Male Sexual Health Questionnaire Research Articles

Which is better to predict erectile dysfunction and male sexual function in the context of metabolic syndrome: triglyceride-glucose index or visceral adiposity index?: a retrospective cross-sectional study.

Many factors influence male sexual function, including metabolic disorders such as metabolic syndrome (MetS). We aimed to investigate the effects of two metabolic indices, the triglyceride-glucose (TyG) index and the visceral adiposity index (VAI), on male sexual function. A total of 400 men having sexual dysfunction were included. Anthropological data, comorbidities were recorded. Serum total testosterone, prolactin, and estradiol levels were recorded. Sex-specific VAI was calculated using the [(WC/39.68) + (1.88xMI)] × (TG/1.03) × (1.31/HDL) formula and using Ln (fasting triglycerides) × (fasting glucose)/2] formula, TyG index was calculated. Turkish-validated 15-item long-form of the International Index of Erectile Dysfunction (IIEF) questionnaire and male sexual health questionnaire (MSHQ) were used for erectile function and ejaculatory function, respectively. The ROC analysis was used to evaluate the predictive abilities of TyG and VAI cut-off values for ED risk. A higher TyG index and VAI were associated with an increased risk of ED. The presence of MetS further worsened sexual function, with lower scores in sexual satisfaction, orgasm, desire, and general satisfaction. The TyG index and VAI showed similar predictive abilities for ED. Patients with MetS had worse ejaculation quality compared to those without MetS. These findings highlight the potential of the TyG index and VAI as convenient tools for predicting and assessing sexual dysfunction in men, particularly in the context of metabolic disorders. Early detection and intervention for metabolic syndrome and insulin resistance may help to mitigate their negative impact on male sexual function.

Effect of benign prostatic hyperplasia surgery on ejaculatory function

Introduction. There are a wide range of techniques available for the removal of hyperplastic prostate tissue. However, the choice of method rarely considers its effect on ejaculatory function.Objectives. To evaluate the effect of surgery for benign prostatic hyperplasia (BPH) by endovideosurgical posterior adenomectomy (EVS AE) and transurethral electroenucleation of the prostate (TUEB) on copulatory function and its ejaculatory component.Materials & methods. Sixty sexually active patients aged 58 to 78 years with indications for surgical treatment of BPH were included in the study. The patients were randomized into two equal groups. The first group (30 patients) underwent EVS AE by standard technique without preservation of the prostatic urethra. The second group (30 patients) underwent TUEB. Before treatment, standard questionnaires used in urologic practice were completed: IIEF-5, IPSS-QOL, and the scale of quantitative assessment of male copulatory function (scale “MCF”). The block of questions specifically characterizing the ejaculatory component and the "Male Sexual Health Questionnaire", namely the section " Ejaculatory function domain", were analyzed separately. The assessment was conducted before treatment and at the 12th week following surgery. No significant differences were found between the groups on any of the questionnaires prior to surgery.Results. Three months following surgery, there was a significant improvement in the IPSS-QOL scores for the EVS AE group, by 24 points and 4.3, respectively, and for the TUEB group, 25.6 points and 4.3 (both p < 0.0001). No change was observed in the IIEF-5 questionnaire (p > 0.05). A slight reduction in scores was noted on the MCF scale for the TUEB group (by 2.9 points, p < 0.05), indicating that the general state of erectile function remained unchanged. However, reductions were seen in the "MCF — Ejaculatory Component" and "Male Sexual Health Questionnaire — Ejaculatory function domain" scales for the TUEB group, with ballpark scores decreasing by 3.2 and 6.8 points, respectively (both p = 0.0326 and p = 0.0254), indicating a worsening in ejaculatory function following TUEB treatment.Conclusion. When selecting a specific surgical approach for BPH management, consideration should be given to the patient's tolerance for the degree of invasiveness of the procedure while preserving ejaculatory function, and adherence to a treatment strategy that aligns with the patient's individual preferences and expectations.

