General Male Population Research Articles

Comparative study of HoLEP in elderly patients with indwelling catheters: a retrospective dual-center study.

This study aimed to evaluate the safety and efficacy of HoLEP in patients aged > 85 years with indwelling catheter (IDC). We retrospectively analyzed our bicentric HoLEP database to identify consecutive patients with IDC and trial without catheter (TWOC) failure who underwent surgery between June 2012 and April 2020. Our primary focus was on the population over 85 years of age; Patients under 70 years of age were used as controls. We evaluated the rate of postoperative spontaneous micturition, adverse events and mortality, as well as catheterization duration, hospital stay, and rate of urinary incontinence. In total, 144 patients were included, with 71 (49.3%) and 73 (50.8%) in the ≥ 85 and control group, respectively. The median [IQR] prostatic volume and Charlson score was 90 [70-130] vs. 90 [65-120] mL and 6 [5-7] vs. 3 [2-4] in the ≥ 85 and control groups, respectively. Postoperatively, the rates of major complications (2% vs. 3%) and transfusion (11% vs. 9%) were not significantly different. The median length of stay (2 [1-3] vs. 1 [1-2]; p = 0.03) and rate of TWOC failure during hospitalization (24% vs. 5%, p < 0.001) were significantly higher in the ≥ 85 group. At 3 months and one year follow-up visits, 0 and 10 patients (14.1%) in the ≥ 85 group and 0 and 2 patients (3%) in the control group died, respectively. One year after surgery, 69 (97%) and 73 (100%) (p = 0.2) patients in the ≥ 85 and control groups, respectively, could void spontaneously. HoLEP is a safe and effective procedure for elderly patients with indwelling catheters. At one year, 97% of patients achieved spontaneous voiding, while the urinary incontinence rate was 11%. The 1-year mortality rate was 14%, comparable to that of the general male population of the same age.

Representation of Masculinity in Chinua Aschebe's "The Voter" and Dimas Jayadinekat's "Si Pemalu Menang Pemilu": A Comparative Analysis

The social construction of masculinity supports men's dominant roles, the subjugation of both the general male and female population, and other suppressed manifestations of masculinity. To reveal that subtle aspect, this study investigates how masculinity is portrayed in "The Voter" by Chinua Achebe and "Si Pemalu Menang Pemilu" by Dimas Jayadinekat. This study used the social construction of masculinity and hegemonic masculinity by Connell. Since the data took the form of narratives about the short stories, the qualitative descriptive method was used. A close reading technique is used to support the analysis of the data to find evidence. The result shows that there is some evidence of the social construction of masculinity and actions done by the main characters that represent hegemonic masculinity. Even though these short stories have different origins, the construction of masculinity of being an ideal man is relatively similar. It has also shown that masculinity is not simply ‘there’, there must be a construction of masculinity by society as depicted in both short stories.

Exploring the Interplay of Handgrip Neuromuscular, Morphological, and Psychological Characteristics in Tactical Athletes and General Population: Gender- and Occupation-Based Specific Patterns

Background/Objectives: The correlation of handgrip strength (HGS) and morphological characteristics with Big Five personality traits is well documented. However, it is unclear whether these relationships also exist in highly trained and specialized populations, such as tactical athletes, and whether there are specific differences compared to the general population. This study aimed to explore the interplay of handgrip neuromuscular, morphological, and psychological characteristics in tactical athletes and the general population of both genders. Methods: The research was conducted on a sample of 205 participants. A standardized method, procedure, and equipment (Sports Medical solutions) were used to measure the isometric neuromuscular characteristics of the handgrip. Basic morphological characteristics of body height, body mass, and body mass index were measured with a portable stadiometer and the InBody 720 device. Psychological characteristics were assessed with the Mental Toughness Index and Dark Triad Dirty Dozen questionnaires. Results: Numerous significant correlations were obtained, as well as differences between tactical athletes and the general population of both genders. The most prominent correlations were between the excitation index with Psychopathy and the Dark Triad (ρ = −0.41, −0.39) in female tactical athletes, as well as Neuroticism with body height, maximal force, and the maximum rate of force development in the male general population (ρ = 0.49, 0.43, 0.41). The obtained results also revealed gender and occupational specific patterns of researched relationships. Conclusions: Although the results of this study indicated the possibility of the existence of correlations between handgrip neuromuscular, morphological, and psychological characteristics in tactical athletes of both genders, nevertheless, at the moment, there is not enough solid evidence for that. That is why new research is needed. An analysis of muscle contractile and time parameters as neuromuscular indicators in the HGS task proved to be a possible promising method, which brought numerous new insights about the researched relationships. For practical application in the field, we propose including Mental Toughness and the Dark Triad traits in the selection process for future police officers and national security personnel based on the obtained results.

