of chronic jet lag on erectile function in rats in order to elucidate the effects of irregular circadian rhythms on future sexual function. 4-week-old rats underwent randomly assigned to remain either under the control light/dark cycle (Cont group) or under chronic light/dark shift schedule to simulate the conditions of chronic jet lag (CJL group). The shift-lag protocol consisted of 8 h light/dark phase advances repeated every 3 days for 4 weeks. Erectile function was examined at 1, 2, and 4 weeks post CJL treatment. After 4 weeks of CJL treatment, the rats were returned to control light/dark cycle for 4 and 8 weeks, as CJL(4w)+Rest(4w) group and CJL(4w)+Rest(8w) group, and erectile function was examined correspondingly. Erectile function was tested using intracavernous pharmacotherapy (ICP) measurements, and endothelial function was tested through an isometric tension study. Western blot analysis was used to assess the levels of endothelial nitric oxide (eNOS) and phosphorylated eNOS (p-eNOS). Additionally, mRNA expressions of clock genes (Bmal1 and Cry 1) and growth factors (TGF-β1 and ICAM-1) were tested using real-time PCR. The ICP/MAP ratio was significantly lower in the CJL group (0.35 ± 0.05) at 4 weeks than in the control group (0.66 ± 0.05) (P < 0.05). CJL group exhibited significantly lower testosterone levels, Bmal1, Cry 1, TGF-β1, and ICAM-1 expression, and p-eNOS and cGMP levels. The ICP/MAP ratio in the CJL(4w)+Rest(4w) group (0.47 ± 0.06) was lower than that in the control group (P < 0.01) whereas the ratio in the CJL(4w)+Rest(8w) group (0.81 ± 0.03) was similar to that in the control group (P > 0.05). In this study, chronic jet lagged (4 weeks) rats exhibited a decreased ICP/MAP ratio, reduced testosterone level, and decreased p-eNOS expression, indicating the development of erectile dysfunction (ED). Upon 8 weeks of normal light/dark shift schedule, erectile function was recovered. This study suggests that irregular circadian rhythms induced by repeated jet lag, especially in childhood, may affect the production of sex hormones and erectile function in the future. Therefore, it is necessary for children to follow a regular circadian rhythm and healthy lifestyle. No.
{"title":"(057) Influence of Circadian Disruption on Erectile Function in Chronic Jet-Lagged Young Rats","authors":"T. Kataoka, J. Hidaka, Y. Hotta, Y. Furukawa-Hibi, K. Kimura","doi":"10.1093/jsxmed/qdae002.053","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae002.053","url":null,"abstract":"\u0000 \u0000 \u0000 Sleep is crucial during the developing stage of one’s life and has been associated with physical activity. However, as the number of 24-hour stores such as convenience stores and supermarkets have increased, along with increased internet usage, people have developed the habit of staying up late, resulting in sleep deprivation due to disruption in the light-dark cycle. Jet lag is widely used in animal models for inducing irregular circadian rhythms. Chronic jet lagged model animals are known to develop a variety of disorders.\u0000 \u0000 \u0000 \u0000 To investigate the influences of chronic jet lag on erectile function in rats in order to elucidate the effects of irregular circadian rhythms on future sexual function.\u0000 \u0000 \u0000 \u0000 4-week-old rats underwent randomly assigned to remain either under the control light/dark cycle (Cont group) or under chronic light/dark shift schedule to simulate the conditions of chronic jet lag (CJL group). The shift-lag protocol consisted of 8 h light/dark phase advances repeated every 3 days for 4 weeks. Erectile function was examined at 1, 2, and 4 weeks post CJL treatment. After 4 weeks of CJL treatment, the rats were returned to control light/dark cycle for 4 and 8 weeks, as CJL(4w)+Rest(4w) group and CJL(4w)+Rest(8w) group, and erectile function was examined correspondingly. Erectile function was tested using intracavernous pharmacotherapy (ICP) measurements, and endothelial function was tested through an isometric tension study. Western blot analysis was used to assess the levels of endothelial nitric oxide (eNOS) and phosphorylated eNOS (p-eNOS). Additionally, mRNA expressions of clock genes (Bmal1 and Cry 1) and growth factors (TGF-β1 and ICAM-1) were tested using real-time PCR.\u0000 \u0000 \u0000 \u0000 The ICP/MAP ratio was significantly lower in the CJL group (0.35 ± 0.05) at 4 weeks than in the control group (0.66 ± 0.05) (P < 0.05). CJL group exhibited significantly lower testosterone levels, Bmal1, Cry 1, TGF-β1, and ICAM-1 expression, and p-eNOS and cGMP levels. The ICP/MAP ratio in the CJL(4w)+Rest(4w) group (0.47 ± 0.06) was lower than that in the control group (P < 0.01) whereas the ratio in the CJL(4w)+Rest(8w) group (0.81 ± 0.03) was similar to that in the control group (P > 0.05).\u0000 \u0000 \u0000 \u0000 In this study, chronic jet lagged (4 weeks) rats exhibited a decreased ICP/MAP ratio, reduced testosterone level, and decreased p-eNOS expression, indicating the development of erectile dysfunction (ED). Upon 8 weeks of normal light/dark shift schedule, erectile function was recovered. This study suggests that irregular circadian rhythms induced by repeated jet lag, especially in childhood, may affect the production of sex hormones and erectile function in the future. Therefore, it is necessary for children to follow a regular circadian rhythm and healthy lifestyle.\u0000 \u0000 \u0000 \u0000 No.\u0000","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"12 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140087708","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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