Erectile Dysfunction In Men Research Articles

Erectile Dysfunction and Penile Bulb Dose Following Definitive Prostate Radiation Therapy

Background: Erectile dysfunction (ED) is a common side effect of prostate cancer treatment, affecting up to 50% of patients after radiation therapy. Objectives: This study aims to analyze the correlation between the dose received by the penile bulb (PB) and ED in men who underwent definitive radiation therapy for early-stage prostate cancer without androgen deprivation therapy. Methods: The study included 40 patients who received 3D conformal radiation therapy (3D-CRT) for localized prostate cancer and were reported to be potent before treatment, as determined by the International Index of Erectile Function (IIEF-15) questionnaire. The dose to the PB was measured using dose volume histograms (DVHs), and the IIEF-15 questionnaire was completed again 3 months after 3D-CRT. The Pearson correlation coefficient and linear regression test were used to examine the correlation between the ED score and PB doses. Statistical significance was considered if the P value was less than 0.05. Results: The mean age of the patients was 75.5 ± 5.70 years. The average ED score based on the questionnaire was 15 ± 10.55. Twenty percent of the patients had moderate ED, while 80% had mild ED (all patients reported a decrease in potency after 3D-CRT). However, the correlation between the ED score and the PB mean dose was not statistically significant. Conclusions: This study revealed ED in all prostate cancer patients after 3D-CRT, but no significant correlation was found between the dose received by the PB and radiotherapy-induced impotence.

Interaction of smoking and spicy habits modifies the risk of erectile dysfunction.

Having a spicy diet and smoking habit may be important factors causing erectile dysfunction (ED). The aim of this study is to investigate the impact of spicy diet and smoking habits on the risk of ED in men, with a focus on the interaction between these lifestyle factors. Our investigation was conducted as a retrospective analysis spanning from June 2017 to June 2023. Participants underwent interviews utilizing the Structured Interview on Erectile Dysfunction (SIEDY) to evaluate the degree of pathological factors. The International Index of Erectile Function-5 (IIEF-5) was employed as a metric for assessing ED. Additionally, the subjects were comprehensively questioned about their smoking history and dietary preferences, which included an inquiry into how often they consumed spicy meals. Our research involved 373 participants, with 67.6% being individuals with ED. Among the participants, 50.7% were non-smokers and 49.3% were smokers, totaling 188 and 185, respectively. There was no significant difference in the spicy food frequency consumption among smokers with ED. However, non-smokers who consumed spicy food more frequently experienced more severe ED (P=0.02). ED patients showed significant differences in body mass index (BMI), blood glucose and testosterone, which were linked to vascular damage (P=0.03, P=0.02, P=0.04, respectively). Additionally, non-smokers who consumed more spicy food had higher scores on the SIEDY 2 scale, indicating marital factors (P=0.004). In non-smoking participant, a high spicy ratio indicated an even higher risk of ED [odds ratio 2.58, 95% confidence interval: 1.27-5.26; P=0.008], while there was no significant impact on ED in smoking participants (data not shown). This retrospective study suggests that a considerable consumption of spicy foods is independently correlated with an elevated risk of ED, particularly among non-smoking men.

Efficacy of Aphrodisiac Drugs Combination with Phosphodiesterase-5 (PDE5) Inhibitors in Patients with Erectile Dysfunction (Pilot Study)