Prevalence of HPV infection in the general population of young and adult males in Italy.

The most prevalent sexually transmitted disease in the world has the human papillomavirus (HPV) as its etiological agent. To evaluate the prevalence of previous and actual HPV infection and the clinical manifestations in unselected males. A total of 718 males participating to a surveillance program were asked to complete a study visit at our unit, including semen collection, balanopreputial sulcus swab, and blood collection for total anti-HPV immunoglobulin G (IgG). When HPV-DNA was detected, we performed HPV fluorescence in situ hybridization, oral and anal swab, and penoscopy. Because previous studies demonstrated a very high risk for HPV infection in subjects with history of HPV-induced lesions, with a partner with diagnosed HPV infection or reporting couple infertility or sexual promiscuity and an increase of the risk in males having sex with males, in subjects with unprotected sexual intercourses or in heavy smokers, patients were therefore stratified according to the presence of these known risk factors (RFs). Actual HPV infection was detected in 401/718 subjects (55.85%). Oral HPV-DNA was reported in 80 subjects and anal HPV infection in 52 subjects. Anti-HPV IgG antibodies have been detected in 288 subjects. The overall prevalence of HPV exposition, considering actual and/or previous infection was 77.99%. Among infected men, high-risk HPV genotypes were detected in 66.08%. A total of 514 subjects were considered as the RF population, while 150 were classified in the non-RF population. There was a significantly higher prevalence of condylomatosis (odds ratio [OR] 4.07) and of seminal infection (OR 6.22) in the RF group. These data represent an alert for the healthcare system to perform informative and screening campaigns for HPV infection in males and to promote HPV vaccination both in young people and for adult males with RF for HPV infections.

Post-Metastasis Survival of Patients with High-Risk Localized and Locally Advanced Prostate Cancer Undergoing Primary Treatment in the United States: A Retrospective Study.

Patients with high-risk localized and locally advanced prostate cancer (HR-LPC/LAPC) have increased risk of metastasis, leading to reduced survival rates. Segmenting the disease course [time to recurrence, recurrence to metastasis, and post-metastasis survival (PMS)] may identify disease states for which the greatest impacts can be made to ultimately improve survival. Evaluate real-world PMS of patients with HR-LPC/LAPC who received primary radical prostatectomy (RP) or radiotherapy (RT) with or without androgen deprivation therapy (ADT). Electronic health records from an oncology database were used to assess PMS. Risk of death was estimated using theKaplan-Meier method. Hazard ratios (HRs) were used to analyze the impact of treatment and time to metastasis (TTM) on PMS. Standardized mortality ratios (SMRs) were calculated for patients with HR-LPC/LAPC versus the US general male population. Overall, 5008 patients with HR-LPC/LAPC were identified, and 1231 developed metastases after primary treatment (RP, n = 885; RT only, n = 262; RT+ADT, n = 84). Age-adjusted PMS HR between the RP and RT only cohorts was 1.19 (p = 0.077) and between RP and RT+ADT cohorts was 1.32 (p = 0.078). TTM was unrelated to PMS in unadjusted (HR 1.01, p = 0.2) and age-adjusted models (HR 0.99, p = 0.3). Relative to pre-metastasis SMRs, post-metastasis SMRs increased eightfold and fivefold in patients treated with RP and RT±ADT, respectively. PMS was unrelated to TTM in patients with HR-LPC/LAPC, suggesting PMS may be independent of the trajectory to development of metastases. Given PMS may be a fixed length of time, delaying the development of metastasis may improve survival in patients with HR-LPC/LAPC.

