- Email: [email protected]
269 Surgical Treatment for Peyronie's Disease (PD)
S79
WMSM 2016 Abstracts
268
269
TRANSURETHRAL RESECTION OF EJACULATORY DUCTS HAD LESS BENEFIT IN THE TREATMENT OF CHINESE AZOOSPERMIC OR SEVERE OLIGOZOOSPERMIC PATIENTS WITH POLYCYSTIC KIDNEY DISEASE AND CONCOMITANT SEMINAL MEGAVESICLES Zhang, Y.1; Yang, X.1; Wu, X.1; Chen, S.1; Feng, J.1 1 The Third Affiliated Hospital, Sun Yat-Sen University, China
SURGICAL TREATMENT FOR PEYRONIE’S DISEASE (PD) Nagao, K.1; Tamura, K.1; Tai, T.1; Saigo, R.1; Ozaki, Y.1; Tanaka, N.1; Kobayashi, H.1; Nakajima, K.1 1 Toho University, Japan
Objectives: Oligospermic or azoospermic patients with low level of semen fructose as well as dilated seminal vesicles are often suspected of having ejaculatory duct obstruction, transurethral resection of ejaculatory ducts (TURED) remains surgical treatment options for ejaculatory duct obstruction. This study aims to analyze the the effectiveness of TURED in the treatment of Chinese oligospermic or azoospermic patients with autosomal dominant polycystic kidney disease and seminal megavesicles. Material and Methods: Three Chinese patients known with adult polycystic kidney disease and concomitant seminal megavesicles, complaining of azooaspermia (1 case), severe oligozoospermia (2 cases) were included in this study. The azooaspermic one never accepted surgical treatment and the other two already accepted TURED in other hospital, but having no improvement. Results: Examination revealed bilateral severe congestion of the epididymis in azooaspermic patient, the vasal fluid containing many sperm, the vasography with instillation of methylene blue dye can be seen from the bilateral ejaculatory ducts at the time of cystoscopy although the stream of left side was little than the right side. The verumontanum is deeply resected down to the ejaculatory ducts. The postoperative semen analysis revealed that the semen contained no spermatozoa with low level of fructose and alpha-glucosidase although with increations of the sperm volume (from 0.2 to 3.6ml). The second patient who had accepted TURED from other hospital, the vasography demonstrated the distal patency of the vas, and the testicular biopsy showed normal spermatogenesis, the level of fructose is low and alpha-glucosidase was normal. The third patients reported postoperative release of post ejaculating pain. He did not have a postoperative increase in ejaculate volume and any improvement in seminal parameters, the level of fructose and alpha-glucosidase was still lower. However, he refused to undergo the vasography and testicular biopsy. Conclusions: The dilated seminal vesicles in polycystic kidney patients may lead to obstructive azoospermia or severe oligozoospermia. It looked like “functional obstruction” but not only “mechanical obstruction”, the obstruction was probably due to partial through compression of the ductal system but mainly because of the failure of the vas deferens and seminal vesicles to contract effectively. TURED was less effective in the treatment of this situation. Disclosure: Work supported by industry: no.
J Sex Med 2017;14:S1-S131
Objective(s): We report about Peyronie’s disease (PD) at our Reproduction center. Material and Method(s): We had 555 cases. The average age was 51.4years. Chief complains were curvature, palpable fibrosis, pain, ED etc. 283 cases (34%) was improved by medication. We had two operation methods, plication and grafting after conservative treatment for 1 year. We have two methods of saphenous vein graft, vein graft after plaque excision or vein graft after. Result(s): 113 cases were performed saphenous vein graft. 11 cases were performed dermal graft. 64 cases were performed plication. Satisfaction rate of Grafting was 93.2%. Slight curvature remain was 6.8%. Complain short penis was 2.1%. Complication rate with ED was 1%. Conclusion(s): 1) Plication method for curvature is very safe. 2) Vein graft is better than plication method for PD with penis shortening. 3) Vein is the best as material for grafting, because the grafted vein is thin and soft. 4) The hourglass-shaped incision method is most suitable for cases of a wide plaque. 5) We need dermal graft for large defect due to calcification of tunica and lateral defect. Disclosure: Work supported by industry: no.
