International Index Of Erectile Function Score Research Articles

Cold hypersensitivity in the hands and feet is associated with erectile dysfunction in young Taiwanese men

Cold hypersensitivity in the hands and feet (CHHF) is a protective or predisposing factor for many diseases; however, the relationship between CHHF and erectile dysfunction (ED) remains unclear. We aimed to investigate associations between CHHF and ED among young men of Southeast Asian origin. In this cross-sectional study, sexually active Taiwanese men aged 20–40 years were enrolled via an online questionnaire comprising general demographic information, comorbidities, subjective thermal sensations of their hands and feet in the past 6 months, and their erectile function using the International Index of Erectile Function-5 (IIEF-5). Participants who reported cold sensation of hands and feet were classified to have CHHF; those with IIEF-5 score ≤ 21 were considered to have ED. Total 54.2% and 27.9% of participants had ED and CHHF, respectively. Men with CHHF were significantly younger, had lower body mass index and IIEF-5 scores (p < 0.001), and a lower prevalence of diabetes mellitus (p = 0.033) along with higher prevalence of ED, psychiatric disorders, and insomnia (p < 0.001). After adjusting for predisposing factors of ED, CHHF (odds ratio 1.410, 95% confidence interval 1.159–1.714; p = 0.001) remained an independent predictor of ED. Thus, CHHF is independently associated with ED, affecting more than a quarter of young Taiwanese men. Autonomic dysregulation and subclinical endothelial dysfunction may be common pathophysiologies of CHHF and ED.

Frequency of Erectile Dysfunction in Patients with Type 2 Diabetes Mellitus Presenting with Peripheral Neuropathy at a Tertiary Care Hospital

Background: Erectile dysfunction (ED) is notably prevalent among patients with type 2 diabetes mellitus (T2DM), especially those suffering from peripheral neuropathy. The condition significantly impacts the quality of life and is often exacerbated by diabetes-related complications. Objective: This study aims to ascertain the frequency and severity of ED among patients with T2DM and peripheral neuropathy, and to examine the association between ED and variables such as age, duration of diabetes, and glycemic control. Methods: A prospective cohort study was conducted at the Baqai Institute of Diabetology and Endocrinology, Karachi, from July 2021 to September 2022. We included 115 male patients aged 35-65 years with T2DM and diagnosed peripheral neuropathy. ED was assessed using the Urdu version of the International Index of Erectile Function-5 (IIEF-5) questionnaire. Demographic details, medical history, and laboratory results were collected and analyzed using SPSS version 25. Statistical tests included chi-squared and one-way ANOVA, with a significance level set at p&lt;0.05. Results: The mean age of the participants was 50.97 ± 7.21 years, and the average duration of diabetes was 9.37 ± 6.56 years. The mean IIEF-5 score was 14.33 ± 6.0, indicating moderate ED. Severe ED was observed in 20% of the participants, moderate ED in 19.1%, and mild to moderate ED in 28.7%. The study found a significant association between the duration of diabetes and ED severity (p &lt; 0.001), while age and HbA1c levels did not show a significant correlation with ED status. Conclusion: ED is highly prevalent and severe among patients with T2DM and peripheral neuropathy, with disease duration being a significant predictor of ED severity. These findings underscore the need for early screening and targeted interventions in this population.

Novel emerging therapy for erectile dysfunction: efficacy and safety of flat magnetic stimulation.

The erectile dysfunction (ED), which is the inability to achieve and/or sustain a penile erection sufficient to result in a satisfying sexual performance, represents a very common complaint. for men over forty years old. The aim of the study was to evaluate if Flat Magnetic Stimulation (FMS) technology could help individuals with symptomatic erectile dysfunction. Twenty patients with erectile dysfunction, underwent eight sessions of about 30 minutes each in a twice a week frequency with the study device. During treatments, every potential side effect was assessed. The International Index of Erectile Function (IIEF) was compiled by all patients at the beginning, after the eighth treatment and at 1 month from the end of the last treatment. The questionnaire scores were presented as median values along with the interquartile range (IQR) and we set the significance threshold at 0.01. After the treatment and at 1-month follow-up, the increase in questionnaire scores was statistically significant compared to the baseline, thus supporting the clinical usefulness of this treatment. In particular, the result of the study indicates a statistically significant difference between IIEF score before treatment (Median = 34) and IIEF score after the end of treatment (Median = 45) and between IIEF score before treatment and IIEF score at 1-month follow-up (Median = 54). The study findings showed that FMS represents a promising treatment option to individuals affected by symptomatic erectile dysfunction.