Abstract Background Erectile dysfunction is a common medical disorder that primarily affects men older than 40 years of age. Many lines of treatments are used. An aphrodisiac is defined as any food or drug that arouses the sexual instinct, induces sexual desire and increases pleasure and performance. Aim of the Work The aim of this study to assess the efficacy of aphrodisiac drugs (Cavigen), in combination with Phosphodiesterase-5 (PDE5)”Sildenafil” Inhibitors in management of erectile dysfunction in men responding to Phosphodiesterase-5 (PDE5) inhibitors in patients with (IIEF) score: Mild (22-25), mild to moderate (17-21). Patients and Methods This study was a prospective, double-blind, case control placebo (pilot study) performed at the outpatient clinic of the Department of Urology and Andrology, Ain Shams University hospitals. The number of patients after the dropouts and exclusion were 40 patients, twenty in each group one group was administrated gingko biloba capsules(Cavigen) twice daily combined with phosphodiesterase 5 inhibitor (Viagra) on demand and the other one administrated placebo capsules similar to the ginkgo biloba twice daily combined with phosphodiesterase 5 inhibitor (Viagra) on demand. The study protocol was approved by our institutional review board. This study was performed in accordance with the Consolidated Standards of Reporting Trials (CONSORT) statement and all participants provided written informed consent before nrolment. Patients were recruited from February 2020 to August 2020 and the final results were obtained in August 2020. Results The present study enrolled two well matched groups, twenty patients in each group as regard base line characteristics including demographic data, pretreatment IIEF total score and pretreatment type of ED. The present study enrolled two well matched groups and both groups showed improvement but there was no significant difference between the studied groups as regard IIEF total score and type of ED at one- and three- months posttreatment. After 6 months posttreatment there was significant difference between the studied groups as regard IIEF total score and type of ED with superiority of combined treatment group. The amount of increase in total score of IIEF after 6 months was found significantly higher in study group (6.35±3.38) than control group (2.15 ± 2.13) with p-value <0.001. In both of studied groups, we found that there was statistically significant increase in the total score of IIEF after 1 month, 3 months and 6 months than pre study and also increase in the percentage of no ED cases after 1 month, 3 months and 6 months than pre study. Conclusion Our findings demonstrate that two Ginkgo Biloba capsules oral intake per day combined with PDE-5 inhibitors on demand were safe and effective for the improvement of erectile function in patients with mild and mild to moderate ED. Overall, Aphrodisiacs drugs seem to be a promising cure for ED and improvement of sexual health.

Erectile Dysfunction in Men with Diabetes: Pathophysiology and Treatment Approaches

Erectile Dysfunction in Men with Diabetes: Pathophysiology and Treatment Approaches

Association between sex hormones and erectile dysfunction in men without hypoandrogenism

In addition to testosterone, various endocrine hormones, such as dehydroepiandrosterone sulfate (DHEA-S) and estradiol, may be involved in erectile function. However, the role of these sex hormones in the erectile function of men without hypoandrogenism remains unclear. This cross-sectional study included 398 community-dwelling men without hypoandrogenism. The participants were categorized into the non-ED and ED groups. Multivariable logistic regression analyses were performed to investigate the relationship between ED and serum sex hormone levels, including total testosterone, DHEA-S, estradiol, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and prolactin. Among the 398 men, 66 (17%) and 332 (83%) were categorized into the non-ED and ED groups, respectively. In the multivariable analyses, serum DHEA-S and estradiol levels were significantly associated with ED (odds ratio [OR]: 0.996, P = 0.030; OR: 1.082, P = 0.002; respectively), whereas serum total testosterone, LH, FSH, and prolactin levels did not demonstrate significant association. After adjusting for age, none of neutrophil-to-lymphocyte ratio, serum plasminogen activator inhibitor-1 levels, and skin advanced glycation end-products levels demonstrated significant correlation with serum DHEA-S and estradiol levels. In conclusion, lower testosterone levels did not affect ED in men with normal testosterone levels, whereas serum DHEA-S and estradiol levels were significantly associated with ED.

Early traumatic experiences are linked to hypersexual behavior and erectile dysfunction in men through the mediation of body uneasiness and general psychopathology.

Childhood traumatic experiences have been associated with hypersexuality and sexual dysfunctions. However, the mediators of the interactions between these variables should be clarified in men. This study aimed to investigate the interaction of early traumatic experiences, psychopathology, and sexuality with respect to erectile dysfunction (ED) and hypersexual behavior. The hypothesized model expected that traumatic experiences would be associated with hypersexual behavior and reduced sexual functioning through the mediation of body uneasiness and psychological distress. The study was cross-sectional and observational. A total of 317 men were enrolled. Male patients with a primary complaint of ED and an indication for psychiatry referral represented the clinical sample (n = 116; mean ± SD age,42.82 ± 16.89years). Clinical classification was assessed with the Structured Interview on Erectile Dysfunction. The second sample (n = 201, 30.82 ± 11.94years) was recruited from the general population. All participants were administered the following questionnaires: Brief Symptom Inventory, Childhood Trauma Questionnaire-Short Form, Hypersexual Behavior Inventory, Body Uneasiness Test-A, and 5-item International Index of Erectile Function. Psychopathology and sexual functioning were assessed by a dimensional approach, and a multivariate model was computed by structural equation model analysis. When compared with the sample from the general population, the clinical sample exhibited a higher prevalence of early traumatic experiences, as measured by scores on the Childhood Trauma Questionnaire-Short Form (45.08 ± 14.25 vs 39.03 ± 10.22, F = 17.63, P < .001), and a higher tendency to engage in hypersexual behaviors (34.63 ± 13.55 vs 30.79 ± 12.44, F = 6.97, P < .01). Structural equation model analysis showed excellent fit indices indicating that early traumatic experiences predicted hypersexual behaviors and ED through the exacerbating mediating effect of body uneasiness and psychopathology. Clinicians should not limit their attention to the behavioral level when assessing sexual dysfunction in men; rather, they should also consider the complex psychopathologic consequences of childhood trauma. Integrated treatments that address the potential presence of childhood trauma with its wider psychological correlates (eg, emotion dysregulation, body uneasiness) might improve treatment response. The study reports novel data on the relationship among childhood maltreatment, male sexuality, and psychopathologic mediators with a dimensional assessment. However, the assessment was cross-sectional, and causality was mainly derived from previous studies. The present study enriches the current literature, strengthening the hypothesis that childhood traumatic experiences significantly shape development and sexuality. Body uneasiness and psychopathology can both tax sexual functioning, as assessed by erectile functioning or hypersexuality.

