MODERATED POSTERS Moderated Poster Session 3 Sexual Function/Dysfunction Monday, September 9 1315-1445 MP-03.01 Effect of Bupropion and Tadalafil Combination Therapy in Female Rat Hypoactive Sexual Desire Disorder Model Yoon H, Chung W Dept. of Urology, Ewha Womans University School of Medicine, Seoul, South Korea Introduction and Objectives: Hypoactive sexual desire disorder (HSDD) in female sexual dysfunction takes significant portion of female sexual dysfunction, but its treatment modalities are few. Bupropion is known to increase sexual desire in serotonin reuptake inhibitor (SSRI) induced HSDD and tadalafil is a well-known PDE5 inhibitor. In this study, we aimed to investigate the efficacy and safety of combination treatment of bupropion and tadalafil in female rat HSDD model Materials and Methods: Bilateral oophorectomized female Sprague-Dawley rats were used as sub-primed HSDD model. In this model, after 2 weeks of oophorectomy, estradiol (2ug) was injected subcutaneously (SQ) before every sexual mating. Experimental groups are VH (Vehicle, injection of sesame oil), B (Bupropion 20mg/Kg, daily, SQ), P (tadalafil 2mg/kg, daily, PO), PB (Bupropion 20mg/ Kg SQ with tadalafil 2mg/kg PO, daily). At baseline, 7th day, and 14th day of drug administration, sexual behaviors were observed in specially designed mating cage. Sexual behaviors were analyzed as proceptive behavior (darts and hops), receptive behavior (lordosis), paced mating behavior (mean time of exit (sec/min). Results: Drug administered group (B,P, and PB) were all significantly improved sexual behavior analysis compared with VH group. At 14th day of drug administration, combination treatment group (PB) showed more significant improvement in proceptive, receptive behaviors and less avoidance time than the other three (VH, B, and P) groups (p<0.01 by ANOVA). There were no drug-related deaths or adverse reactions. Conclusion: In female rat HSDD model, combination treatment of bupropion and tadalafil showed significant improvement of sexual behavior than single-drug treatment with time-correlation. This supports that the combination of bupropion and S54 tadalafil may have a beneficial effect on human HSDD. MP-03.02 Study for the Blood Supply of Corpus Cavernosum by ‘Virtual Cavernoscopy’ Tomida R, Kawanishi Y, Oyama T, Yamamoto H, Izumi K, Mori H, Yamanaka M, Kanayama H Takamatsu Red Cross Hospital, Takamatsu, Japan; 2Tokushima University Hospital, Tokushima, Japan Introduction and Objectives: There are few papers concerning the blood supply of corpus cavernosum in erectile dysfunction (ED) patients, because until recently, there have been no methods to visualize the intracavernous artery without sufficient blood flow. Advancements in technology have made it possible to create virtual cavernoscopic images to observe the intracavernous artery in detail. We investigated intracavernous artery type by virtual cavernoscopy and studied the factors which might correlate with intracavernous artery type. Materials and Methods: The study subjects were 70 ED patients who visited our hospital for further examination. Intracavernous artery type was investigated by virtual cavernoscopy. Factors affecting variation type were further examined. Logistic regression was used. This study was carried out with the approval and permission of the ethics committee at our hospital, as well as the written consent of the patients involved. Results: Out of the 140 corpus cavernosum, 74 had a main artery beginning from the furcation of the crus and running toward the distal section of the lumen (Figure 1). Other types included blood flow that was supplied by contra lateral cavernous arteries, the penetrating branches of the dorsal artery or emissary artery, and so on. According to the results MP-03.02, Figure 1. of the analysis, cardiovascular risk factors and age did not link with cavernous artery type. Figure 1. Conclusion: It was revealed that, the intracavernous arterial supply depends on various types of arteries. As age and cardiovascular risk factors did not link with the intracavernous artery type, it is suggested that variation is not collateral circulation developed as an acquired response but