Psychological and sexological assessment of patients with chronic prostatitis

Purpose: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is characterized by a multiform clinical presentation requiring a differentiated treatment based on different phenotypes including the psychosocial and sexual domains. The aim of this study was assessing the complex correlations between somatic, psychological, and sexual symptoms of CP/CPPS patients. Materials and methods: We performed a cross-sectional study on patients attending a Prostatitis Clinic. Patients were administered the following questionnaires: National Institutes of Health- Chronic Prostatitis Symptom Index (NIH-CPSI), International Prostate Symptom Score (IPSS), International Index of Erectile Function (IIEF), Premature Ejaculation Diagnostic Tool (PEDT), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder 7-item (GAD-7), Oxford Happiness Questionnaire (OHQ), and Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire (TEMPS-A). Results: Linear regression analyses show highly significant correlations between scores of the NIH-CPSI and the scores of the GAD-7, PHQ-9 and OHQ psychometric questionnaires. IPSS scores correlate significantly with the psychometric scores only when a non-parametric analysis is performed. IIEF and PEDT sexual function scores did not correlate with any of the psychometric tests. NIH-CPSI scores correlate positively with most of the TEMPS-A profiles but the hyperthymic profile correlated negatively with the total and QoL NIH-CPSI and with PEDT scores. Conclusions: Scores measuring anxiety, depression, and psychological well-being in patients with CP/CPPS are strictly correlated with prostatitis-like symptoms although they are poorly correlated with symptoms of prostatism, as measured by IPSS, and not correlated with scores of sexual dysfunctions, as measured by IIEF and PEDT. A hyperthymic temperament may increase resilience against the disease. 

Association between air pollution and male sexual function: A nationwide observational study in China

This study aimed to explore the associations between air pollution and male sexual function. A total of 5047 male subjects in China were included in this study. The average air pollution exposure (PM2.5, PM10, SO2, CO, NO2, and O3) for the preceding 1, 3, 6, and 12 months before the participants' response was assessed. Male sexual function was evaluated using the International Index of Erectile Function-5 (IIEF-5) and the Premature Ejaculation Diagnostic Tool (PEDT). Generalized linear models were utilized to explore the associations between air pollution and male sexual function. K-prototype algorithm was conducted to identify the association among specific populations. Significant adverse effects on the IIEF-5 score were observed with NO2 exposure during the preceding 1, 3, and 6 months (1 m: β = −5.26E-05; 3 m: β = −4.83E-05; 6 m: β = −4.23E-05, P < 0.05). PM2.5 exposure during the preceding 12 months was found to significantly negatively affect the PEDT after adjusting for confounding variables. Our research indicated negative correlations between air pollutant exposures and male sexual function for the first time. Furthermore, these associations were more pronounced among specific participants who maintain a normal BMI, exhibit extroverted traits, and currently engage in smoking and alcohol consumption.

Effect of laparoscopic sleeve gastrectomy on male reproductive function in chinese men with obesity: A prospective cohort study.

Obesity is a widely recognized global public health issue, and bariatric surgery has emerged as an effective intervention for alleviating obesity associated health complications. However, the impact of bariatric surgery on male reproductive function remains inconclusive in the literature. The current understanding of the impact of laparoscopic sleeve gastrectomy on male reproductive function remains ambiguous, despite its status as the most commonly performed bariatric surgery. This prospective cohort study aimed to investigate the impact of laparoscopic sleeve gastrectomy on erectile function and semen quality. A total of thirty-four obese patients were enrolled in this study and underwent laparoscopic sleeve gastrectomy (LSG). Prior to the operation and at 3, 6, and 12 months postoperation, all participants were required to complete the International Index of Erectile Function-5 (IIEF-5) questionnaire and undergo a nocturnal erectile function test and semen quality analysis. Within 12 months postoperation, body mass index, blood lipids, and insulin resistance showed significant improvement. The IIEF-5 score increased significantly (18.88±5.97 vs. 23.78±3.19, P < 0.05), and the frequency and duration of erections significantly improved compared to baseline. Sperm concentration, total motility, survival rate, and sperm morphology parameters exhibited a significant decline at 3 months but demonstrated a significant improvement at 6 and 12 months post-operation. At 12 months, sperm concentration was shown to be correlated with changes in zinc (r = 0.25, P = 0.033) as well as changes in testosterone (r = 0.43, P = 0.013). LSG has beneficial effects on erectile function, despite a transient decline in semen quality at 3 months postoperatively, followed by a significant improvement at 12 months.

Comparative Study of the Outcome of Buccal Mucosa Graft Urethroplasty and Preputial Flap Urethroplasty for Anterior Urethral Stricture: A Prospective Randomized Study.