Sexual function and pelvic floor function in men with systemic sclerosis compared to healthy controls: a cross-sectional study

Objectives This cross-sectional study aimed to compare the sexual function (SF) and pelvic floor function of men with systemic sclerosis (SSc) with age-matched healthy controls (HC) and to identify the implications of clinical features on SF. Material and method Twenty SSc males and 20 HC aged 18–70 years completed eleven questionnaires assessing SF [International Index of Erectile Function (IIEF), Male Sexual Health Questionnaire (MSHQ)]; sexual quality of life: Sexual Quality of Life Questionnaire-Male (SQoL-M); pelvic floor function: Pelvic Floor Impact Questionnaire-Short Form 7 (PFIQ-7), fatigue, depression, physical fitness, functional disability, and quality of life. Clinical data were collected. Results Significantly worse SF was observed in patients (median IIEF erectile function 12 in SSc versus 29 in HC, p < 0.001), with 70% reporting erectile dysfunction (ED) compared to 15% in HC. However, no significant difference was observed regarding pelvic floor function (median PFIQ7 8.8 in SSc versus 7.0 in HC, p = 0.141). Impaired SF was associated with higher disease activity, increased systemic inflammation, more pronounced fatigue, reduced physical fitness, severe depression, impaired overall quality of life, dyspepsia, and arthralgias (p < 0.05 for all). Conclusions Sexual dysfunction is highly prevalent in our SSc patients, whereas pelvic floor dysfunction is unlikely to be associated with these problems.

Partner Satisfaction in Labiaplasty Patients.

Labiaplasty operation, which has become increasingly popular in recent years, is frequently preferred by women for cosmetic and functional reasons. It creates significant changes on female sexuality with high satsfaction rates. But there is limited data on its effects on male sexual response. To investigate the effects of labiaplasty on partners. Partners of 49 patients who underwent labiaplasty between January 2020 and May 2023 were included in the study. Male Sexual Health Questionnaire Ejaculatory Dysfunction (MSHQ-EjD), Golombok Rust Sexual Satisfaction Scale and New Sexual Satisfaction Scale (NSSS) questionnaires were administered to the partners preoperatively and 6 months postoperatively. There was no significant difference between preoperative and postoperative results in the MSHQ-EjD questionnaire applied to the partners included in the study. The postoperative increase in the new sexual satisfaction scale compared to the preoperative sexual satisfaction score was statistically significant. In the Golombok Rust sexual satisfaction scale, statistically significant, positive changes were observed in the categories of frequency of intercourse, communication, satisfaction, and nature of sexual intercourse in postoperative results. Labiaplasty operation had positive effects onmale sexual response, but had no effect on ejaculation function and difficulty.

Ejaculatory and erectile function outcomes following holmium laser enucleation of the prostate.

Holmium laser enucleation of the prostate (HoLEP) is a surgical treatment option for benign prostatic hyperplasia (BPH). Many men develop retrograde ejaculation postprocedure, but there is conflicting evidence regarding sexual function outcomes post-HoLEP. We sought to examine significant variations in patient-reported erectile and ejaculatory function within 12 months post-HoLEP. We conducted a retrospective study for patients who underwent HoLEP between Nov 2018 and Feb 2022. Of the reviewed patients, 277 patients met inclusion criteria and completed pre and postoperative questionnaires, which included the Male Sexual Health Questionnaire- Ejaculatory Dysfunction (MSHQ-EJD) and the International Index of Erectile Function/Sexual Health Inventory for Men (IIEF-5/SHIM). Surveys were provided to patients up to 12 months postprocedure. Demographics and comorbidities associated with sexual dysfunction were collected. Responses to each question were analyzed to detect sub-categorical variations in sexual function as the secondary objective. Data was analyzed by using a linear mixed model. There was a significant decline in total scores for the MSHQ-EJD (8.70 pre-HoLEP vs. 6.58 post HoLEP, p ≤ 0.001) including a significant decline (p < 0.005) in questions 1-3 which assess ejaculatory ability, strength, and volume. There was not a significant decline in question 4 which assesses bother (2.552 pre-HoLEP vs. 3.119 post-HoLEP, p = 0.526). There was not a significant decline in the IIEF-5/SHIM postoperatively (11.51 pre-HoLEP vs. 13.327 post-HoLEP, p = 0.498). Patients undergoing HoLEP do not experience a decline in erectile function. Patients do experience a decline in ejaculatory function but did not find this bothersome.

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.

(139) Efficacy of a New Vacuum Erection Device (Vigor 2020) for Erectile Dysfunction in a Retrospective Study in Japan