is inherent. When we make plans for revascularization, the intracavernous artery type of each individual patient must be studied by virtual cavernoscopy. MP-03.03 Has OAB Impact on Male Sexual Health? Drasa K1, Dredha H2, Rusi R3 1 Central Polyclinic, Tirana, Albania; 2 QSUT, Tirana, Albania; 3Privat Clinic, Tirana, Albania Introduction and Objectives: The impact of overactive bladder (OAB) on overall male sexual health (MSH) is little known. For this reason we evaluated the impact of OAB on MSH, within an epidemiological study of men over 40 years of age. Materials and Methods: Patients (pts) were asked to rate how often they experienced urinary symptoms during the past 4 weeks on a 5-point Likert skale. They were permitted to opt out from the sexual health survey which contained the IIEF for erectile dysfunction (ED) and question about ejaculation dysfunction (EjD) and premature ejaculation (PE). Those with OAB and/or lower urinary tract symptoms (LUTS) were asked questions about urinary symptoms impact on sexual health. Descriptive statistic and logistic regressions were used to assess the impact of OAB on sexual health. Results: The average of our 97 pts was 55.5 years. Using the ≥ “sometimes” definition ,49% of men had No/minimal symptoms (NMS), 24% had continent OAB (C-OAB) and OAB (I-OAB); 87% of pts with NMS reported that they were sexual 25% incontinent active, compared to 63% with C-OAB and 51% I-OAB. Men with OAB were > three times more likely to report their own health reasons prevented them from being sexually active as compared to NMS men (C-OAB, 29%; I-OAB, 32%; NMS, 8%). In addition, 21% with C-OAB and 31% with I-OAB reported that they had decreased or stopped sexual activity due to their urinary symptoms compared to 3% with NMS. Also, 22% with C-OAB and 32% with I-OAB reported UROLOGY 82 (3 Supplement 1), September 2013 MODERATED POSTERS that their urinary symptoms decreased their enjoyment of sexual activity compared to 3% NMS. Of the NMS patients, 16% reported mild or greater ED (≤ 21 IIEF) as compared to 32% and 38% of men with C-OAB and I-OAB, respectively. Finally, 18% of NMS experienced PE half the time or greater, as compared to 27% and 33% with C-OAB and I-OAB. Conclusion: OAB is significantly associated with diminished sexual health and ED and PE. Sexual health should be assessed in men presenting with OAB. MP-03.04 Hyperuricemia: A Possible Cause of Hemospermia Kurkar A, Elderwy A, Abulsorour S, Awad S Assiut University Hospital, Assiut, Egypt Introduction and Objectives: Hemospermia is often considered idiopathic. We report our experience with hemospermia and a long-term follow-up. Materials and Methods: Between July 2005 to July 2012, 143 patients with hemospermia presented to outpatient clinic in our hospital. History, examination, work-up, treatment, outcomes and long term follow-up were reported in a prospective database. Patients were followed at monthly intervals by semen analysis till disappearance of hemospermia then every 3 months for one year. Results: The commonest 5 findings identified as a possible cause of hemospermia were: bilharziasis 21.6%, hyperuricemia 15.4%, idiopathic 14.7%, tuberculosis 8.4% and chronic prostatitis 8.4%. Of hemospermia patients; 22 had hyperuricemia with mean serum uric acid level was 9.2 mg/dL (range 7.6-11.4). The mean age at presentation was 32 years (range 2048). Those patients had 5-12 hemospermia attacks for 2-8 months before presentation. Associated findings were: LUTS in 14 patients, painful ejaculation in 15, arthralgia in 12, positive urine for urate crystals in 10, positive semen for urate crystals in 7, dotted prostate calcifications in TRUS in 5. All cases were treated with allopurinol 300 mg tablets twice daily for 8 weeks and maintenance dose of 300 mg daily. Hemospermia disappeared within a mean of 2 months (range 1-4) for all patients. Conclusion: Hyperuricemia is a new probable cause of hemospermia. Further randomized studies are mandatory for establishment of such postulation. MP-03.05 Impact of Abdominal Obesity on Testosterone Levels and Erectile Dysfunction Fillo J1, Breza J1, Levcikova M2, Luha J2 1 Urology Department, Comenius University, Faculty