Long-Term Adverse Effects and Complications After Prostate Cancer Treatment

Due to the often indolent nature of prostate cancer (PCA), treatment decisions must weigh the risks and benefits of cancer control with those of treatment-associated morbidities. To characterize long-term treatment-related adverse effects and complications in patients treated for PCA compared to a general population of older males. This cohort study used a novel approach linking data from 2 large PCA prevention clinical trials (the Prostate Cancer Prevention Trial and the Selenium and Vitamin-E Cancer Prevention Trial) with Medicare claims records. This analysis included patients with PCA who had been treated with prostatectomy or radiotherapy compared with an untreated control group. Multivariable Cox regression was used, with a time-varying covariate for the occurrence of PCA treatment, adjusted for age, race, and year of time-at-risk initiation, and stratified by study and intervention arm. Data analyses were performed from September 21, 2022, to March 18, 2024. Prostatectomy and radiotherapy occurring after a PCA diagnosis, identified from trial data or Medicare claims records. Ten potential PCA treatment-related complications identified from Medicare claims data. The study sample comprised 29 196 participants (mean [SD] age at time-at-risk initiation, 68.7 [4.8] years). Of these, 3946 participants had PCA, among whom 655 were treated with prostatectomy and 1056 with radiotherapy. The 12-year hazard risk of urinary or sexual complications was 7.23 times greater for those with prostatectomy (95% CI, 5.96-8.78; P < .001) and 2.76 times greater for radiotherapy (95% CI, 2.26-3.37; P < .001) compared to untreated participants. Moreover, among participants treated with radiotherapy, there was a nearly 3-fold greater hazard risk of bladder cancer than in the untreated (hazard ratio [HR], 2.78; 95% CI, 1.92-4.02; P < .001), as well as an approximately 100-fold increased hazard risk of radiation-specific outcomes including radiation cystitis (HR, 131.47; 95% CI, 52.48-329.35; P < .001) and radiation proctitis (HR, 87.91; 95% CI, 48.12-160.61; P < .001). The incidence per 1000 person-years of any 1 of the 10 treatment-related complications was 124.26 for prostatectomy, 62.15 for radiotherapy, and 23.61 for untreated participants. This cohort study found that, even after accounting for age-related symptoms and disease, PCA treatment was associated with higher rates of complications in the 12 years after treatment. Given the uncertain benefit of PCA treatment for most patients, these findings highlight the importance of patient counseling before PCA screening and treatment and provide a rationale for pursuing opportunities for cancer prevention.

Sexual behaviours and risk of SARS-CoV-2 infection among MSM during the first COVID-19 lockdown

BackgroundThe social distancing measures associated with the COVID-19 pandemic had far reaching effects on sexual behavior worldwide. However, it remains unclear whether sexual contact with non-steady partners was a contributor to the spread of SARS-CoV-2. The aim of this study was to (i) describe risk factors for SARS-CoV-2 seropositivity after the first pandemic wave among people using HIV Pre-Exposure Prophylaxis (PrEP) in Zurich, Switzerland, including sexual contact with non-steady partners, and (ii) assess whether the SARS-CoV-2 seropositivity among PrEP users in this time period differed from that of a demographic matched population level comparison group.MethodsThe study was conducted between July 2020 and October 2020 as a nested cross-sectional study within two ongoing cohort studies, SwissPrEPared (all eligible PrEP users in Switzerland ≥ 18 years old) and Corona Immunitas (a series of cross-sectional and longitudinal studies measuring the SARS-CoV-2 seroprevalence across Switzerland, beginning in April 2020). All SwissPrEPared participants were recruited from Checkpoint Zurich (the main PrEP clinic in Zurich) and were men having sex with men or transgender women. Data were collected on participants’ SARS-CoV-2 antibody status, social characteristics and behavioral data after the first wave of the pandemic in Switzerland, and seroprevalence was compared with a propensity score-matched sample from the general Zurich population.ResultsOf the 218 participants enrolled, 8.7% (n = 19, 95% CI: 5.5–13.5%) were seropositive for SARS-CoV-2 during the first pandemic wave, higher than that of the general male population in Zurich aged 20–65 (5.5%, 95% CI: 3.8–8.2%). Participants on average reduced their social outings, but the seronegative were more socially active before, during, and after the first lockdown period. In a logistic model, increasing mean sexual partner count was not associated with seropositivity (OR: 1.02, 95% CI: 0.95, 1.07). The estimated risk ratio for seropositivity for the participants compared to the general Zurich population after propensity score matching was 1.46 (95% CI: 0.53, 3.99).ConclusionsOur study suggests that SARS-CoV-2 seropositivity was slightly elevated among people taking PrEP in Zurich during the first wave of the pandemic, but that socializing and sexual activity were less important than other factors in contributing to risk.