Urethroplasty using a buccal mucosa graft (BMG) and a preputial skin flap (PSF) are two common techniques used for the treatment of anterior urethral stricture. The present study compared the efficacy of these two techniques on the basis of success rate, preservation of sexual function, and complications. This prospective, randomized, interventional study was conducted on adult male patients diagnosed with non-obliterative anterior urethral strictures of length >2 cm from August 2021 to December 2022. Pre-operative and post-operative work-up done included assessment of the International Prostate Symptom Score (IPSS), Quality of Life (QOL), International Index of Erectile Function (IIEF) Score, Male Sexual Health Questionnaire for Ejaculatory Dysfunction (MSHQ-EJD), Bother score, Urethral Stricture Surgery-Patient-Related Outcome Measure (USS-PROM), and peak urinary flow rate (Qmax) for each patient. Post-operative values for each score were compared with pre-operative values. Out of 31 patients, 16 underwent BMG urethroplasty, and 15 underwent PSF urethroplasty. The most common cause of stricture in both groups was idiopathic (35.5% and 53.3%). A statistically significant increase in IIEF score was observed in the BMG group in comparison to the PSF group (P<0.0001). The mean IPPS score in USS-PROM has shown a significant drop in BMG (19.6 vs. 17.3; P = 0.020). Hemoglobin drop was significantly higher in PSF than in BMG (2.6 vs. 1.9; P = 0.011). A higher incidence of surgical site infection was reported in the PSF group than in the BMG group (46.7% vs. 12.5%). The average operative time for surgery was higher in PSF than in BMG (154.8 min vs. 145.0 min), respectively. Each group had one patient with a recurrence. Both techniques are equally good for urethral reconstruction (UR); however, improvement of sexual function is more in favor of the BMG urethroplasty group.

(281) Low-Intensity Shockwave Therapy Combined with Tadalafil 5mg Daily has Better Efficacy for Mild and Moderate Erectile Dysfunction: The Preliminary Results of a Multicenter Clinical Study in China

Abstract Introduction Most clinical studies have demonstrated that low-intensity extracorporeal shockwave therapy (Li-ESWT) can improved erectile function in patients with erectile dysfunction (ED). The EAU guideline recommended to use Li-ESWT for mild vasculogenic ED patients. However, the therapeutic advantages of Li-ESWT combined with phosphodiesterase type 5 inhibitors (PDE5i) have not been explored clearly in clinical practice for mild and moderate ED patients. Objective To compare the therapeutic effects of Li-ESWT and Li-ESWT combined with PDE5i in mild and moderate ED patients with 8≤IIEF-5≤16 from a multicenter clinical study in China. Methods Patients with ED which IIEF-5 score is less than 22 and aged 18–60 years old were enrolled from three clinical centers from Jun. 2019 to Mar. 2023. The demographic data, International Index of Erectile Function-5 (IIEF-5), erectile hardness score (EHS) and self-reported symptom questions were collected. Patients were treated by a linear low-energy shock waves generator (Renova). Low-intensity shock wave (energy density of 0.09mJ/mm2) treatments were applied (once a week, 4 weeks in total, 5000 shocks each time). Patients in Li-ESWT combined with PDE5i group took 5mg of tadalafil once a day for one continuous month during ESWT. Comparative analyses of pre- and post-treatment and intergroup were used for statistics. Results In total, 42 ED cases (37.43±11.86 years) in Li-ESWT group and 116 cases (37.41±10.14 years) in combined group were enrolled for analysis. The IIEF-5 score and EHS in both groups were significantly improved after 1 month treatment (p&amp;lt;0.01). Compared with Li-ESWT group, patients in combined group significantly had higher self-reported efficiency (61.2% vs. 47.6%, p=0.013), IIEF-5 scores (15.34±7.15 vs. 13.96±7.71, p=0.039) and EHS (2.85±0.82 vs. 2.69±0.89, p=0.050). In the mild and moderate ED (with 8≤IIEF-5≤16) sub-group, 30 ED cases (36.81±10.99 years) in Li-ESWT group and 96 cases (36.80±10.69 years) in combined group were enrolled for analysis. The combined regimen showed better therapeutic advantages, including effective parameters IIEF-5(14.50±6.74 vs. 12.87±8.54, p=0.040), EHS (2.85±0.75 vs. 2.81±0.67, p=0.046) and self-reported efficiency (64.2% vs. 54.1%, p=0.001). Conclusions Li-ESWT can effectively improve erectile function in this multicenter clinical study in China, and the combination of Li-ESWT with daily use PDE5i had a better therapeutic effect on Chinese ED patients, especially on mild and moderate ED. Long-term follow-up with large sample study need to be developed for exploring the optimal therapeutic regimen. Disclosure No.