Hospital, Bratislava, Slovakia; 2Internal Medicine, Comenius University, Faculty Hospital, Bratislava, Slovakia Introduction and Objectives: Male sex hormones play an important role in ED and variety of testosterone deficiency symptoms. The number of men with abdominal obesity (AO) is continuously growing. Testosterone deficiency syndrome (TDS) significantly decrease quality of life and his occurrence is 38,7% of men over 45 yr. Obesity appears to be a driving factor since adipose cells secrete leptin, which results in a decrease in testosterone level. Materials and Methods: We examined from 2/2006 up to now 206 men from 42 years to 78 years. AO (waist circumference over 94cm) has 192 men and 14 men as control group without AO. Every patient had complete urological examination with hormonal evaluation. To assess subjective symptoms related TDS were utilized the Aging Males Symptoms Scale, to evaluate ED we used Sexual Health Questionnaire IIEF 5. Results: From our group 206 patients we found some degree of ED in 73.3% (151/206) pts. TST levels below 14 nmol/l had 134/206 pts (65.0%) and below 9 nmol/l 62/206 pts (30.0%). We found association with AO and TST levels (Table 1). Number of patients with low TST levels increases with increasing waist circumference. Low levels of TST were found in all age groups. Conclusion: Patients over 40 years of age with AO and ED should also be examined for TDS and metabolic syndrome. In this group of patients we found TST levels below 14 nmol/l in 134/206 pts (65.0%) and below 9 nmol/l 62/206 pts (30.0%). It is important not treat only ED; with appropriate treatment we can improve the quality of life of the affected men. MP-03.06 Effects of Tadalafil Treatment on Erectile Function Recovery Post Bilateral Nerve-Sparing Radical Prostatectomy Brock G1, Montorsi F2, Stolzenburg J3, Mulhall J4, Moncada I5, Patel H6, Chevallier D7, Krajka K8, Dickson R9, Henneges C10, Büttner H10 1 University of Western Ontario, London, Ontario, Canada; 2Instituto Scientifico Universitario San Raffaele, Milan, Italy; 3Universitätsklinikum Leipzig, Leipzig, Germany; 4Memorial SloanKettering Cancer Center, New York, USA; 5 Hospital La Zarzuela, Madrid, Spain; 6 University Hospital North Norway, Tromso, Norway; 7Hôpital Universitaire Archet 2, Nice, France; 8Uniwersyteckie Centrum Kliniczne, Gdansk, Poland; 9 Lilly Canada Inc, Toronto, Ontario, Canada; 10Lilly Deutschland GmbH, Bad Homburg, Germany Introduction and Objectives: The rehabilitative impact of Tadalafil (TAD) following nerve-sparing prostatectomy (nsRP) on penile function remains unclear. This multicenter, randomized, double-blind, double-dummy, placebo (PLC)-controlled trial (NCT01026818) primarily assessed the proportion of patients (pts) achieving an International Index of Erectile Function Domain score (IIEF-EF)≥22 after 6wk washout. Secondary measures included IIEF-EF, Sexual Encounter Profile question 3 (SEP3) and penile length (PL). Materials and Methods: Pts≤68yrs with adenocarcinoma of the prostate (Gleason≤7) and normal preoperative EF were randomized 1:1:1 to either 9-month treatment of TAD 5mg once a day (OaD), TAD 20mg on demand (pro re nata, PRN) or PLC post nsRP, followed by a 6 wks washout phase and a 3 month open-label phase on TAD OaD (all pts). Logistic MP-03.05, Table 1. Influence of AO on TST Levels. Waist circumference below 94cm Grade I. 94-101cm Grade II. 102-109cm Grade III. 110-119cm Grade IV. 120cm+ Total TST level 0-9nmol/l 1pts 8.3% 11 23.4% 14 22.6% 20 34.4% 16 57.1% 62 pts (100%) 9-14 3 25.0% 18 38.3% 26 41.9% 19 34.5% 8 28.6% 74 14+ 8 66.7% 18 38.3% 22 35.5% 16 29.1% 4 14.3% 68 Total 14 pts 47 62 55 28 206 pts UROLOGY 82 (3 Supplement 1), September 2013 S55 MODERATED POSTERS regression and ANCOVA adjusting for treatment, age and country were applied to IIEF-EF≥22, SEP3 and PL. Results: A total of 423 pts were randomized to TAD OaD (N=139), TAD PRN (N=143) and PLC (N=141). Mean (SD) age was 57.9 (5.58) yrs. 20.9% in the TAD OaD, 16.9% in the TAD PRN and 19.1% in the PLC arm reached an IIEFEF≥22; odds ratios (95%CI) for TAD OaD and TAD PRN vs PLC were 1.14 (0.63, 2.06; p=0.675) and 0.89 (0.48, 1.65; p=0.704). SEP3 (Figure 1.) improved