Erectile dysfunction in men with type 2 diabetes mellitus in Livingstone district, Zambia

Erectile dysfunction in men with type 2 diabetes mellitus in Livingstone district, Zambia

High prevalence of erectile dysfunction in men with hyperthyroidism: a meta-analysis

ObjectiveThe objective of this study was to evaluate the association between hyperthyroidism and the risk of developing erectile dysfunction (ED).MethodsA comprehensive search of multiple databases, including PubMed, Embase, Cochrane, and Web of Science, was conducted to identify relevant studies investigating the relationship between hyperthyroidism and ED in men. The quality of the included studies was assessed using the Newcastle‒Ottawa Quality Rating Scale, and a meta-analysis was performed using Stata 16.0 and RevMan 5.3 software.ResultsA total of four papers encompassing 25,519 study subjects were included in the analysis. Among these, 6,429 individuals had hyperthyroidism, while 19,090 served as controls. The overall prevalence of ED in patients with hyperthyroidism was determined to be 31.1% (95% CI 0.06–0.56). In patients with uncomplicated hyperthyroidism, the incidence of ED was 21.9% (95% CI 0.05–0.38). The combined odds ratio (OR) for the four studies was 1.73 (OR: 1.73; 95% CI [1.46–2.04]; p < .00001).ConclusionOur findings demonstrate a higher incidence of ED in patients with hyperthyroidism. These results provide valuable information for healthcare professionals and can facilitate discussions surrounding appropriate treatment options for ED in patients with hyperthyroidism.

Risk factors for erectile dysfunction in diabetes mellitus: a systematic review and meta-analysis.

Previous studies have established that diabetes mellitus (DM) markedly raises the risk of developing erectile dysfunction (ED). Despite extensive investigations, the risk factors associated with ED in diabetic men have yet to be unequivocally determined, owing to incongruent and inconclusive results reported in various studies. The objective of this systematic review and meta-analysis was to assess the risk factors for ED in men with DM. A comprehensive systematic review was conducted, encompassing studies published in the PubMed, Scopus and Embase databases up to August 24th, 2023. All studies examining the risk factors of ED in patients with DM were included in the analysis. To identify significant variations among the risk factors, odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were employed. The risk of bias was evaluated using the Newcastle-Ottawa Scale(NOS) for longitudinal studies and the Agency for Healthcare Research and Quality Scale(AHRQ) for cross-sectional studies. A total of 58 studies, including a substantial participant pool of 66,925 individuals diagnosed with DM, both with or without ED, were included in the meta-analysis. Mean age (OR: 1.31, 95% CI=1.24-1.37), smoking status (OR: 1.32, 95% CI=1.18-1.47), HbA1C (OR: 1.44, 95% CI=1.28-1.62), duration of DM (OR: 1.39, 95% CI=1.29-1.50), diabetic neuropathy (OR: 3.47, 95% CI=2.16-5.56), diabetic retinopathy (OR: 3.01, 95% CI=2.02-4.48), diabetic foot (OR: 3.96, 95% CI=2.87-5.47), cardiovascular disease (OR: 1.92, 95% CI=1.71-2.16), hypertension (OR: 1.74, 95% CI=1.52-2.00), microvascular disease (OR: 2.14, 95% CI=1.61-2.85), vascular disease (OR: 2.75, 95% CI=2.35-3.21), nephropathy (OR: 2.67, 95% CI=2.06-3.46), depression (OR: 1.82, 95% CI=1.04-3.20), metabolic syndrome (OR: 2.22, 95% CI=1.98-2.49), and diuretic treatment (OR: 2.42, 95% CI=1.38-4.22) were associated with increased risk factors of ED in men with DM. Our study indicates that in men with DM, several risk factors for ED have been identified, including mean age, HbA1C, duration of DM, diabetic neuropathy, diabetic retinopathy, diabetic foot, cardiovascular disease, hypertension, microvascular disease, vascular disease, nephropathy, depression, metabolic syndrome, and diuretic treatment. By clarifying the connection between these risk factors and ED, clinicians and scientific experts can intervene and address these risk factors, ultimately reducing the occurrence of ED and improving patient management.