(155) The Erectile Restoration Registry: It MATTERS

Abstract Introduction Treatment methodology for erectile dysfunction can vary from surgeon to surgeon. The It MATTERS registry has been developed to align prospective, long-term, real-world outcomes with current clinical practice. It MATTERS is an immediate avenue (following market approval of a product) to collect and monitor real-world data on existing and future innovation, with respect to Boston Scientific’s penile prostheses (2- and 3-piece inflatable, and malleable), Rear Tip Extenders, surgical tools (sterile and non-sterile), accessories, kits, and all included components. This includes, but is not limited to, the Furlow Insertion Tool, Disposable Dilators, Sizers, Insertion Package (tubing passers), Proximal Tool, Quick Connect Assembly Tool, AMS Closing Tool, and the Deactivation Package. Objective Description of a real-world registry that evaluates erectile function, post-penile prosthesis implantation, over time. Methods It MATTERS is a single-arm, prospective, multi-center registry with follow-up occurring post-surgery and at 6 months, 12 months, and annually, thereafter. Subjects will serve as their own control; follow-up assessments will be compared to values collected at baseline. The registry is designed to capture the wide array of immediate, post-surgery follow-up schedules without dictating a specific visit cadence. Following signature of an informed consent, eligible subjects are treated with a Boston Scientific penile prosthesis. The registry will enroll over the lifetime of each device, allowing for up to 150 active subjects in follow-up, per device. Results Registry endpoints include measuring change in erectile function from baseline using the Erectile Function domain of the International Index of Erectile Function (IIEF-EF), change in depressive symptoms using the Patient Health Questionnaire (PHQ)-9, overall sexual function using the IIEF Total Score, and change in work productivity using the Work Productivity and Activity Impairment Questionnaire: General Health (WPAI:GH). Additional measures, amongst many, include patient-reported device satisfaction using a 5-point Likert scale and adverse events. For each penile prothesis group in the registry, a two-sided 95% confidence interval may be constructed for interpreting the change in IIEF-EF score over time compared to baseline. Descriptive statistics will summarize continuous and categorical variables. Currently, 51 penile prosthesis implants have been completed: Tactra™ Malleable Penile Prosthesis (n = 34), Spectra™ Concealable Penile Prosthesis (n = 9), and AMS Ambicor™ Inflatable Penile Prosthesis (2-piece; n = 8). Conclusions The It MATTERS registry builds on over 50 years of erectile dysfunction patient care and data. It will allow for the comparison of outcomes and clinical practice on legacy and new market-approved products, which will pave the way for future innovation and advancing patient care. Disclosure Yes, this is sponsored by industry/sponsor: Industry initiated, executed, and funded registry. All authors act as consultants, employees, or shareholders of Boston Scientific Corporation. Clarification: Industry initiated, executed and funded study. Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific Corporation.

(014) Safety and Efficacy of Platelet-Rich Plasma Injection for the Treatment of Erectile Dysfunction; A Randomized Prospective Study

Abstract Introduction Platelet-rich plasma (PRP) intracorporeal injection is one of the popular regenerative therapies that has been gaining much interest in recent years as an adjunct or alternative treatment for erectile dysfunction (ED). Nevertheless, scientific evidence to support its clinical efficacy remains controversial. Objective The aim of this study was to evaluate the safety and efficacy of PRP injections for the treatment of ED. Methods A prospective, randomized, double-blinded, placebo-controlled, interventional clinical study was conducted on 52 subjects at the Department of Urology, Faculty of Medicine, Beni-Suef University. Patients were randomized into two groups: the PRP group (n=26) and the placebo (saline) group (n=26). Each participant received three sessions (at two-week intervals) of PRP or saline injections according to his assigned group. International index of erectile function-5 (IIEF-5) scores and safety-related observations were collected at the 1st, 3rd, and 6th months of follow-up. Results The median age and ED duration were statistically comparable for both groups, 52.2 versus 52.5 years and 12.87 versus 11.8, respectively (P = 0.285). With regards to the efficacy of PRP, there were no statistically significant differences between both groups after 1, 3, and 6 months of treatment. After 1 month of treatment, the mean IIEF-5 score for the PRP group was 16.12 ± 1.25 versus 15.99 ± 1.21 for the placebo group (P = 0.683). After 3 months, the IIEF-5 score for the PRP group was 16.44 ± 1.17 compared to 16.31 ± 1.06 for the placebo group (P = 0.653). Also after 6 months, the IIEF-5 score for the PRP group was 16.35 ± 1.45 close to 16.23 ± 1.19 for the placebo group (P = 0.727). No transient hemorrhagic adverse events (hematuria, local petechial bleeding, or ecchymosis) or other side effects were reported during the injection and follow-up period for both groups. Conclusions The results of this trial suggest that although the treatment of ED with 3 injections of intracavernosal PRP separated by two-week intervals may be safe, it is not more effective than a placebo injection. Disclosure No.