Perspectives and Misconceptions of an Online Adult Male Cohort Regarding Prostate Cancer Screening.

Congruent with most guideline publishers, the Canadian Urological Association (CUA) recommends shared decision-making (SDM) on PSA screening (PSAS) for prostate cancer (PCa) following a discussion of its benefits and harms. However, there are limited data on how the general male population feels about these topics. A survey was completed by 906 male-identifying participants (age > 18) recruited via Amazon Mechanical Turk (MTurk), which is a crowdsourcing platform providing minimal compensation. Participants answered questions regarding demographics (15), personal/family history (9), PCa/PSA knowledge (41), and opinions regarding PSAS (45). The median age was 38.2 (SD = 12.0), with 22% reporting a family history of PCa and 20% reporting personally undergoing PSAS. Although most participants had heard of PCa (85%) and that they could be screened for it (81%), they generally did not feel knowledgeable about PCa or PSAS guidelines. Most want to talk to their clinician about PCa and PSAS (74%) and are supportive of SDM (48%) or patient-centered decision-making (25%). In general, participants thought PSAS was still worthwhile, even if it led to additional testing or side effects. Similarly, participants thought higher-risk patients should be screened earlier (p < 0.001). A number of misconceptions were evident in the responses. Men approaching the age of PSAS do not feel knowledgeable about PCa or PSAS and want their clinician to discuss these topics with them. The majority believe in PSAS and would like to undergo this screening following SDM. Clinicians also have a role in correcting common misconceptions about PCa.

The Propensity for Deviant Sexual Behavior in the General Population: An Empirical Examination of the Motivation-Facilitation Model.

In their influential paper Wurtele et al. (2014) investigated the degree to which individuals within the general population (N = 435) express sexual interest in children. In the male population of their study (n = 173), about 6% showed a propensity to engage in sexual activity with a child. Based on a German general population sample consisting of women and men (N = 911, n = 206 males), we were able to replicate most of the results of Wurtele and colleagues (e.g., 6% of men indicated some likelihood of having sex with a child). To explain sexual offending, Seto (2019) developed the motivation-facilitation model (MFM). In our study, we were interested whether this model also translates to explaining the propensity for deviant sexual behavior in the general population. Moderated hierarchical logistic regression analyses revealed that hypersexuality and sexual fantasies had significant effects as motivating factors for deviant sexual behavior (e.g., sexually assaulting an adult), whereas we found no significant effect of psychopathy as a facilitator. For the prediction of child sexual abuse, only hypersexuality had a significant effect. Notably, after including gender in both models the effect of hypersexuality was no longer significant. Accordingly, we were able to show that the MFM is useful in explaining the propensity for deviant sexual behavior foremost in the male general population. Thus, in clinical practice an assessment of hypersexuality seems to be most relevant for the male population.

Long-Term Kidney Outcomes in Children with Posterior Urethral Valves: A Population-Based Cohort Study.

Posterior urethral valves represent the most common cause of lower urinary tract obstruction in male infants (∼1/4000 live births). Long-term kidney outcomes of posterior urethral valves remain uncertain. We aimed to determine the time-varying risk of major adverse kidney events (MAKE) following children with posterior urethral valves into adulthood. A population-based retrospective cohort study of all males (<2 years) diagnosed with posterior urethral valves between 1991-2021 in Ontario, Canada. Comparator cohorts were: 1) male general population and 2) male pyeloplasty patients (both <2 years). The primary outcome was MAKE (death, long-term kidney replacement therapy [dialysis or kidney transplant], or chronic kidney disease). Time-to-MAKE was analyzed using multivariable-adjusted Cox proportional hazards models. We censored for provincial emigration, or administrative censoring (March 31, 2022). We included 727 children with posterior urethral valves, 855 pyeloplasty comparators, and 1,013,052 general population comparators. Median follow-up time was 16.6 years (Q1-3 8.6-24.5) overall. Throughout follow-up, 32% of children with posterior urethral valves developed MAKE vs. 1% of the general population and 6% of pyeloplasty comparators. Their adjusted hazard ratio for MAKE was 36.6 (95%CI 31.6-42.4) vs. the general population. The risk of developing MAKE declined over the first 5 years after posterior urethral valves diagnosis but remained elevated for >30-year follow-up. Children with posterior urethral valves were also at higher risk of death, chronic kidney disease, long-term kidney replacement therapy, hypertension, and acute kidney injury than general population or pyeloplasty comparators. Children with posterior urethral valves are at higher risk of adverse long-term kidney outcomes well into adulthood.

