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Diabetes (DM) is a known risk factor for ED. The impact of DM on erectile function recovery (EFR) after radical prostatectomy (RP) is poorly understood. We aimed to assess the impact of DM on the EFR after RP. Men who had RP with ≥2 years follow-up constituted the study population. EFR was assessed using International Index of Erectile Function, Erectile Function Domain (EFD) score pre-RP and at 2 years post RP. ADT and radiation therapy before or after RP were exclusions. Demographics, comorbidities, pathological parameters were recorded. We performed univariate and multivariate logistic regression assessments to evaluate predictive factors, including DM, patient age, nerve sparing status (NSS) scored between 1 (preserved) to 4 (resected) for each side, and comorbidity profile, associated with poor EFR post-RP. 2024 men were included. Mean age at RP was 61.3±7.1 years. Median baseline and 2-year EFD scores were 27 (IQR = 19-30), and 13 (IQR = 5-25). 10% had DM with a mean pre-RP hemoglobin A1c of 6.6±1.3%. 44% had hypertension, 51% dyslipidemia, 14.5% obstructive sleep apnea, 5% history of coronary artery disease, 8% were current and 34% former smokers. 38% reported two or more comorbidities pre-RP. Median Gleason sum was 7. Nerves were preserved bilaterally in 77% and unilaterally in 16%. Median NS score was 3 (IQR 2-4). Median EFD scores at 2 years with and without DM were 7 (IQR 3-16), and 14 (IQR 5-25), respectively (p<0.001). At 2 years, in men with and without DM, the proportion with EFD ≥24 was 14% and 32% and EFD ≤10 was 63% and 42% respectively. In our cohort, DM was a significant predictor of lower EFR at 2 years post-RP. No [ABSTRACT FROM AUTHOR]

NADT has gained increasing recognition in the management of men with high risk disease prior to RP No large study to date has examined EFR in such patients We aimed to define such outcomes with this analysis. Men who underwent NADT pre-RP with ≥2-year follow-up post-RP constituted the study population. Patients who received ADT post-RP and radiation therapy pre and post-RP were excluded. Demographics, comorbidity, hormone and pathological parameters were recorded. EFR was assessed using the International Index Erectile Function-Erectile Function Domain (EFD) score. Predictors of EFR were analyzed using logistic regression models. 260 men were analyzed. Mean age of 63.6 ± 7.1 years. 11.2% had diabetes, 55% hypertension, 54.2% dyslipidemia, and 16.9% and 5.8% history of sleep apnea and coronary artery disease respectively. Regarding smoking history, 6.9% was current smoker, and 33.1% former smoker. Baseline testosterone was 352.1 ± 225.9 ng/dL, PSA 9.6 ± 8.4 ng/mL, and median EFD score 24 (IQR = 14-30). Median Gleason sum was 7 (IQR = 7-9). 43.4% patients had bilateral nerve sparing status (NSS), and 34% unilateral. 13.1% received NADT. Median duration of NADT was 1 (IQR = 1-3) months. At 2 years post-RP, median EFD was 7 (IQR = 3-22) for men without NADT and 4 (IQR = 2-13) for men with NADT; 8.8% and 21.2% had an EFD score ≥ 24 in men with and without NADT. 73.5% and 55.3% had an EFD score ≤ 10 in men with and without NADT. Men with NADT had lower EFR at 2 years post-RP, however NADT did not predict EFR in our cohort. No [ABSTRACT FROM AUTHOR]