Erectile Dysfunction as an Obesity-Related Condition in Elderly Men with Coronary Artery Disease.

Background: This cross-sectional study aimed to investigate the prevalence of erectile dysfunction (ED) in elderly men with overweight or obesity and coronary artery disease. Methods: Patients recruited in cardiac rehabilitation centers post-myocardial infarction provided demographic and anthropomorphic data. ED was assessed using the abbreviated International Index of Erectile Function 5 (IIEF-5) Questionnaire. Results: The study included 661 men with a mean age of 67.3 ± 5.57 years, a mean BMI of 27.9 ± 3.6 m/kg2, and a mean waist circumference of 98.9 ± 10.23 cm. Over 90% of men experienced ED, with similar proportions across BMI categories. The development of ED in men with a waist circumference of ≥100 cm had 3.74 times higher odds (OR 3.74; 95% CI: 1.0-13.7; p = 0.04) than in men with a waist circumference of <100 cm. Men with obesity and moderate-to-severe and severe ED were older compared to those without these disorders (67.1 ± 5.29 vs. 65.3 ± 4.35; p = 0.23). Conclusions: The prevalence of ED in men with coronary artery disease surpasses 90%. An increased body weight raises the risk of ED, with waist circumference proving to be a more reliable predictor of this risk compared to BMI. Physicians are encouraged to screen elderly patients with cardiovascular disease for ED and address obesity to enhance overall health.

Sexual dysfunction, depression, and the impact of antidepressants

IntroductionSexual dysfunction is a common side effect of antidepressants and can have significant impact on the person’s quality of life, relationships, mental health, and recovery. The reported incidence of sexual dysfunction associated with antidepressant medication varies considerably between studies, making it difficult to estimate the exact incidence or prevalence.ObjectivesThe focus of this e-poster is to explore the incidence, pathophysiology, and treatment of depression disorder and antidepressant iatrogenic sexual dysfunction.MethodsA bibliopgraphical review was performed using PubMed platform. All relevant articles were found using the keywords: depression, sexual disfunction, antidepressant.Results Sexual dysfunction is a common symptom of depression. Although decreased libido is most often reported, difficulties with arousal, resulting in vaginal dryness in women and erectile dysfunction in men, and absent or delayed orgasm are also prevalent. Sexual dysfunction is also a frequent adverse effect of treatment with most antidepressants and is one of the predominant reasons for premature drug discontinuation. Selective serotonin reuptake inhibitors are the most widely prescribed antidepressants and have significant effects on arousal and orgasm compared with antidepressants that target norepinephrine, dopamine, and melatonin systems. The availability of an antidepressant that does not cause or exacerbate sexual dysfunction represents an advance in pharmacotherapy for mood disorders and should reduce treatment noncompliance and decrease the need for switching antidepressants.ConclusionsThe sexual problems reported range from decreased sexual desire, decreased sexual excitement, diminished or delayed orgasm, to erection or delayed ejaculation problems. There are a number of case reports of sexual side effects, such as priapism, painful ejaculation, penile anesthesia, loss of sensation in the vagina and nipples, persistent genital arousal and nonpuerperal lactation in women.Disclosure of InterestNone Declared

Which PDE5 inhibitor is the most effective in the treatment of erectile dysfunction in men with spinal cord injury? A systematic review and network meta-analysis.