P-018 Study of sperm DNA fragmentation in the infertile population before, during and after the SARS-CoV-2 pandemic: a nationwide retrospective cohort study

Abstract Study question Did the values of single- and double-strand sperm DNA breaks (SSB and DSB) increase during the SARS-CoV-2 pandemic? Summary answer During the SARS-CoV-2 pandemic (2020), the mean values of SSB and DSB in infertile patients were statistically higher compared to the periods 2018-2019 and 2021-2022. What is known already Some studies have found lower sperm concentration and motility in patients during and after SARS-CoV-2 infection (COVID-19). These effects appear to be reversible, with significant improvements being observed after three months post-infection (complete spermatogenesis cycle). On the contrary, vaccination against this virus does not seem to affect semen parameters. The objective of the study was to compare the values of SSB and DSB sperm DNA fragmentation in the periods before the pandemic (2018-2019), during (2020, highest number of infections and social confinement), and after (2021-2022, lower infection rate, end of social confinement and vaccination period). Study design, size, duration The average SSB and DSB sperm DNA fragmentation values of 11,215 patients referred from 74 fertility centres throughout Spain from January 2018 to December 2022 were retrospectively compared. Participants/materials, setting, methods Semen samples from infertile patients were analysed using the Comet assay in alkaline or neutral pH conditions to evaluate SSB or DSB, respectively. Three periods were compared (two years before, during 2020, and two years after). Mean SSB and DSB values were statistically compared among these periods using the Kruskal-Wallis and Mann-Whitney tests. Differences were established at the 99% confidence interval. Main results and the role of chance The average SSB values obtained were: 41.67%±15.33 in 2018-2019; 43.92%±17.84 in 2020, and 41.68%±18.58 in 2021-2022. The average DSB values obtained were: 65.64%±14.27 in 2018-2019; 67.77%±13.90 in 2020, and 65.23%±15.18 in 2021-2022. The SSB and DSB values were statistically higher in 2020 compared to the periods 2018-2019 and 2021-2022 (p &amp;lt; 0.001 in both cases). No differences were detected between the previous period (2018-2019) and the following period (2021-2022) (p = 0.101 and p = 0.235, respectively). Limitations, reasons for caution The observed increase in SSB and DSB values during 2020 cannot be directly attributed to the SARS-CoV-2 infection (COVID-19). It is possible that it is associated with other concurrent factors. The studied samples were only from infertile patients, not from the general male population. Wider implications of the findings Given that the SARS-CoV-2 virus still exists in 2021-2022 but the social situation has normalized, the increase in fragmentation observed during 2020 could be more related to other aspects of the pandemic, such as social confinement, stress, among others. Trial registration number Not applicable

Factors Associated with Erectile Dysfunction Among Older Gay Men

Erectile dysfunction (ED) is a common issue that aging men encounter, but whether internalized gay ageism (i.e., the internalization of ageist messages within the context of aging as a gay man) is related to ED among older gay men is unknown. A cross-sectional web-based survey explored the relationship between internalized gay ageism, health-related and social factors, and ED among older gay men who resided in the Midwest United States (N = 181). Internalized gay ageism was not significantly associated with ED. However, hierarchical regression analysis found that age (β = .224, t = 2.70, p = .008) and overall health (β = −.247, t = −3.05, p = .003) were significantly associated with ED among older gay men, suggesting that older gay men share similar risk factors for ED as the general male population. Future research should continue to explore other factors that are unique to gay men that may be associated with ED.

Sociodemographic differences in suicide/intentional self-harm among cancer survivors versus the general United States population.