Abstract Introduction Phosphodiesterase 5 inhibitors (PDE5i) are the first-line treatment for erectile dysfunction (ED), but there is in approximately 30% of ineffective patients or contraindicated in patients taking nitrate medications. Although vacuum erection device (VED) is the second line in ED guidelines, they have long been unavailable in Japan, due to the withdrawal of their manufacturers. Objective A new VED, Vigor 2020, has now been manufactured and received medical approval by the Pharmaceuticals and Medical Devices Agency (PMDA) in Japan. It is very important to be able to sexual intercourse with VED, recommended in the ED guidelines. We conducted a retrospective observational study of patients with Vigor 2020 in clinical practice. Methods We analyzed male patients aged 20 years or older who presented to an outpatient clinic with ED and were treated with Vigor 2020 as a second-line treatment, because PDE5i was ineffective or contraindicated. Sexual and ejaculatory function were assessed using questionnaires [Erection Hardness Score (EHS), International Index of Erectile Function (IIEF), Male Sexual Health Questionnaire for assessing ejaculatory dysfunction (MSHQ-EjD), the numerical rating scale (NRS)]. Results There were 34 participants who could be evaluated before and after the use of Vigor 2020, with a mean age of 57.85 (27–86) years. Significant improvement in EHS and IIEF total score were observed with the use of Vigor 2020 in all participants. There was a significant improvement in MSHQ-EjD and NRS for participants who had an EHS of 3 or higher after the use of Vigor 2020. But no significant improvement in MSHQ-EjD and NRS for participants who had an EHS of 2 or lower after the use of Vigor 2020. The participants experienced no significant adverse events. Conclusions Vigor 2020 may be one treatment tool for ED, as defined in the ED guidelines. There is not only significant improvement of erection with Vigor 2020 but also improvement of ejaculation in cases of significant erectile efficacy. Disclosure No.

Effects of Korean Versus Western Diets on Reproductive Function in Young Korean Men: A 12-Week Randomized Parallel Clinical Trial.

Studies report that diet may have contributed to a 50-60% decrease in human sperm quality over the past few decades. Unhealthy lifestyles affect the structure of spermatozoa, affecting the male reproductive potential. This study aimed to compare the effects of Korean and Western diets on reproductive function in young male Koreans. Study participants were provided either the Korean Diet (KD group) or the Western Diet (WD group) for 12 weeks. Semen quality parameters such as volume, motility, cell count, and sex hormone levels were evaluated. Sexual function was assessed using the International Index of Erectile Function and the Male Sexual Health Questionnaire. Efficacy and safety evaluations were conducted at baseline, 8 weeks, and 12 weeks. The KD group demonstrated a significantly increased sperm motility after 8 weeks relative to baseline but decreased after 12 weeks. In contrast, sperm motility in the WD group significantly decreased after 8 weeks compared with baseline and remained constant after 12 weeks. Statistically, a near-significant difference was observed between groups (p = 0.057). Similarly, free testosterone levels in the KD group increased after 12 weeks compared with baseline, whereas that in the WD group decreased. The free testosterone levels in the KD group were significantly higher than those in the WD group (p = 0.020). There were no statistically significant differences in other sex hormone and sexual function questionnaires between the groups. None of the participants reported any severe side effects, and no significant alterations in clinical diagnostic test values were detected. The results of the study strongly reveal that KD positively affects sperm motility and male hormone levels in young men, indicating potential benefits for reproductive function.

The problem of calculating the prevalence of sexual dysfunction: a meta-analysis attending gender.

Sexuality is an integral part of human health, and sexual dysfunctions are prevalent issues that affect men and women. While reviews on sexual dysfunctions in various diseases have been conducted, overall data are scarce. To update the overall prevalence of sexual dysfunctions from available prevalence studies on both sexes. We used a 2-phase selection process to include cross-sectional studies that were conducted on the adult population and published between 2017 and 2022. The extracted data were prevalence, methodology, sample size, and location. Sensitivity and subgroup analyses were conducted to assess heterogeneity. This review analyzed 4407 studies. Twenty-three met the established criteria: 9 on the male population and 14 on the female population. The meta-analysis included 7 articles on males and 13 on females. The prevalence of sexual dysfunction was 31% in men and 41% in women, with significant heterogeneity among the studies. Sociocultural differences and use of varying measurement methods were identified as the main factors contributing to heterogeneity. Subgroup analysis revealed decreased heterogeneity among studies that used the Female Sexual Function Index as a diagnostic tool for females. The review highlights the notable variability in results due to methodological and geographic variations. Therefore, enhancing the training of professionals and standardizing the recording of patient data-through the Female Sexual Function Index and Male Sexual Health Questionnaire or by developing new ones for this purpose-could improve the consistency of research on sexual health.

(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.

(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.