Evaluation of the effect of prostate diameters on erectile dysfunction in patients who underwent low-anterior resection.

Male erectile dysfunction is an important complication of rectal surgery. In this research, the effect of prostate dimensions on the development of postoperative erectile dysfunction in patients diagnosed with mid-rectum adenocarcinoma who underwent low anterior resection (LAR) is examined. Thirty-one male patients diagnosed as mid-rectal adenocancer were included. The International Index of Erectile Function (IIEF) questionnaire was used to determine the patients' pre and postoperative erectile dysfunction levels, and the level of relationship between the change in these IIEF scores and prostate measurements determined by computed tomography were evaluated. There were statistically significant differences between IIEF index score and anterior posterior (AP) and transverse (TR) measurements (p≤0.001; p≤0.001), but no statistically significant difference was found between craniocaudal (CC) measurement values (p=0.169). The risk of nerve injury will be higher in those with a small prostate transverse diameter. Intraoperative nerve monitoring should be recommended primarily in younger patient groups.

Erectile dysfunction in patient with obstructive sleep apnea: effects of continuous positive airway pressure

Background Obstructive sleep apnea (OSA) is linked to various health complications, including erectile dysfunction (ED), which is more prevalent in individuals with OSA. This study explored ED in Korean OSA patients and assessed the impact of continuous positive airway pressure (CPAP) therapy on ED. Methods A total of 87 male patients with OSA from four different sleep centers underwent physical measurements and completed sleep and mental health (MH) questionnaires, including the Korean version of the International index of erectile function (IIEF), before and three months after initiating CPAP therapy. Results After three months of CPAP therapy, the patients demonstrated a significant improvement in ED as measured on the IIEF. However, the study found no significant correlation between the duration of CPAP use and the improvement in IIEF score. It did identify the SF36 quality of life assessment as a significant factor influencing ED improvement after CPAP. Conclusions ED is a prevalent issue that escalates with age and is associated with OSA. CPAP therapy has shown potential in alleviating ED symptoms, particularly in those with underlying psychological conditions, although further research is required to confirm these findings and understand the underlying mechanisms.

(122) Preservation of Sexual Function: 12-month Outcomes from a Randomized, Double-Blind, Sham Controlled Study Evaluating the Optilume BPH System, a Novel Drug Coated Balloon

Abstract Introduction Many front-line treatments for lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH), such as medications and transurethral resection of the prostate, have well established negative effects on sexual function. New minimally invasive surgical therapy (MIST) for LUTS/BPH need to preserve sexual function to meet the needs of men. Data from the randomized controlled blinded study of the Optilume BPH System was analyzed to evaluate the sexual side effects of this novel treatment. Objective The PINNACLE study is a prospective, randomized, double-blind, sham controlled study evaluating the Optilume BPH System. Optilume BPH is a novel MIST that combines mechanical dilation with delivery of paclitaxel for treatment of LUTS/BPH. The mechanical dilation with Optilume BPH achieves an anterior commissurotomy, while delivery of paclitaxel is intended to maintain luminal patency during healing, while preserving sexual function. Methods 148 subjects with symptomatic LUTS/BPH and a prostate size between 20-80 grams were randomized in a 2:1 fashion (Optilume to Sham) at 18 centers in the US and Canada. Follow-up is complete through 12-months. To evaluate the effect of the treatment on sexual function, the International Index of Erectile Function (IIEF) and Male Sexual Health Questionnaire to assess Ejaculatory Dysfunction (MSHQ-EjD) questionnaires were used. Questionnaires were administered at baseline and 3, 6, and 12-months post procedure, regardless of sexual activity at baseline. A sub-set of 15 non-randomized subjects treated with Optilume BPH underwent further testing for semen quality and measurement of the amount of paclitaxel found in semen post-treatment. Results The average IIEF-EF score at baseline was 15-16 for both arms, mild to moderate erectile dysfunction (Figure 1). Scores across all domains improved slightly from baseline through 12 months, indicating that treatment with the Optilume BPH device had no significant impact on perceived sexual function. This finding is consistent when looking at men who were sexually active at baseline (Figure 2). Ejaculatory function also showed slight improvement from baseline to 12 months in both the overall population and the subset of men who were sexually active at baseline (Figure 1, Figure 2). There is no appreciable change in ejaculation bother from baseline to 12-months in the overall population and the sexually active subset (Figure 1, Figure 2). Overall semen quality parameters did not change post-procedure (Table 1). A slight decrease in sperm concentration was noted post-treatment, although this decrease was not significant at the 3- and 6-month timepoints. Paclitaxel was detected in semen in the majority of subjects tested at 30 days and 3 months post-procedure. The paclitaxel concentration in semen steadily decreased over time, nearing the limit of quantitation of the method by 6 months post-procedure. Conclusions Treatment with Optilume BPH preserved erectile and ejaculatory function. IIEF and MSHQ-EjD scores were not different from control at any time point. New MISTs for LUTS/BPH need to preserve sexual function to meet the needs of men and Optilume appears to meet this objective. Disclosure Yes, this is sponsored by industry/sponsor: Urotronic. Clarification: Industry initiated, executed and funded study. Any of the authors act as a consultant, employee or shareholder of an industry for: Urotronic.