Introduction: The prevalence of male sexual dysfunction (MSD) increases with age, with greater than 50% of men aged over 40 years reporting erectile dysfunction (ED). In recent years, wearable male sex devices (WMSDs) have been both increasingly utilized by patients and recommended by sexual medicine clinicians. Objective: This study seeks to investigate the safety and efficacy of products currently marketed for the treatment of MSD. Methods: Available products for WMSDs were reviewed by analyzing product websites, forums, advertisements, and clinical recommendations. Qualitative comparisons were made based on patient reviews, cost, and specific features of each device. Investigatory evidence and FDA status were also reviewed (Figure 1). Additionally, Google Trends was used to determine the popularity of different devices over time (Figure 2). Results: Eight WMSDs for the treatment of MSD and enhancement of sexual pleasure were reviewed. Constriction bands, such as the Maintain Ring Loop, Eddie by Giddy, and Xialla, have shown significant benefits in clinical trials and were found to be the most popular devices among patients. Smart devices can provide real-time feedback on erectile quality and/or sexual performance. Similar to the Rigiscan, the ADAM sensor provides feedback on erectile quality while also monitoring changes in penile tumescence during sleep with additional analysis available through a mobile application. Neuromodulation devices like Morari Patch and vPatch / in2 patch use electrical stimulation to delay ejaculation and improve sexual function. The FirmTech Performance Ring uses sensors to track the vital signs of erectile fitness with clinical trials ongoing. Conclusions: Overall, this review describes the available investigatory evidence for a range of WMSDs, and highlights the potential benefits and limitations of these devices in treating MSD and enhancing sexual pleasure. Further research is needed to evaluate the effectiveness of these devices and to determine which ones may be the most suitable for individual patients. Disclosure: Any of the authors act as a consultant, employee or shareholder of an industry for: Charles A Loeb, MD - None relevant Muhammad A M Hammad, MBBCh - None relevant David W Barham, MD - None relevant Jake Miller MD - None relevant Kirsten Young, MS - None relevant Rainey Horwitz, MD – Paid collaboration with FirmTech on Instagram Eliad Amini, BS - None relevant Mai Xuan Nguyen, BS - None relevant Nitish Nag, MD, PhD - None relevant Lawrence Jenkins, MD – None relevant Amy M Pearlman, MD – Consultant for/received grant funding from Boston Scientific; consultant for Endo Pharmaceuticals; consultant for FirmTech; investor in ByteMD; influencer in Urology Times Faysal A Yafi, MD – Advisory board and speaker for Coloplast; consultant for Cynosure; advisory board and speaker for Halozyme; intellectual property with Masimo; advisory board for Promescent; consultant for Sprout; advisory board for Xialla. [ABSTRACT FROM AUTHOR]

Introduction: Multiple sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system and is widely recognized as a disease primarily affecting women. However, recent studies have shown that patients with MS, both male and female, may also suffer from hypogonadism, a condition characterized by decreased testosterone production and decreased gonadal function. The relationship between MS and hypogonadism is complex and not fully understood, with recent evidence showing that hypogonadism may have a significant impact on the quality of life and disease progression of MS patients. Objective: This review aims to provide an overview of the current knowledge regarding the relationship between MS and hypogonadism, including the mechanisms underlying this relationship, the effects of hypogonadism on MS patients, and the potential benefits and drawbacks of testosterone replacement therapy for MS patients with hypogonadism. Methods: This scientific review analyzed 19 articles that investigated the potential relationship between MS, testosterone levels, and hypogonadism. The articles were published between November 2008 and March 2022 and were identified through a comprehensive search of the PubMed database. The search terms used included "multiple sclerosis," "testosterone," "hypogonadism," and "MS and testosterone levels." The inclusion criteria for articles were as follows: (1) articles that investigated the relationship between MS, testosterone levels, and hypogonadism, (2) articles that were published in English, and (3) articles that provided original data. Exclusion criteria included (1) articles that were not related to the topic, (2) reviews and editorials, and (3) articles that did not provide original data. Results: Of the 19 articles reviewed, 11 described a positive correlation between low testosterone levels and dysfunction within the hypothalamic-pituitary-gonadal axis in individuals with MS. These findings suggest that low testosterone levels may contribute to dysfunction within the hypothalamus-pituitary-gonadal axis, which plays a crucial role in regulating testosterone production. The results also showed a relationship between sexual dysfunction and low testosterone levels, as well as a positive correlative relationship between these two factors. Conclusions: The reviewed articles indicate a complex relationship between MS, testosterone levels, and the hypothalamic-pituitary-gonadal axis, with low testosterone levels potentially contributing to dysfunction in this axis and to sexual dysfunction. Further research is needed to better understand the effects of testosterone therapy on MS and sexual dysfunction in MS patients. Disclosure: Any of the authors act as a consultant, employee or shareholder of an industry for: Advisory board and speaker for Coloplast; consultant for Cynosure; advisory board and speaker for Halozyme; intellectual property with Masimo; advisory board for Promescent; consultant for Sprout; advisory board for Xialla. [ABSTRACT FROM AUTHOR]