The effect of drug holidays on sexual dysfunction in men treated with selective serotonin reuptake inhibitors (SSRIs) other than fluoxetine: an 8-week open-label randomized clinical trial

IntroductionSelective serotonin reuptake inhibitors (SSRIs) are widely used for the treatment of various mental disorders. Sexual dysfunction is one of the most common side effects of SSRIs, and often leads to poor adherence and treatment discontinuation. While several strategies have been employed to manage SSRI-induced sexual dysfunction, drug holidays has not been extensively studied for this purpose. This clinical trial aims to assess the effect of drug holidays on sexual dysfunction in married men under treatment with SSRIs other than fluoxetine (as its long half-life makes drug holidays ineffective).MethodsThis 8-week double-center, randomized, open-label, controlled trial was conducted in the outpatient clinics of Iran Psychiatric Hospital and Tehran Institute of Psychiatry, from January 2022 to March 2023. We included married men aged between18 and 50 years who had experienced sexual dysfunction during treatment with SSRIs, other than fluoxetine. The Male Sexual Health Questionnaire (MSHQ) and the 28-Question General Health Questionnaire (GHQ-28) were used for the assessment of sexual function and mental health status. The drug holidays group was instructed not to take their medications on the weekends. The control group was asked to continue their regular medication regimen without any changes. Both groups were assessed at baseline, and weeks 4 and 8.ResultsSixty-three patients were included and randomly assigned to the drug holidays group (N = 32) or the control group (N = 31). Fifty patients (25 in each group) completed the trial. Drug holidays significantly improved erection, ejaculation, satisfaction, and the overall sexual health of the participants (P < 0.001). No significant change was observed in their mental health status. No major side effects were recorded.ConclusionsDrug holidays significantly improved the MSHQ scores in ‘erection’, ‘ejaculation’, ‘satisfaction’ and ‘total’ in married men with sexual dysfunction induced by SSRIs, other than fluoxetine, without causing any significant changes in their mental health status. Further research is needed to reach a certain conclusion.Trial registrationThe trial was registered at the Iranian Registry of Clinical Trials on 2021.10.25 (www.irct.ir; IRCT ID: IRCT20170123032145N6) before the trial.

An Innovative Technique for Ejaculation-Sparing Prostatic Enucleation with Thulium:YAG Laser.

Purpose: We report our experience with 100 patients who underwent an innovative prostate enucleation technique that spares the complete urethral-plate from the veru montanum to the bladder neck using a low-energy thulium laser emission. The aim of our study was to evaluate the short-term effects of this procedure on ejaculation preservation and urinary obstruction. Materials and Methods: The International Prostate Symptom Index (IPSS), quality of life (QoL), and Male Sexual Health Questionnaire Ejaculatory Dysfunction (MSHQ-EJD) Short Form were used as validated instruments to quantify ejaculatory dysfunction before and 6 months after the surgery. Results: The median IPSS score pre- and postoperatively was 20 and 5, respectively (p < 0.0001); QoL dropped from a median of 4-1 (p < 0.0001); and the mean preoperative maximal flow rate improved significantly (8.5 vs 21.2 mL/min) (p < 0.0001). Furthermore, there was significant reduction in postvoid residual postoperatively (p < 0.0001). Postoperative ejaculatory function was preserved in 92/100 patients (92%). According to the MSHQ-EJD score, patients reported a slight nonsignificant decrease in frequency of ejaculation (item 1), force of expulsion (item 2) and reduction in semen volume during ejaculation (item 3), with the exception of ejaculation discomfort (item 4). Conclusion: According to our results, complete removal of the apical tissue, which has been advocated as an integral part of the so called ejaculatory hood, does not interfere with ejaculation if the ventral lissosphincter remains intact.

Parenting desire among men who have sex with men in a heteronormative context.

The desire for parenthood in the LGBT+ community is still a matter of critical debate worldwide. We aimed to (i) analyse the prevalence of desire for fatherhood in a cohort of white-European sexually active men who have sex with men and (ii) explore the characteristics of men who have sex with men with respect to those without the desire for fatherhood. An anonymous self-compiled survey with 23 closed socio-demographic general questions, one section aimed to assess medical history and recreational habits and two sections devoted to investigate genital and sexual health, was provided to each participant. Likewise, all participants were invited to complete a number of questionnaires, including the Male Sexual Health Questionnaire and the Beck Inventory for Depression. Of 191 men who have sex with men white-European participants who eventually completed the survey, 112 (58.6%) clearly expressed their desire for fatherhood. Of all, the wish to become a parent was strong in 99 (51.8%) individuals and higher in younger participants (35 [28-46] vs. 43 [32-50] years, p=0.01). No other significant differences in terms of educational level and relational status were identified between the two groups. Of all, the wish to become a parent was strong in 99 (51.8%) individuals and higher in younger participants (35 [28-46] vs. 43 [32-50] years, p=0.01). Current preliminary findings highlight that more than one in two men who have sex with men has a desire for fatherhood, with almost 81% of all having a high desire for fathering, which is clearly more intense in younger men.

Three years outcomes of transperineal laser ablation of the prostate.