Phosphodiesterase 5 inhibitors (PDE5i) are the first-line drugs for erectile dysfunction (ED) but differences among available molecules should drive therapy personalization. Choosing one PDE5i over another is a challenge in men with spinal cord injury (SCI), as the evidence of efficacy for each molecule is derived from few studies and comparative "head-to-head" trials are lacking. To assess the efficacy of the different PDE5i for SCI-related ED with a network meta-analysis (NMA) approach. Databases from PubMed, Web of Science, Scopus, and Cochrane Library were checked for randomized controlled trials (RCTs) comparing any PDE5i to each other or placebo in men with traumatic SCI lasting ≥6 months. Data were incorporated in a random-effect NMA, where treatments' efficacy was ranked using the surface under the cumulative ranking curve (SUCRA). The 10 RCTs included provided information about 1,492 men with ED due to traumatic SCI. Intervention arms included sildenafil, tadalafil, and/or vardenafil. Overall, at the pairwise meta-analysis, PDE5i were four times more effective than placebo in improving erectile function (risk ratio: 4.13, 95% CI: 2.76, 6.19). The comparative analysis from NMA revealed that tadalafil was associated with the highest SUCRA value (81%), followed by vardenafil (68%) and sildenafil (49%). Within the grading of comparison network, tadalafil appeared to be the best PDE5i in the treatment of SCI-related ED. Further focused studies are warranted to confirm these findings and define optimal doses and duration of therapy.

(113) Investigating the Prevalence of Erectile Dysfunction in Patients with Non-Alcoholic Fatty Liver and Its Relationship with the Severity of Fatty Liver

Abstract Introduction Today, the relationship between erectile dysfunction in men and the pathogenesis process in the field of metabolic syndrome is of interest. Non-alcoholic fatty liver disease is one of the diseases related to metabolic syndrome, which has a high prevalence. This study was conducted with the aim of evaluating the prevalence of erectile dysfunction in men with non-alcoholic fatty liver disease and investigating the relationship between its severity and the grading of liver complications. Objective In this research, the frequency of erectile dysfunction and decreased libido and sexual satisfaction in patients with non-alcoholic fatty liver disease have been investigated and compared with the control group. Also, the relationship between the severity of sexual dysfunction and fatty liver grading has been investigated. Methods In this study, 1200 patients with non-alcoholic fatty liver disease were randomly selected and participated in this study between 2019 and 2022. In order to investigate sexual disorders, the standard male sexual performance questionnaire was used along with the demographic questionnaire. Results The results of this study showed that the indicators of male sexual dysfunction in patients with non-alcoholic fatty liver have a high prevalence (44.5%). Also, the severity of erectile dysfunction has a significant relationship with the severity of non-alcoholic fatty liver disease (pv=0.002). Conclusions A holistic view of the health category requires that in the treatment of medical disorders, the effective factors and consequences of the disorder should be considered. Paying attention to the diagnosis and treatment of sexual disorders in the treatment process will be one of the most important aspects of the patient's health; Because erectile dysfunction in men, apart from the effect on sexual relations, will have destructive consequences on their psychological indicators and quality of life. On the other hand, it is possible to improve the quality of patients' health by modifying the lifestyle and interdisciplinary cooperation. Disclosure No.

(189) Associated Between Covid-19 Vaccination and Erectile Dysfunction

Abstract Introduction The COVID-19 pandemic negatively affected the sexual health of individuals. While SARS-CoV-2 vaccines have not been linked to dysfunction erectile, several reports have identified COVID-19 as a potential etiology of dysfunction erectile Objective To investigate the impact of COVID-19 vaccination on erectile dysfunction. Methods A cross-sectional study was conducted on 264 male patients who visited for fertility and infertility health check-ups at Andrology and Fertility Hospital of Hanoi, Vietnam from December 2022 to Mar 2023. We used the International Index of Erectile Function (IIEF) questionnaire for data collection. Results The mean age was 29.17. Most patients were vaccinated (97.4%); in which almost patients were vaccinated 3 doses (62.6%); 63.8% were injected with the same vaccine. The mean erectile dysfunction score was 18.64; the proportion of erectile dysfunction was 40.1%. There was no association between COVID-19 vaccination (the number of COVID-19 vaccinations, the combined injection) and the risk of erectile dysfunction in men. Conclusions COVID-19 vaccination was not associated with an increased risk of erectile dysfunction in males. Disclosure No.

Global prevalence of erectile dysfunction and its associated risk factors among men with type 1 diabetes: a systematic review and meta-analysis.