more during the double-blind phase in pts actively treated, where only TAD OaD vs PLC was significant, decreased during washout, but further improved during open-label treatment (numerically best for pts randomized to TAD OaD). IIEF-EF showed consistent results. PL reduction after the double-blind phase was significantly lower vs PLC in the TAD OaD arm only (LSmean; 95%CI: 4.20; 0.47, 7.93; p=0.028). Treatments were well-tolerated. Conclusion: EF improvements gained during 9-month active TAD treatment were not maintained after a 6wk washout. However, TAD OaD given early after nsRP suggests advantages versus delayed treatment in responsiveness to treatment and in protecting from structural penile impairment post nsRP. Figure 1. MP-03.07 A Randomized, Double-Blind, Placebo-Controlled, Crossover Trial of “On–Demand” Tramadol for Treatment of Premature Ejaculation Kurkar A, Elderwy A, Abulsorour S, Awad S Assiut University Hospital, Assiut, Egypt Introduction and Objectives: To assess the dose-related effects of tramadol on a group of patients with premature ejaculation (PE). Materials and Methods: Between June 2010 and July 2012, 180 PE patients presented to outpatient clinic of our hospital. Patients were randomized in a 1:1:1 fashion to receive different sequences of the 3 medications: placebo, 50 mg of tramadol and 100 mg of tramadol. Every patient received 10 doses of each medication for 2 months. Intravaginal ejaculatory latency time (IELT) was recorded in seconds initially and for each arm. Successful treatment of PE is defined if IELT exceeded 120 seconds. Side effects with medications were reported. Results: Of patients enrolled, 125 (69.4%) continued the study. Patients’ age range was 20-55 years with PE complaint S56 MP-03.06, Figure 1. of one to ten year duration. Mean IELT was 72 at presentation, 82 for placebo, 150 for tramadol 50 mg and 272 for tramadol 100 mg (p<0.001 for all comparisons). PE was successfully treated in only 2.4% of patients with placebo, in contrast to 53.6% and 85.6% with 50 and 100 mg tramadol respectively (p<0.001 for all comparisons). Post-micturition dribble annoyed 12.8% of those who received 50 mg tramadol and 33.6% of those who received 100 mg tramadol (p<0.001). MP-03.08, Table 1. Comparison between Pre- and Post-Treatment of Desmopressin. pre post p-value IPSS score 17.7 ± 7.3 13.9 ± 6.7 <0.001* IPSS – QOL 3.8 ± 1.3 3.2 ± 1.0 0.002* AMS score 33.7 ± 9.6 31.1 ± 7.9 0.054 IIEF score 33.4 ± 18.8 29.3 ± 21.2 0.136 Total volume 1702.8 ± 509.3 1704.5 ± 560.3 0.987 NUV 789.3 ± 356.3 475.1 ± 156.3 <0.001* NPi 46.6 ± 14.4 30.1 ± 13.1 <0.001* ANV 3.6 ± 1.5 2.5 ± 0.7 <0.001* Ni 2.5 ± 0.9 1.7 ± 0.7 <0.001* NBCi 2.0 ± 0.7 1.7 ± 0.5 0.018* Testosterone 5.28 ± 2.4 4.71 ± 1.9 0.094 Free testosterone 5.43 ± 2.9 5.16 ± 2.0 0.454 Na+ 139.4 ± 2.8 139.3 ± 3.2 0.803 Questionnaire Frequency Volume Chart Lab IPSS = international prostate symptom score, AMS = aging male’s symptom IIEF = international index of erectile function NUV = nocturnal urine volume, NPi = nocturnal polyuria index = NUV / total volume ANV = actual number of nightly voids, Ni = nocturia index = NUV / maximum voided volume NBCi = nocturnal bladder capacity index = ANV - Ni +1 UROLOGY 82 (3 Supplement 1), September 2013 MODERATED POSTERS Weak scanty ejaculation was the main complaint in 7.2% vs. 21.6% of those using 50 and 100 mg tramadol respectively (p=0.002). Conclusion: Tramadol hydrochloride exhibits a significant dose-related efficacy and side effects over placebo for treatment of PE. MP-03.08 Is Nocturia Related to LOH (Late Onset Hypogonadism)? Relationship of Nocturia with Serum Testosterone Level, IIEF (International Index of Erectile Function) and AMS (Aging Male’s Symptom) Scale Kim J1, Chae J1, Kim J1, Oh M1, Yoon C1, Park H1, Kim J1, Lee S2, Moon D1 1 Department of Urology, Korea University Medical Center, Seoul, South Korea; 2Department of Urology, Sungkyunkwan University School of Medicine, Seoul, South Korea Introduction and Objectives: To assess the effect of nocturia on serum testosterone level in association with IIEF and AMS scales and to assess the effect of desmopressin in improvement of not only nocturia but also serum