Ultra-minimally Invasive Surgical Techniques (uMISTs) play an increasingly significant role in treating benign prostatic obstruction (BPO) as an alternative to both medical therapy and surgery. Transperineal laser ablation of the prostate (TPLA) is an uMIST that has shown its efficacy in symptom relief and improvement of urodynamic parameters while sparing ejaculatory function and having a low risk of complications. This is the 3-year follow-up of a pilot study on TPLA. TPLA was performed using the SoracteLite™ system. It consists of ablating prostate tissue through a diode laser, eventually causing prostate volume reduction. We recorded International Prostate Symptom Score (IPSS), uroflowmetry parameters, the Male Sexual Health Questionnaire (MSHQ-EjD), and prostate volume at baseline and after 3 years. The Wilcoxon Test was employed to compare continuous variables. Twenty men completed a 3-year follow-up after TPLA. The median prostate volume was 41.5 mL (IQR: 40.0-54.3). Preoperative median IPSS, Q<inf>max</inf>, and MSHQ-EjD were 18 (IQR: 16-21), 8.8 mL/s (IQR: 7.8-10.8), and 4 (IQR: 3-8). TPLA showed significant improvement in IPSS (-37.2%; P<0.01) and Q<inf>max</inf> (45.8%; P<0.01); median MSHQ-EjD improvement was by 60% (P<0.01) and median prostate volume reduction was by -20.4% (P<0.01). This analysis shows that TPLA maintains satisfactory results within 3 years. Therefore, TPLA confirms its role in the treatment of patients unsatisfied or intolerant to oral therapies but not eligible for surgery to avoid impact on sexual function or due to anesthesiologic contraindications.

Preservation of Erectile and Ejaculatory Functions After Tetramodal Bladder-Sparing Therapy Incorporating Consolidative Partial Cystectomy Against Muscle Invasive Bladder Cancer.

To cross-sectionally assess erectile and ejaculatory functions after tetramodal bladder-sparing therapy consisting of transurethral resection, chemoradiotherapy, and consolidative partial cystectomy in patients with muscle invasive bladder cancer. Among 72 enrolled male patients who underwent tetramodal bladder-sparing therapy from 2006 to 2019, 42 who visited the outpatient clinic from February to October 2020 received questionnaires. Erectile function, ejaculatory function, and quality of life were assessed using the International Index of Erectile Function short form, the Male Sexual Health Questionnaire Ejaculatory Dysfunction short form, and the Functional Assessment of Cancer Therapy. Among the 42 patients, 9 were excluded because of incomplete responses and 33 were eligible for analyses. The median (range) age at survey and the time from treatment completion to responding to the questionnaires was 70 (50-87) years and 4.2 (0.4-14.0) years, respectively. The median International Index of Erectile Function short form-5 score was 11 (5-25), and 3 (9.1%) and 9 (27.3%) patients had no and mild erectile dysfunction, respectively. The Male Sexual Health Questionnaire Ejaculatory Dysfunction short form results showed that 23 (69.7%) patients responded that they could ejaculate. Patients with higher Male Sexual Health Questionnaire Ejaculatory Dysfunction short form scores had better erectile function and quality of life than those with lower Male Sexual Health Questionnaire Ejaculatory Dysfunction short form scores. Preservation of erectile and ejaculatory functions was demonstrated in muscle invasive bladder cancer patients treated with tetramodal bladder-sparing therapy. In addition to lower urinary tract function, preservation of male sexual function, especially ejaculatory function, in bladder-sparing therapy can be an advantage over radical cystectomy.

Long-Term Male Sexual Function and Fecal Incontinence Outcomes for Adult Patients with Hirschsprung Disease or Anorectal Malformation

BackgroundThis study sought to characterize sexual function and fecal incontinence related quality of life (QOL) outcomes for adult males with anorectal malformation (ARM) or Hirschsprung's Disease (HD). MethodsWe conducted a cross-sectional survey study of male patients ≥18 years with ARM or HD. Patients were identified from our institutional database, contacted and consented by telephone, and sent a REDCap survey via email. The International Index of Erectile Function (IIEF-5) and Male Sexual Health Questionnaire (MSHQ) evaluated erectile dysfunction (ED) and ejaculatory dysfunction (EjD), respectively. The Cleveland Clinic Incontinence Score (CCIS) and the Fecal Incontinence Quality of Life Scale (FIQLS) assessed fecal incontinence-related outcomes. A linear regression analysis of IIEF-5 scores compared to CCIS scores was used to evaluate for an association between ED and incontinence. ResultsOf 63 patients contacted, 48 completed the survey. The median age for respondents was 22.5 years (IQR 20–25). There were 19 patients with HD and 29 patients with ARM. On the IIEF-5 survey, 35.3% report some level of ED. On the MSHQ-EjD survey, the median score was 14 out of 15 (IQR 10.75–15), indicating few EjD concerns. The median CCIS was 5 (IQR 2.25–7.75) and the median FIQL scores ranged from 2.7 to 3.5 depending on the domain assessed, demonstrating some QOL challenges secondary to fecal incontinence. On linear regression analysis, IIEF-5 and CCIS scores were weakly associated (B = −0.55, p = 0.045). ConclusionsMale adult patients with ARM or HD may have ongoing concerns with sexual function and fecal incontinence. Level of EvidenceLevel 4. Type of StudyCross-Sectional Survey Study.