Various observational studies have examined the prevalence and determinants of erectile dysfunction (ED) in men with type 1 diabetes across different geographical areas. Nevertheless, a comprehensive systematic review and meta-analysis to consolidate the worldwide prevalence and risk factors remains lacking. Hence, the primary study objective was to perform an extensive systematic review and meta-analysis that specifically examined ED prevalence and determinants in men with type 1 diabetes. A thorough exploration was conducted by examining electronic databases, such as PubMed, Embase, and Web of Science. The general ED prevalence and a 95% confidence interval (CI) in men with type 1 diabetes were summarized. The relevant risk factors were analyzed by deriving a comprehensive odds ratio (OR) from merging the ORs using fixed- or random-effects models. The sources of heterogeneity were investigated using subgroup analyses and meta-regression. This systematic review and meta-analysis included 19 articles involving 3788 men with type 1 diabetes. The meta-analysis revealed that men with type 1 diabetes had a combined ED prevalence of 42.5% (95% CI: 34.3%-50.8%). This prevalence showed significant heterogeneity (I2 = 96.2%, P < 0.01). Meta-regression revealed that age (P = 0.016) and type 1 diabetes duration (P = 0.004) were significant causes of heterogeneity. Furthermore, the ED risk in men with type 1 diabetes was significantly influenced by age, type 1 diabetes duration, body mass index, glycated hemoglobin (HbA1c), retinopathy, and smoking habits (all P < 0.05). In summary, this systematic review and meta-analysis revealed a significant prevalence of ED in men with type 1 diabetes, highlighting the importance of clinicians addressing concerns regarding ED in this specific group of individuals.

Erectile Function in Men during the COVID-19 Pandemic

This research focused on two age groups of men (under 40 and over 40 years) and their sexual function during the COVID-19 pandemic. Somatic examinations, including the measurement of hormone levels, were conducted on all patients. The subjects also completed two questionnaires and provided personal history data. The first questionnaire covered the evaluation of erectile function, while the second assessed psychosocial trauma and stress. The results in the first group (men under 40 years of age) showed a correlation between prolactin values and erectile function score results (R = 0.54), between erectile function score results and trauma and psychosocial stress symptoms (R = 0.49) and also between prolactin values and trauma and psychosocial stress symptoms (R = 0.53). The results in the second group (men over the age of 40) showed a correlation between prolactin values and erectile function score results (R = 0.42), between erectile function score results and trauma and psychosocial stress symptoms (R = 0.54) and between free testosterone level and erectile function score results (R = 0.32). These findings support the hypothesis of a different impact of stress on the development of erectile dysfunction in men under 40 and over 40 years of age during COVID-19.

(160) Improving Symptoms in Young Men with Erectile Dysfunction: Testosterone Therapy With or Without PDE5 Inhibitors

Abstract Introduction While erectile dysfunction (ED) in young men has traditionally been viewed as primarily psychogenic in etiology, a growing body of evidence supports a higher prevalence of organic etiology. Objective The aim of this study was to further characterize the etiology and treatment outcomes of ED in men under 40 years at a single institution. Methods A retrospective chart review of men presenting with ED from 2010-2022 was undertaken. Men initially presenting under the age of 40 years were included and analyzed for hypogonadism, ED etiology, and treatment outcomes. Results Of our cohort, a total of 74 men under the age of 40 years presented with complaint of ED (mean age 31.6 years). Twenty-three (31.1%) men were eugonadal without organic etiology of ED. Of these men, 22 (95.7%) were started on phosphodiesterase-5 inhibitors (PDE5i) and one (4.3%) reported symptom resolution without treatment. The remaining 51 (68.9%) men presented with ED of likely organic origin. Forty-two (82.4%) of these men were hypogonadal and were started on testosterone, human chorionic gonadotropin, clomid and/or a PDE5i. Of those who followed up, 32 (91.9%) men reported improvement in symptoms after therapy. The organic etiologies of ED in the nine (17.6%) eugonadal men included history of urologic surgery (4), Peyronie’s disease (2), prior genitourinary trauma (1), spinal cord tumor (1), and prolactinoma (1). Within this group, four (44.4%) progressed to intra-cavernosal injection, two (22.2%) improved with PDE5i, and three (33.3%) were lost to follow-up. Conclusions It appears that the majority of young patients who present with ED are hypogonadal. Treating this population of men with medication to raise natural testosterone with or without the addition of a PDE5i has been shown to improve their symptoms. Young eugonadal men with no discernable organic etiology of ED respond well to oral PDE5i alone but tended to not follow-up, suggesting possible ED resolution without a need for prolonged treatment. In all, clinicians should check serum testosterone levels and conduct a thorough urological history to identify potential organic etiologies of ED in younger men before assuming a psychogenic basis. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Consultant for AbbVie, Marius, Tolmar, Endo, Petros, Boston Scientific, Coloplast Investor: Sprout.