11097 Background: Suicide is a national public health crisis, and one of the leading causes of death in the United States. Worse yet, the suicide mortality rate is at least double among cancer survivors compared to the general population. Suicide rates vary across the population, but it is unclear how sociodemographic factors explain differences in suicide rates among cancer survivors versus the general United States population. Methods: We analyzed two sets of population-based data. First, we retrieved suicide/self-harm mortality rates for the general population from the National Vital Statistics System. Next, we accessed cancer case data from the Surveillance, Epidemiology, End Results (SEER) program to estimate number of deaths due to suicide/self-harm among cancer patients, per 100,000 persons, with a 95% confidence interval. All analyses were restricted to contiguous states with full state representation in SEER (CA, CT, GA, ID, IA, KY, LA, NJ, NM, NY, TX, UT). We then compared subgroup differences by sex, race/ethnicity, age, and state. Results: In 2020, there were 15,813 deaths in the general population (12.1 suicide/100,000 persons; 95% CI: 11.9, 12.3), and 1,127 among cancer survivors (22.1 suicide/100,000 persons; 95% CI: 22.0, 22.1) due to suicide/intentional self-harm. Among racial/ethnic groups, the largest difference was found in the non-Hispanic White cancer survivors, with 10.4 more suicide/100,000 persons vs. White individuals in the general population. In contrast, two racial minority groups had higher suicide mortality rate in the general population vs. cancer survivors: Non-Hispanic Black individuals (general population = 7.4 suicide/100,000 persons vs cancer survivors = 6.9 suicide/100,000 persons), and Native American Indian (general population = 16.6 suicide/100,000 persons vs. cancer survivors = 11.3 suicide/100,000 persons). Among females, suicide mortality rate was slightly higher by 1.3 suicide/100,000 persons in cancer survivors vs. general population, and much higher among male cancer survivors vs. general population (19.9 suicide/100,000 persons more). For age groups, the lowest difference in suicide mortality between cancer survivors vs. general population was in the 65-84 age group (5.1 more suicide/100,000 persons). Across all other age groups, suicide rates were 11.9 to 14.4 higher in cancer survivors vs. the general population. Across the 12 states in our analysis, the smallest difference was in Iowa (1.9 more suicide/100,000 persons), and the largest difference was in Idaho (27.0 more suicide/100,000 persons). Conclusions: In most subgroups, people diagnosed with cancer appear to be at greater risk of death from suicide/intentional self-harm than the general population. As the number of people living with cancer continues to grow, policies increasing the quality of life for cancer patients are warranted.

Toward clinical exomes in diagnostics and management of male infertility

Infertility, affecting ∼10% of men, is predominantly caused by primary spermatogenic failure (SPGF). We screened likely pathogenic and pathogenic (LP/P) variants in 638 candidate genes for male infertility in 521 individuals presenting idiopathic SPGF and 323 normozoospermic men in the ESTAND cohort. Molecular diagnosis was reached for 64 men with SPGF (12%), with findings in 39 genes (6%). The yield did not differ significantly between the subgroups with azoospermia (20/185, 11%), oligozoospermia (18/181, 10%), and primary cryptorchidism with SPGF (26/155, 17%). Notably, 19 of 64 LP/P variants (30%) identified in 28 subjects represented recurrent findings in this study and/or with other male infertility cohorts. NR5A1 was the most frequently affected gene, with seven LP/P variants in six SPGF-affected men and two normozoospermic men. The link to SPGF was validated for recently proposed candidate genes ACTRT1, ASZ1, GLUD2, GREB1L, LEO1, RBM5, ROS1, and TGIF2LY. Heterozygous truncating variants in BNC1, reported in female infertility, emerged as plausible causes of severe oligozoospermia. Data suggested that several infertile men may present congenital conditions with less pronounced or pleiotropic phenotypes affecting the development and function of the reproductive system. Genes regulating the hypothalamic-pituitary-gonadal axis were affected in >30% of subjects with LP/P variants. Six individuals had more than one LP/P variant, including five with two findings from the gene panel. A 4-fold increased prevalence of cancer was observed in men with genetic infertility compared to the general male population (8% vs. 2%; p= 4.4×10-3). Expanding genetic testing in andrology will contribute to the multidisciplinary management of SPGF.

Organ Damage and Quality of Life in Takayasu Arteritis - Evidence From a National Registry Analysis.