MP59-09 NOVEL COMPOSITE ‘BPH3’trifecta FOR ROBOTIC ASSISTED SIMPLE PROSTATECTOMY (RASP) VS BPH6; A MULTICENTER OUTCOMES COMPARISON

You have accessJournal of UrologyCME1 Apr 2023MP59-09 NOVEL COMPOSITE ‘BPH3’trifecta FOR ROBOTIC ASSISTED SIMPLE PROSTATECTOMY (RASP) VS BPH6; A MULTICENTER OUTCOMES COMPARISON Alfredo Maria Bove, Aldo Brassetti, Riccardo Mastroianni, Gabriele Tuderti, Umberto Anceschi, Simone D'Annunzio, Mariaconsiglia Ferriero, Leonardo Misuraca, Iannuzzi Andrea, Prata Francesco, Alberto Ragusa, Michele Gallucci, Simone Giuseppe, Porpiglia Francesco, Daniele Amparore, Sabrina De Cillis, Alberto Quarà, Michele Ortenzi, Cristian Fiori, and Checcucci Enrico Alfredo Maria BoveAlfredo Maria Bove More articles by this author , Aldo BrassettiAldo Brassetti More articles by this author , Riccardo MastroianniRiccardo Mastroianni More articles by this author , Gabriele TudertiGabriele Tuderti More articles by this author , Umberto AnceschiUmberto Anceschi More articles by this author , Simone D'AnnunzioSimone D'Annunzio More articles by this author , Mariaconsiglia FerrieroMariaconsiglia Ferriero More articles by this author , Leonardo MisuracaLeonardo Misuraca More articles by this author , Iannuzzi AndreaIannuzzi Andrea More articles by this author , Prata FrancescoPrata Francesco More articles by this author , Alberto RagusaAlberto Ragusa More articles by this author , Michele GallucciMichele Gallucci More articles by this author , Simone GiuseppeSimone Giuseppe More articles by this author , Porpiglia FrancescoPorpiglia Francesco More articles by this author , Daniele AmparoreDaniele Amparore More articles by this author , Sabrina De CillisSabrina De Cillis More articles by this author , Alberto QuaràAlberto Quarà More articles by this author , Michele OrtenziMichele Ortenzi More articles by this author , Cristian FioriCristian Fiori More articles by this author , and Checcucci EnricoCheccucci Enrico More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003312.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: BPH6 is a comprehensive metric to assess outcomes after treatment for BPO. Since the BPH6 includes: reduction of <6 points in International Index of Erectile Function (IIEF) and persistence of antegrade ejaculation at Male Sexual Health Questionnaire (MSHQ), only a small percentage of disobstructive procedures can lead to its achievement. We tested our novel BPH3 trifecta, in assessing the disobstructive proficiency of RASP according to different techniques. METHODS: Baseline prostate volume (PV), flowmetry parameters and Validated questionnaires: IIEF, Incontinence severity index score (ISI), International prostatic symptoms score (IPSS), MSHQ, Quality of recovery (QOR), were recorded preoperatively and 12 months postoperatively. RASP were performed according to the urethra-sparing (Madigan) technique and a non urethra-sparing trans-vescical (Freyer) approach. The 2 cohorts were tested for our novel composite BPH-3 achievement rate as well as for BPH-6 achievement rate. BPH3 was defined as: ΔIPSS≥30%, ISI score≤4, and No complications Clavien>1. RESULTS: 158 patients underwent RASP (93 Madigan and 65 Freyer). Patients scheduled for Madigan procedure were younger, with lower PV, baseline IPSS score, overactive symptoms (ISI score), but higher MSHQ and IIEF score, when compared to the Freyer population (all p<0.02) (Table 1). At 12 months follow-up, Madigan patients reported a shorter bladder irrigation time and time to catheter removal (both p<0.001). A superiority in postoperative IEEF and MSHQ score were reported by the Madigan patients as expected (all p<0.001). Postoperative complication incidence was higher in the Madigan cohort, mainly due to UTI (p<0.001). Although there were no differences in postoperative IPSS and Q-max between groups, the Madigan cohort presented with higher post void residue (p<0.001) (Table 2). BPH6 achievement was higher in the Madigan cohort (48% vs 28%) (p<0.001), while no difference was found in BPH3 achievement rate. CONCLUSIONS: Novel BPH3 composite trifecta appears to be more suitable than BPH6 in assessing the proficiency in disobstructive symptoms relief after RASP. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e810 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alfredo Maria Bove More articles by this author Aldo Brassetti More articles by this author Riccardo Mastroianni More articles by this author Gabriele Tuderti More articles by this author Umberto Anceschi More articles by this author Simone D'Annunzio More articles by this author Mariaconsiglia Ferriero More articles by this author Leonardo Misuraca More articles by this author Iannuzzi Andrea More articles by this author Prata Francesco More articles by this author Alberto Ragusa More articles by this author Michele Gallucci More articles by this author Simone Giuseppe More articles by this author Porpiglia Francesco More articles by this author Daniele Amparore More articles by this author Sabrina De Cillis More articles by this author Alberto Quarà More articles by this author Michele Ortenzi More articles by this author Cristian Fiori More articles by this author Checcucci Enrico More articles by this author Expand All Advertisement PDF downloadLoading ...