(132) Comparing the Frequencies of Different Species Present in Revision Penile Prostheses Surgery due to Infectious or Non-Infectious Causes

Abstract Introduction Inflatable penile prosthesis (IPP) is a third-line treatment for treating erectile dysfunction in men. However, complications in the prostheses can cause the patient to undergo secondary penile prostheses (PP) surgery. Infection is a feared complication of IPP surgery and has a higher risk at secondary surgery. Next-generation sequencing (NGS) compares DNA to identify species and report relative abundances. NGS is an established method of microbial detection and identification in Orthopedics, Otolaryngology, wound care, and infectious disease. In prosthetic urology, NGS has been shown to provide better and more acute information than traditional cultures. Characterizing biofilm may allow for a better understanding of potential issues that could reduce IPP durability. Objective This study aims to identify the frequency of microbial species present in penile prostheses that needed revision surgery and compare the quantitative data between infectious etiology and mechanical failure cases. We hypothesize that, during secondary surgery, mechanical failure and clinically infected IPPs will display different frequencies of microbial species. Methods This study comprised 126 patients from 2 different centers that underwent revision PP surgery for either infectious or non-infectious issues. Upon entering the pump space (wiped pump/tubing/capsule) during surgery, 2 swabs specimens were collected and sent to the institutional laboratory for routine culture and the other to MicrogenDx for NGS testing. During the specimen evaluation, the frequency of microbial species in each specimen was recorded and sorted based on the reason for revision PP surgery. ANOVA was used to test effects of ethnicity, age, diabetes status, implant duration, and year of implant removal. Results The demographics of the 126 patients consisted of a median age of 69 (1st quartile= 61, 3rd quartile= 76), of which 84 were White, 41 were African American, and 1 was of unknown ethnicity. 104 patients (83%) needed revision PP surgery due to mechanical failure causes, and 22 patients (17%) needed revision PP surgery due to infectious causes. From the data collected and analyzed, the mechanical and infection specimens differed significantly in a few species. In the infection samples, E. coli, C. tuberculostearicum, and C. acnes were significantly underrepresented, and P. aeruginosa was significantly overrepresented compared to the mechanical samples (Figure 1). Asterisks denote these species in Figure 1. Conclusions NGS has been shown to accurately represent the characteristics of biofilm present in secondary PP surgery, supported by similar results in Ortho and ENT literature. When the PP was clinically infected, four microbial species experienced significant differences in expression frequency compared to mechanical failure IPPs. In addition, the NGS data collected contradicts the traditional theory that the coagulase-negative Staphylococcus species is the most present microbial species in PP biofilm, as we observed more prevalence of E. coli in the biofilm we analyzed. Disclosure Yes, this is sponsored by industry/sponsor: MicroGenDX. Clarification: Industry funding only - investigator initiated and executed study. Any of the authors act as a consultant, employee or shareholder of an industry for: MicroGenDX, Irrisept.

(157) Prescribing Ozempic and Wegovy for Weight Loss is Associated with an Increased Risk of Erectile Dysfunction and Hypogonadism in Non-Diabetic Males