271 VULVOSCOPIC FINDINGS, PATIENT REPORTED OUTCOME (PRO) MEASURES, AND HORMONAL BLOOD TEST VALUES IN MENOPAUSAL WOMEN WITH FEMALE SEXUAL DYSFUNCTION PRE- AND POST-HORMONAL TREATMENT: A RETROSPECTIVE SINGLE CENTER STUDY Da Silva, S.1; Espenschied, C.2; Gagnon, C.2; Minton, J.2; Goldstein, I.3 1 UCSD, United States; 2San Diego Sexual Medicine, United States; 3 Alvarado Hospital, United States Introduction and Objectives: Menopausal women frequently experience symptoms and signs associated with reduced sex steroid hormones. Estradiol deficiency related symptoms of Genitourinary Syndrome of Menopause (GSM) include dryness, burning, thinning, itching, urinary frequency and dyspareunia. Testosterone deficiency related symptoms include diminished sense of well-being, reduced muscle and bone mass, provoked vestibulodynia, and decreased sexual desire, arousability, and orgasmic pleasure. The hypothesisis
WMSM 2016 Abstracts
268
269
TRANSURETHRAL RESECTION OF EJACULATORY DUCTS HAD LESS BENEFIT IN THE TREATMENT OF CHINESE AZOOSPERMIC OR SEVERE OLIGOZOOSPERMIC PATIENTS WITH POLYCYSTIC KIDNEY DISEASE AND CONCOMITANT SEMINAL MEGAVESICLES Zhang, Y.1; Yang, X.1; Wu, X.1; Chen, S.1; Feng, J.1 1 The Third Affiliated Hospital, Sun Yat-Sen University, China
SURGICAL TREATMENT FOR PEYRONIE’S DISEASE (PD) Nagao, K.1; Tamura, K.1; Tai, T.1; Saigo, R.1; Ozaki, Y.1; Tanaka, N.1; Kobayashi, H.1; Nakajima, K.1 1 Toho University, Japan
Objectives: Oligospermic or azoospermic patients with low level of semen fructose as well as dilated seminal vesicles are often suspected of having ejaculatory duct obstruction, transurethral resection of ejaculatory ducts (TURED) remains surgical treatment options for ejaculatory duct obstruction. This study aims to analyze the the effectiveness of TURED in the treatment of Chinese oligospermic or azoospermic patients with autosomal dominant polycystic kidney disease and seminal megavesicles. Material and Methods: Three Chinese patients known with adult polycystic kidney disease and concomitant seminal megavesicles, complaining of azooaspermia (1 case), severe oligozoospermia (2 cases) were included in this study. The azooaspermic one never accepted surgical treatment and the other two already accepted TURED in other hospital, but having no improvement. Results: Examination revealed bilateral severe congestion of the epididymis in azooaspermic patient, the vasal fluid containing many sperm, the vasography with instillation of methylene blue dye can be seen from the bilateral ejaculatory ducts at the time of cystoscopy although the stream of left side was little than the right side. The verumontanum is deeply resected down to the ejaculatory ducts. The postoperative semen analysis revealed that the semen contained no spermatozoa with low level of fructose and alpha-glucosidase although with increations of the sperm volume (from 0.2 to 3.6ml). The second patient who had accepted TURED from other hospital, the vasography demonstrated the distal patency of the vas, and the testicular biopsy showed normal spermatogenesis, the level of fructose is low and alpha-glucosidase was normal. The third patients reported postoperative release of post ejaculating pain. He did not have a postoperative increase in ejaculate volume and any improvement in seminal parameters, the level of fructose and alpha-glucosidase was still lower. However, he refused to undergo the vasography and testicular biopsy. Conclusions: The dilated seminal vesicles in polycystic kidney patients may lead to obstructive azoospermia or severe oligozoospermia. It looked like “functional obstruction” but not only “mechanical obstruction”, the obstruction was probably due to partial through compression of the ductal system but mainly because of the failure of the vas deferens and seminal vesicles to contract effectively. TURED was less effective in the treatment of this situation. Disclosure: Work supported by industry: no.
J Sex Med 2017;14:S1-S131
Objective(s): We report about Peyronie’s disease (PD) at our Reproduction center. Material and Method(s): We had 555 cases. The average age was 51.4years. Chief complains were curvature, palpable fibrosis, pain, ED etc. 283 cases (34%) was improved by medication. We had two operation methods, plication and grafting after conservative treatment for 1 year. We have two methods of saphenous vein graft, vein graft after plaque excision or vein graft after. Result(s): 113 cases were performed saphenous vein graft. 11 cases were performed dermal graft. 64 cases were performed plication. Satisfaction rate of Grafting was 93.2%. Slight curvature remain was 6.8%. Complain short penis was 2.1%. Complication rate with ED was 1%. Conclusion(s): 1) Plication method for curvature is very safe. 2) Vein graft is better than plication method for PD with penis shortening. 3) Vein is the best as material for grafting, because the grafted vein is thin and soft. 4) The hourglass-shaped incision method is most suitable for cases of a wide plaque. 5) We need dermal graft for large defect due to calcification of tunica and lateral defect. Disclosure: Work supported by industry: no.
271 VULVOSCOPIC FINDINGS, PATIENT REPORTED OUTCOME (PRO) MEASURES, AND HORMONAL BLOOD TEST VALUES IN MENOPAUSAL WOMEN WITH FEMALE SEXUAL DYSFUNCTION PRE- AND POST-HORMONAL TREATMENT: A RETROSPECTIVE SINGLE CENTER STUDY Da Silva, S.1; Espenschied, C.2; Gagnon, C.2; Minton, J.2; Goldstein, I.3 1 UCSD, United States; 2San Diego Sexual Medicine, United States; 3 Alvarado Hospital, United States Introduction and Objectives: Menopausal women frequently experience symptoms and signs associated with reduced sex steroid hormones. Estradiol deficiency related symptoms of Genitourinary Syndrome of Menopause (GSM) include dryness, burning, thinning, itching, urinary frequency and dyspareunia. Testosterone deficiency related symptoms include diminished sense of well-being, reduced muscle and bone mass, provoked vestibulodynia, and decreased sexual desire, arousability, and orgasmic pleasure. The hypothesisis