MP51-18 NEW MINIMALLY INVASIVE TECHNIQUES VERSUS GOLD STANDARD TREATMENT FOR MIDDLE VOLUME (30-80 ML) PROSTATES: A PROSPECTIVE RANDOMIZED STUDY

You have accessJournal of UrologyCME1 Apr 2023MP51-18 NEW MINIMALLY INVASIVE TECHNIQUES VERSUS GOLD STANDARD TREATMENT FOR MIDDLE VOLUME (30-80 ML) PROSTATES: A PROSPECTIVE RANDOMIZED STUDY Antonio Luigi Pastore, Yazan Al salhi, Andrea Fuschi, Alessia Martoccia, Alessandro Sciarra, Stefano Salciccia, De Nunzio Cosimo, Andrea Tubaro, Costantino Leonardo, Giorgio Franco, Paolo Pietro Suraci, Onofrio Antonio Rera, and Antonio Carbone Antonio Luigi PastoreAntonio Luigi Pastore More articles by this author , Yazan Al salhiYazan Al salhi More articles by this author , Andrea FuschiAndrea Fuschi More articles by this author , Alessia MartocciaAlessia Martoccia More articles by this author , Alessandro SciarraAlessandro Sciarra More articles by this author , Stefano SalcicciaStefano Salciccia More articles by this author , De Nunzio CosimoDe Nunzio Cosimo More articles by this author , Andrea TubaroAndrea Tubaro More articles by this author , Costantino LeonardoCostantino Leonardo More articles by this author , Giorgio FrancoGiorgio Franco More articles by this author , Paolo Pietro SuraciPaolo Pietro Suraci More articles by this author , Onofrio Antonio ReraOnofrio Antonio Rera More articles by this author , and Antonio CarboneAntonio Carbone More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003299.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In the last years minimally invasive endoscopic approaches have been proposed and introduced with the aim to reduce the morbidity related to TURP, such as: convective water vapor energy (Rezum) and heat free water-jet ablation (Aquablation).The aim of this prospective randomized study is to compare the perioperative and functional outcomes between gold standard surgery (TransUrethral Resection of Prostate, TURP) and these two new minimally invasive approaches (Rezum and Aquablation). METHODS: Patients with benign prostatic obstruction were prospectively enrolled and randomized for the three surgical approaches between January 2021 and September 2022. All patients were preoperatively evaluated with digital rectal examination, PSA value and abdominal ultrasound for prostate volume measurement. Preoperatively and 6 months after surgery, patients were studied as follows: Uroflowmetry (Qmax and Qave) with postvoid residual (PVR), International Prostatic Symptoms Score (IPSS), Male Sexual Health Questionnaire (MSHQ) and International Index of Erectile Function (IIEF-5). All patients were also investigated by urodynamics. Operating time, days of hospital stay, intraoperative and postoperative bleeding, postoperative catheterization time were evaluated for each procedure. RESULTS: 252 patients with mean age of 64.6 years old were included in the study. Patients were prospectively randomized to the following treatment groups: 61 subjects underwent Rezum (group A), 92 patients Aquablation (group B), and 99 patients bipolar TURP (group C). Postoperative IPSS resulted lower in patients underwent TURP and AQUABEAM than Rezum (p<0.001). Postoperative IIEF5 mean scores significantly increased in groups A and B (25 and 24, respectively) than in group C (18, p<0.001). The antegrade ejaculation was spared in all Rezum and Aquablation subjects, whereas all TURP patients reported retrograde ejaculation. The TURP group reported mean flowmetry parameters significantly better when compared to Aquabeam and Rezum groups (p<.005). Operating time and length of hospital stay were longer after TURP (respectively 75 min, 3 days) when compared to the other two groups (8 min, 0.6 days; 5.2 min, 1 day, in group A and B, respectively). The mean estimated blood loss (evaluated as postoperative drop in Hb) was significantly higher in group C (DHb 1.2 mg/dl) than in the other two groups (DHb 0.1 mg/dl observed in both groups, p<.005). CONCLUSIONS: This prospective randomized study is the first to compare new endoscopic approaches to gold standard surgery in the treatment of non-neurogenic LUTS secondary to BPH for prostate volumes 30-80 ml. Our results condrm that Rezum and Aquablation are safe and effective. Postoperative outcomes are better in new approaches in terms of sexual function and overall satisfaction, especially related to the preservation of the antegrade ejaculation. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e700 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Antonio Luigi Pastore More articles by this author Yazan Al salhi More articles by this author Andrea Fuschi More articles by this author Alessia Martoccia More articles by this author Alessandro Sciarra More articles by this author Stefano Salciccia More articles by this author De Nunzio Cosimo More articles by this author Andrea Tubaro More articles by this author Costantino Leonardo More articles by this author Giorgio Franco More articles by this author Paolo Pietro Suraci More articles by this author Onofrio Antonio Rera More articles by this author Antonio Carbone More articles by this author Expand All Advertisement PDF downloadLoading ...