Takayasu arteritis, affecting primarily young women, damages large arteries and organs. We examined the impact of disease duration and sex on organ damage and quality of life using Japan's Intractable Disease Registry. After refining data, 2,013 of 2,795 patients were included in the study. Longer disease duration was related to a lower prevalence of disease activity symptoms, a higher prevalence of organ damage, and a higher proportion of patients requiring nursing care. Compared with men, women tended to have an earlier onset age, exhibiting longer disease duration. A higher proportion of women had aortic regurgitation and required nursing care. The proportion of female patients in employment was lower than that of the general female population, whereas no difference was observed between male patients and the general male population. Logistic regression analysis revealed that age at surveillance, brain ischemia, visual impairment/loss, and ischemic heart disease were significant factors associated with high nursing care needs (Level ≥2, with daily activity limitations). Early diagnosis and effective treatment, particularly to prevent brain ischemia, visual impairment, and ischemic heart disease, may improve the quality of life of patients with Takayasu arteritis, especially women.

(099) Intersection of Sexual and Mental Health: Prevalence of Anxiety and Depression in a Men's Health Clinic and Feasibility of Mental Health Surveys

Abstract Introduction Depression and general anxiety disorder (GAD) are the most prevalent mental health conditions in men, affecting 5% and 2%, respectively. 31% of men suffer depression in their lifetime and only 1/4 of men speak to a mental health professional about it. Suicide rates are 4 times higher in men and men are more likely to succeed at attempts. Men with high depression scores are nearly twice as likely to report erectile dysfunction (ED) than nondepressed men. Objective We aim to identify the prevalence of depression and GAD among patients presenting to a men's health clinic (MHC). Secondary objectives include demonstrating the feasibility of administering mental health surveys in a busy MHC to early identify men who may benefit from a referral to a mental health practitioner in order to improve overall men's health. Methods We retrospectively reviewed the records of patients presenting to a MHC during a three-month period in 2023 who completed all surveys. We measured ED and ejaculatory dysfunction severity with the Sexual Health Inventory for Men (SHIM) and Male Sexual Health Questionnaire (MSHQ-EJ), respectively. Screening for depression and anxiety was performed with the Patient Health Questionnaire (PHQ-7) and the General Anxiety Disorder (GAD-7) questionnaire. Both questionnaires rate disease severity as mild, moderate, or severe. Linear regression models were used to compare the severity of depression and anxiety to ED severity. Non-parametric statistics were used to analyze the prevalence of mental health disorders and the reason for the patient’s visit to the men’s health clinic. Referral to a mental health specialist was offered for any patients meeting scoring criteria. Results We identified 255 men (77% white, 18% black, 5% Asian, and 94% non-Hispanic) with a median age of 48 years (IQR: 33-64) and a BMI of 28 (IQR: 25-32). Overall, 63% of men had some ED, while 88% had some degree of ejaculatory dysfunction. Prevalence of depression and GAD was 15% and 11%, respectively. A linear regression model showed that as ED severity increases, so does depression severity (F [1, 244] = 13.53, p = .0001, coefficient: 0.15, R-squared: 0.05) and anxiety severity (F [1, 244] = 5.93, p=0.02, coefficient: 0.08, R-squared: 0.02). The study found no significant correlation between prevalence of depression and the reason for the patients' visits to the MHC: ED (17%, 20/117), hypogonadism (22%, 26/120), Peyronie's (28%, 7/25), fertility evaluation (33%, 5/15), varicocele (30%, 8/27), and vasectomy evaluation (5%, 1/21) (p=0.27). Conclusions The prevalence of depression and GAD among men attending a MHC is higher than that of the general male population. The degree of ED and its association with the severity of depression and anxiety emphasizes the importance of addressing both sexual and mental health in the context of men's healthcare. ED should be considered a multifactorial condition that requires a multidisciplinary approach to treatment, especially when depression is present. Patients reporting ED should be routinely screened for depression. Administration of mental health surveys in a MHC is feasible and helps guide early referral to a mental health specialist. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific, Coloplast and BK Ultrasound.

Trends in suicide mortality among prostate cancer survivors in the United States, 1975–2019