Abstract Introduction The use of antidiabetic medications, such as metformin or sulfonylureas, can have diverse effects on sex hormones, potentially influencing erectile function. While both Ozempic and Wegovy (semaglutide) include sexual dysfunction as a side effect of the medication, no study has assessed how frequently men will experience sexual dysfunction with these medications. Recently, semaglutide was approved in June of 2021 for weight loss in non-diabetic patients and has exploded in popularity. Objective Our objective is to assess the risk of developing ED in non-diabetic males after starting semaglutide using a large claims-based database. Methods We queried the TriNetX Research database, a comprehensive insurance claims database. Our study cohort included males aged 18 to 50 who have been prescribed semaglutide after June 1st, 2021. We excluded individuals with a history of pelvic radiation, prostatectomy, pulmonary hypertension, diabetes mellitus, or any hemoglobin A1c measurement ≥7%. Propensity-matching was performed between the cohorts for age, ethnicity, race, BMI, hypertension, sleep apnea, and hyperlipidemia. Our primary outcome was comparing the proportion of men that received an ED diagnosis and/or prescription for phosphodiesterase-5 inhibitors (PDE5i) from one day to any time after the index prescription of semaglutide. The secondary outcome of interest included the risk of developing testosterone deficiency. Risk was reported using relative risk (RR) with 95% confidence intervals (CI). Statistical significance was set using a two-sided alpha at 0.05. Results We found 2,117 non-diabetic males with a prescription of semaglutide, which were compared to an equivalent number of propensity matched controls (Table 1). Compared to matched controls, males with a semaglutide prescription were significantly more likely to be diagnosed with ED and/or prescribed PDE5i (1.4%) when compared to control males who were never prescribed semaglutide (0.14%) (RR: 10.0, 95% CI [3.05 – 32.82]). Similarly, males with a prescription for semaglutide were more likely to receive a subsequent diagnose of testosterone deficiency (3.83%) compared to controls (1.7%), (RR: 2.25, 95% CI [1.53 – 3.32]) from one day to any time after the index prescription. Conclusions In this claims-based analysis, we found that non-diabetic males with a prescription of semaglutide have a significantly higher risk of developing ED and testosterone deficiency. Rates of erectile dysfunction in men prescribed semaglutide are overall low at 1.4% but, we were surprised that these rates were so much higher than those not receiving semaglutide as we expected that weight loss drugs would improve erectile function. Further studies are needed to assess the impact of semaglutide in non-diabetic men to assess how this drug impacts the male hypothalamic-pituitary-gonadal axis. Despite its increasing popularity for weight loss, both clinicians and patients should be aware of potential hormonal effects when discussing and considering the medication. Disclosure No.

(374) Comparing the Species Richness in Infectious versus Mechanical Failure Cases in Secondary Penile Prostheses Surgeries

Abstract Introduction Inflatable penile prosthesis (IPP) is a third-line treatment for treating erectile dysfunction in men. However, complications in the prostheses can cause the patient to undergo secondary penile prostheses (PP) surgery. Infection is a feared complication of IPP surgery and has a higher risk at secondary surgery. Next-generation sequencing (NGS) compares DNA to identify species and report relative abundances. NGS is an established method of microbial detection and identification in Orthopedics, Otolaryngology, wound care, and infectious disease. In prosthetic urology, NGS has been shown to provide better and more acute information than traditional cultures. Objective This study aims to identify species richness (i.e., number of species occurring in a sample) in penile prostheses that needed revision surgery in comparison between infectious etiology and mechanical failure cases. We hypothesize that, during secondary surgery, mechanical failure IPPs will display a greater species richness than infectious caused. Methods This study comprised 126 patients from 2 different centers that underwent revision PP surgery for either infectious or non-infectious issues. Upon entering the pump space (wiped pump/tubing/capsule) during surgery, 2 swabs specimens were collected and sent to the institutional laboratory for routine culture and the other to MicrogenDx for NGS testing. During the specimen evaluation, the species richness of each specimen was recorded and sorted based on the reason for revision PP surgery. ANOVA was used to test effects of ethnicity, age, diabetes status, implant duration, and year of implant removal. Results The demographics of the 126 patients consisted of a median age of 69 (1st quartile= 61, 3rd quartile= 76), of which 84 were White, 41 were African American, and 1 was of unknown ethnicity. 104 patients (83%) needed revision PP surgery due to mechanical failure causes, and 22 patients (17%) needed revision PP surgery due to infectious causes. From the data collected and analyzed, patients who needed revision PP surgery due to mechanical failure showed a larger species richness in the collected biofilm than patients who needed surgery due to infectious reasons (Figure 1; p= 0.04). Conclusions NGS has been shown to accurately represent the characteristics of biofilm present in secondary PP surgery, supported by similar results in Ortho and ENT literature. When the PP was clinically infected, NGS identified less species richness in biofilm from revision PP surgery than non-infectious PP biofilm which is consistent with infections being caused by a few key pathogens per case. Disclosure Yes, this is sponsored by industry/sponsor: MicroGenDX. Clarification: Industry funding only - investigator initiated and executed study. Any of the authors act as a consultant, employee or shareholder of an industry for: MicroGenDX, Irrisept.