MP51-10 SEXUAL FUNCTION OUTCOMES FOLLOWING HOLEP

You have accessJournal of UrologyCME1 Apr 2023MP51-10 SEXUAL FUNCTION OUTCOMES FOLLOWING HOLEP Chinade Roper, Austen Slade, Ronald J. Caras, Thomas Shelton, and Marcelino Rivera Chinade RoperChinade Roper More articles by this author , Austen SladeAusten Slade More articles by this author , Ronald J. CarasRonald J. Caras More articles by this author , Thomas SheltonThomas Shelton More articles by this author , and Marcelino RiveraMarcelino Rivera More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003299.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Holmium laser enucleation of the prostate (HoLEP) is the platinum standard surgical procedure for treatment of benign prostatic hyperplasia (BPH). As is common with BPH surgeries, many men develop retrograde ejaculation post-operatively. There is some conflicting evidence regarding the sexual function outcomes of this procedure. We sought to examine sexual outcomes post-HoLEP to assess changes in ejaculatory and erectile function. METHODS: With IRB approval, we conducted a retrospective study of patients who underwent HoLEP between Nov 2018 and Feb 2022. 346 patients met inclusion criteria and had completed pre and post operative questionnaires, which included the Male Sexual Health Questionnaire – Ejaculatory Dysfunction (MSHQ- EJD) and the 5 question International Index of Erectile Function/Sexual Health Inventory for Men (IIEF-5/SHIM). Both surveys were provided to patients up to 12 months post procedure. Patient demographics and comorbidities associated with sexual dysfunction were collected. Responses to each question were analyzed to detect sub-categorical improvements or declines in sexual function as the secondary objective. An autoregressive heterogeneous linear mixed model was performed in SPSS 28 to analyze the data. RESULTS: There was a significant decline in the total scores for the MSHQ-EJD from a mean of 7.48 pre-HoLEP to 6.23 post HoLEP (p=0.001) including a significant decline (p<0.005) in questions 1-3 which assess ejaculatory ability, strength, and volume; but there was not a significant decline in question 4 which assesses bother in ejaculatory function with a mean of 2.494 pre-HoLEP compared to 2.922 post-HoLEP (p=0.291). There was not a significant decline in the IIEF-5/SHIM post-operatively with mean pre-HoLEP score 9.21 vs 8.87 post-HoLEP (p=0.98). CONCLUSIONS: These findings suggest that patients undergoing HoLEP do not experience a decline in erectile function. Patients do appear to experience a decline in ejaculatory function post-operatively, but do not find the decline to be more bothersome. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e696 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Chinade Roper More articles by this author Austen Slade More articles by this author Ronald J. Caras More articles by this author Thomas Shelton More articles by this author Marcelino Rivera More articles by this author Expand All Advertisement PDF downloadLoading ...