(154) Safety and Efficacy of Platelet-rich Plasma Injection for the Treatment of Erectile Dysfunction; A Randomized Prospective Study

Abstract Introduction Platelet-rich plasma (PRP) intracorporeal injection is one of the popular regenerative therapies that has been gaining much interest in recent years as an adjunct or alternative treatment for erectile dysfunction (ED). Nevertheless, scientific evidence to support its clinical efficacy remains controversial. Objective The aim of this study was to evaluate the safety and efficacy of PRP injections for the treatment of ED. Methods A prospective, randomized, double-blinded, placebo-controlled, interventional clinical study was conducted on 52 subjects. Patients were randomized into two groups: the PRP group (n=26) and the placebo (saline) group (n=26). Each participant received three sessions (at two-week intervals) of PRP or saline injections according to his assigned group. International index of erectile function-5 (IIEF-5) scores and safety-related observations were collected during the 1st, 3rd, and 6th months of follow-up. Results The median age and ED duration were statistically comparable for both groups, 52.2 versus 52.5 years and 12.87 versus 11.8, respectively (P = 0.285). With regards to the efficacy of PRP, there were no statistically significant differences between both groups after 1, 3, and 6 months of treatment. After 1 month of treatment, the mean IIEF-5 score for the PRP group was 16.12 ± 1.25 versus 15.99 ± 1.21 for the placebo group (P = 0.683). After 3 months, the IIEF-5 score for the PRP group was 16.44 ± 1.17 compared to 16.31 ± 1.06 for the placebo group (P = 0.653). Also after 6 months, the IIEF-5 score for the PRP group was 16.35 ± 1.45 close to 16.23 ± 1.19 for the placebo group (P = 0.727). No transient hemorrhagic adverse events (hematuria, local petechial bleeding, or ecchymosis) or other side effects were reported during the injection and follow-up period for both groups. Conclusions The results of this trial suggest that although the treatment of ED with 3 injections of intracavernosal PRP separated by two-week intervals may be safe, it is not more effective than a placebo injection. Disclosure No.

(107) “Can Sexual Dysfunction and Stress in Couples Attempting Conception Be Explained by the Ovulation Calculator?” An Evaluation Study

Abstract Introduction Stress and sexual dysfunction affect a significant portion of couples seeking conception, leading to emotional strain. We hypothesized that ovulation calculators, widely used as a tool to predict fertile days, may play a role in the stress experienced by couples undergoing fertility treatments. We evaluated the impact of ovulation calculators on stress levels in couples seeking fertility treatment and explored the associations with sexual dysfunction and mental health implications due to the stress of infertility. Objective The objective of this study is to evaluate the impact of ovulation calculators on stress levels in couples seeking fertility treatment and to explore the associations with sexual dysfunction and mental health implications due to the stress of infertility. Methods Participants were recruited from the University of Miami Health System Clinics. Fifty couples consulting for infertility were included in the study. Both partners were asked to complete anonymous self-reported surveys consisting of validated questions related to stress levels, sexual function, and the use of ovulation calculators. The surveys included the Female Sexual Function Index (FSFI) for females and the International Index of Erectile Function (IIEF) for males to assess sexual function. Additionally, the Fertility Problem Inventory (FPI) was used to measure fertility-related stress and distress. The data collected included age, duration of attempts to conceive, and responses to stress-related questions. Results A total of 50 couples who we reattempting conception completed the cross-sectional study with all the questionnaires were included in the study. Whether or not they were using ovulation calculators, women scored similarly in the 4 variables of the FSFI, including Arousal, Orgasm, Satisfaction, and Lubrication. When evaluating IIEF scores for Male Erectile Function, the average score of men tracking ovulation was 12.0 ± 4.8, compared to 11.5 ± 5.4 in male patients who were not (P-Value: 0.81). The results showed no statistically significant difference in stress levels between couples who used ovulation calculators and those who did not. However, both male and female participants reported higher levels of sexual dysfunction in couples experiencing higher stress levels due to infertility. Fertility-related stress was also found to be significantly associated with mental health implications, with increased anxiety and depression reported by couples undergoing fertility treatments. Conclusions The findings suggest that the use of ovulation calculators did not significantly influence the stress experienced by couples seeking fertility treatment. However, the study highlights the significant impact of infertility-related stress on sexual function and mental health in both male and female partners. These results emphasize the importance of addressing the psychological aspects of infertility and providing comprehensive support to couples undergoing fertility treatments. Further research is warranted to explore the complex interplay between ovulation calculator usage, infertility-related stress, sexual dysfunction, and mental health implications in couples seeking to conceive. Healthcare providers should consider incorporating mental health support into fertility treatment programs to optimize patient outcomes and overall well-being. Disclosure No.