BackgroundSuicide was an important cause of death in prostate cancer. This study intended to investigate trends in suicide mortality among prostate cancer (PCa) survivors from 1975 to 2019 in the United States.MethodWe identified PCa survivors from the Surveillance, Epidemiology, and End Results (SEER) program from January 1975 to December 2019. Standardized mortality rate (SMR) was calculated d to assess the relative risk of suicide in PCa survivors compared with the general men population. Poisson regression model was performed to test for trend of SMRs. The cumulative mortality rate of suicide was calculated to assess the clinical burden of suicide mortality.Results7108 (0.2%) cases were death from suicide cause, and 2,308,923(65.04%%) cases recorded as dying from non-suicidal causes. Overall, a slightly higher suicide mortality rate among PCa survivors was observed compared with general male population (SMR: 1.15, 95%CI: 1.09–1.2). The suicide mortality rate declined significantly relative to the general population by the calendar year of diagnosis, from an SMR of 1.74(95%CI: 1.17–2.51) in 1975–1979 to 0.99(0.89–1.1) in 2015–2019 (Ptrend < 0.001). PCa survivors with aged over 84 years, black and other races, registered in registrations (including Utah, New Mexico, and Hawaii) failed to observe a decrease in suicide mortality (Ptrend > 0.05). The cumulative suicide mortality during 1975–1994 was distinctly higher than in 1995–2019(P < 0.001).ConclusionThe trend in suicide mortality declined significantly from 1975 to 2019 among PCa survivors compared with the general male population in the United States. Notably, part of PCa survivors had no improvement in suicide mortality, and additional studies in the future were needed to explore it.

Depression and anxiety-related disorders and suicide among Swedish male elite football players: a nationwide cohort study

ObjectiveTo assess whether male elite football players, during and after their active career, were at increased risk of depression and anxiety-related disorders and suicide, as compared with the general male...

Combination of High Ligation and Intraoperative Embolization using Polidocanol for Treatment of Varicoceles.

Varicoceles are dilated veins within the pampiniform plexus and are relatively common in the general male population. The spermatic vein has many branches in the scrotal segment and then gradually merges into 1-2 trunks after passing through the internal inguinal ring. The key to a successful varicocelectomy is to ligate all the spermatic veins while protecting the testicular arteries and spermatic lymphatic vessels from damage. The small veins, including the branches of spermatic veins and collateral veins, are easily missed for ligation during conventional high ligation of varicocele, which has been suggested as a major cause of postoperative recurrence. Although microsurgery effectively reduces the risk of missing ligation of the spermatic veins during surgery, it has several shortcomings, such as long operation time and a steep learning curve. More importantly, this technique is difficult to carry out in primary hospitals due to the requirement of specialized equipment. Therefore, an attempt to modify the traditional high ligation aiming to reduce the postoperative recurrence rate has been carried out here. The protocol here combines traditional high ligation with intraoperative embolization to seal off the branches of the spermatic vein and collateral veins. We rapidly injected foamed sclerosant into the internal spermatic vein under direct observation after separation of the spermatic vein and then ligated all the veins. The foamed sclerosant through the varicose vein hampers endothelial cell growth, promotes the growth of thrombus and fibrosis, and ultimately forms fibrous streaks that permanently fill the venous. The results showed a more satisfactory effect on reducing the postoperative recurrence rate compared with traditional high ligation. Since this protocol is simple to carry out and has better results in reducing the recurrence rate, this can be an alternative surgical method for the treatment of varicocele, especially in primary hospitals.

Mortality, cancer incidence, and disability among professional drivers in Slovenia.

Literature data about all-cause and cause-specific mortality among professional drivers are inconsistent. Most studies report lower all-cause and higher cause-specific mortality. Higher cause-specific mortality is most often the result of malignant and circulatory diseases. The aim of our retrospective cohort study was to get a better insight into the mortality, cancer incidence, and occupational disability of the entire professional driver population in Slovenia (N=8,231) from 1997 to 2016 through standardised mortality ratio (SMR), standardised proportional mortality ratio (SPMR), standardised cancer incidence ratio (SIR), and standardised disability ratio (SDR). Total mortality was significantly lower than that of the general working population (SMR=0.49; 95 % CI=0.44-0.55). When SPMR was calculated, however, the risk of all-cause mortality increased to 1 (SPMR=1.00; 95 % CI=0.89-1.12), of cancer-related mortality to 1.13 (95 % CI=0.94-1.35), and of injury-related mortality to 1.25 (95 % CI=0.97-1.59). Cancer incidence was lower than in the general male working population for all types of cancer (SIR=0.66; 95 % CI=0.59-0.72), lung cancer included (SIR=0.56; 95 % CI=0.41-0.73). Occupational all-cause and cause-specific disability were also lower than in the rest of the working population. Even though all types of cancer and injuries were established among professional drivers in Slovenia, no major risk stand out. However, our findings may have been skewed by the healthy worker effect.