(341) First-time Orgasm in a Man with Flibanserin Use: A Case Report

Abstract Introduction Anorgasmia is a poorly understood phenomenon defined as either a lifelong or an acquired consistent inability to achieve ejaculation. Despite the prevalence of anorgasmia, there is currently no established treatment. Objective In this abstract, we present the unique case of a patient with lifelong anorgasmia who was able to achieve his first orgasm with off-label use of flibanserin. Methods A 28-year-old male presented to our office with complaints of lifelong anejaculation and anorgasmia, without any signs of erectile dysfunction. He reported good libido and energy levels and denied any urinary symptoms or history of depression. Physical examination revealed normal genital anatomy without lesions. Testicular size was within normal limits, and a palpable varicocele was noted. Hormonal evaluations revealed total testosterone levels of 590 ng/dl and prolactin levels of 12 ng/ml. The baseline International Index of Erectile Function (IIEF) score was 41, with an orgasmic function sub-domain (IIEF-OF) score of 2. The patient had no history of major surgeries. He denied any neurological, infectious, or endocrine cause of anejaculation or anorgasmia. He was not taking medications that could cause these symptoms, except for over-the-counter allergy medications. Upon further questioning, the patient equated orgasm with ejaculation and reported having never experienced any previous orgasms. Results The patient was prescribed 150 mg of bupropion daily, which was increased to 300 mg daily after two weeks, in combination with sex therapy. Despite having received four–five sex therapy sessions over three months, the patient reported that this treatment approach was not effective. Subsequently, bupropion was tapered and discontinued. The patient was then started on bremelanotide, administered at a dose of 10 mg/mL, injecting 0.2mL (2 mg) before sexual activity. Although various forms of stimulation were attempted, the patient was unable to achieve orgasm with bremelanotide, and experienced penile pain. Flibanserin was then initiated, and after 28-32 doses over four weeks, the patient achieved his first orgasm. Notably, the patient also experienced nocturia and insomnia after initiating this medication. The follow-up IIEF score marginally improved by two points without any improvement in IIEF-OF. Conclusions This case highlights the challenges in managing anorgasmia and anejaculation in a young male patient. A stepwise approach, involving pharmacotherapy and sex therapy, was unsuccessful. However, off-label use of flibanserin ultimately resulted in the patient achieving his first orgasm, albeit with some side effects. Further studies are required to evaluate the efficacy and safety of flibanserin for this indication. 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.

(403) Pilot Study: Fractional CO2 Laser in the Treatment of Chronic Phase Peyronie’s Disease

Abstract Introduction Peyronie’s Disease (PD) is a fibrosing disorder of the penis which may result in penile curvature and deformity of the erect penis. Fractional CO2 laser therapy has been used to remodel severe skin scarring and more recently led to improvements in Dupytren’s contractures. Objective We sought to evaluate the safety of Fractional CO2 Laser Therapy in treating Peyronie’s disease. The assessment includes changes in penile curvature, Peyronie’s Disease Questionnaire (PDQ) Symptom bother score, and International Index of Erectile Function (IIEF) scores. Methods This pilot study examined the use of fractional CO2 laser therapy with adjuvant topical triamcinolone (10mg/cc) in patients with PD. Each patient underwent three treatment cycles with 6 weeks interval between each treatment. During the interval time period, patients were required to perform at-home penile modeling three times daily. Penile curvature assessments, self-reported questionnaires and any adverse events were collected at baseline, 24 weeks and 52 weeks. Results A total of 5 patients were included. The mean baseline curvature was 41.80 ± 10.57 degrees and at 24-week follow-up mean curvature was found to be 34.20 ±18.21 degrees, resulting in an 18.1% reduction in curve (p=0.44). Mean IIEF scores were 55.40 ± 14.26 vs. 61.40 ± 6.58, (p=0.234) at baseline and 24-week follow-up, respectively. Similarly, the IIEF erectile function domain scores were 24.40 ± 4.72 vs. 28.60 ±1.52, (p=0.061) at baseline and 24-week, respectively. PDQ symptom bother average scores were 7.6 vs. 5.4 at baseline and 24-week, respectively. Mild adverse effects such as temporary bruising and penile pain were reported. There were no significant adverse events noted. Conclusions Preliminary results, at 24 weeks, suggest that fractionated CO2 laser therapy may serve as a well-tolerated therapy for PD. While this pilot trial was not powered to assess effectiveness, initial results are encouraging. Based upon these findings, a dose escalating phase I clinical trial is warranted to further systematically evaluate the tolerability and utility of Fractional CO2 laser therapy in the treatment of PD. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast, Boston Scientific. Allergen/Abvie, Galderma, Johnson and Johnson, Leo, MetOptima, Pfizer.

Sexual Function After Surgical Treatment for Benign Anorectal Disorders.

Benign anorectal diseases such as hemorrhoidal disease, anal fissure, anal pruritus, perianal abscess, and fistula are the most common ones. The aim of this study was to assess sexual function in patients after surgery for benign anorectal diseases. Sixty-one male patients with perianal fistulas, operated on at Department of General Surgery, Faculty of Medicine, completed a self-administered questionnaire including the International Index of Erectile Function (IIEF) score. The median IIEF score of the postoperative patients was significantly higher (24, range [10-25]) than that of preoperative patients (22, range [5-25]), p < .0001. Sexual function is significantly influenced by surgery for benign anorectal diseases.

Impact of sexual function domains on sexual satisfaction and quality of life: Importance across the age spectrum.

Sexual satisfaction is an important component of global quality life for many adult men. Substantial gaps exist in our appreciation of how age mediates sexual satisfaction in the context of functional sexual measures. We sought to evaluate modifiable factors associated with overall sexual satisfaction and health-related quality of life (HRQoL) in a large, age-stratified community-based sample of adult men. A sample of adult males registered with the online research service ResearchMatch completed a 75-item online questionnaire in this cross-sectional study. Queries included demographics, general health data, and validated sexual health measures including International Index of Erectile Function-5 (IIEF-5) and Premature Ejaculation Diagnostic Tool (PEDT). Multivariable regression was performed to assess associations with self-reported sexual satisfaction (defined by "moderately satisfied" or "very satisfied" on the 5-level Likert scale) and overall HRQoL (as measured by the EQ-5D-visual analog scale (VAS) stratified by age. One thousand thirty-three men completed the survey and were stratified by age cohorts. IIEF-5 and PEDT scores were higher in younger cohorts. On multivariable regression analysis, higher IIEF-5, lower PEDT, better overall health-related quality of life, and the presence of a sexual partner within the last month were associated with an increased likelihood of overall sexual satisfaction. When stratified by age cohort, higher IIEF-5 scores were consistently positively associated with sexual satisfaction (Odds Ratio (OR) 1.18, 95% CI 1.15-1.22, P < 0.001), as well as independently associated with improved overall HRQoL by EQ-5D-VAS (β = 0.71, Standard Error (SE) = 0.08, P < 0.001). The erectile function was independently associated with sexual satisfaction and quality of life across all age strata and predictive of both sexual satisfaction and global HRQoL. Low overall rates of sexual satisfaction across cohorts highlight the critical importance of evaluation and treatment of sexual health, regardless of age.

Sexual dysfunctions in psoriatic patients.

Psoriasis is one the most common skin diseases associated with a great decrease in the quality of patients' lives. We aimed to study sexual dysfunctions in psoriatic patients using the Female Sexual Function Index (FSFI) for women and the International Index of Erectile Function (IIEF) for men via an anonymous online survey. The study included 80 psoriatic patients and 75 controls without dermatoses. There was a downward trend in the total IIEF score in psoriatic men compared to controls. 58% of male patients and 76% of controls had a normal IIEF score. There was no significant difference in IIEF between patients treated and not with systemic agents. 62% of female patients had a decreased FSFI score, whereas in the control group, the majority of subjects (54%) had a normal FSFI score. There was no significant difference in FSFI score between patients and controls. Female patients treated with systemic antipsoriatic agents had significantly worse lubrication, satisfaction with sexual life, and pain. Our study has shown that the majority of questioned female psoriatic patients had sexual dysfunction according to FSFI, particularly they had worse satisfaction with sexual life and less sexual desire compared to women without psoriasis. The majority of male patients did not have sexual dysfunction according to IIEF, however, they had significantly worse overall satisfaction with sexual life and confidence to keep an erection. Systemic antipsoriatic treatment does not probably influence sexual dysfunctions in men but it does in women although we were not able to assess the severity or resolution of lesions after those treatments. However embarrassing, psoriatic patients should be questioned about their sexual lives by dermatologists, and more studies are needed to explore this matter.