testosterone level, IIEF, AMS scale. Materials and Methods: The study was an open-label, non-placebo controlled, observational trial. We prospectively enrolled men with nocturia and symptoms of late onset hypogonadism. The patients were given desmopressin for 3 months then we compared testosterone level, indices of frequency volume chart (FVC), change of IIEF, IPSS (International Prostate Symptom Score), AMS scale before and after treatment. Patients with history of cardiovascular disease, or hyponatremia, using hypnotics, with primary hypogonadism or hypogonadotrophic hypogonadism were excluded. Results: Sixty-two men (mean age 66.9 years) had complete pre-and post treatment questionnaires and laboratory test. By the end of study, mean scores decreased from 17.7 to 13.9 (IPSS), 3.8 to 3.2 (IPSS-QOL score), 33.7 to 31.1 (AMS), 33.4 to 29.3 (IIEF). In FVC, nocturnal urine volume, nocturnal polyuria index, actual number of nocturia, nocturia index, nocturnal bladder capacity index were significantly decreased (Table 1). Testosterone in men with low testosterone level (<3.5 ng/ml) was improved after 3-month desmopressin treatment (2.85 to 3.71, p=0.044). Conclusion: Desmopressin improved indices of FVC, lower urinary symptoms (IPSS), symptoms of late onset hypogonadism (AMS, IIEF). In addition, testosterone level increased in men with low testosterone level after 3-month desmopressin treatment. MP-03.09 The Reason of Withdrawal from Intracavernosal Injection Treatment in Patients with Erectile Dysfunction Lee S1, Choo S1, Sung H1, Moon D2 1 Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea; 2Korea University Hospital, Seoul, South Korea Introduction and Objectives: Intracavernosal injection (ICI) treatment for erectile dysfunction (ED) was introduced earlier than phosphodiesterase 5 inhibitors (PDE5Is). ICI treatment still has been advocated as second line therapy for ED in many treatment algorithms since the introduction of PDE5Is. Despite high response rate of ICI treatment, withdrawal rate has been reported up to 80%. About ICI treatment, there have been few data available in the era of PDE5Is. The aim of this study was to investigate withdrawal rate and its reason from ICI treatment in patients with ED. Materials and Methods: From the introduction of sildenafil in Korea, Oct 1999 to Dec 2011, all medical record of patients who have been prescribed with ICI treatment was reviewed. Medical record review and telephone survey on all patients were performed to investigate intercourse, withdrawal rate and its reason, adverse events, and satisfaction on sex life after ICI treatments. Satisfaction domain of the international index of erectile function questionnaire was used to ask satisfaction about overall sex life. Results: During the period, 845 patients were prescribed with ICI treatments. Of these, we were able to contact with 384 patients. Mean age was 59.3±8.9 years with follow-up duration of 34.6±47.2 months. After ICI treatments, 65.7% were able to intercourse, and withdrawal rate was 81.2%. The reason of withdrawal from ICI treatments were poor response (37.6%), inconvenience for use (18.2%), switch to other treatments (14.1%), adverse events (5.7%), high maintenance (5.7%), decreased libido (4.8%), and return of spontaneous erection (2.5%). Sixty-two patients switching treatments selected PDE5Is (60.7%) and insertion of penile prosthesis (21.3%). Adverse events occurred in the 25.5%, and which included pain (38.2%), priapism (28.4%), curvature (16.3%), plaque (11.4%), and subcutaneous hematoma (5.7%). In terms UROLOGY 82 (3 Supplement 1), September 2013 of adverse events, there was no difference between withdrawal (23.5%) and nonwithdrawal group (34.8%, p>0.05). Satisfaction rate was higher in the treatmentcontinuing group than non-continuing group (satisfied plus moderately satisfied, 78.3 vs. 37.3%, p<0.001). Conclusion: Withdrawal rate from ICI treatments was as high as 81.2%. The most common reason of withdrawal was poor response and inconvenience for use. However, treatment-continuing group was more satisfied with ICI treatment than non-continuing group. Sufficient counseling is needed before ICI treatments. MP-03.10 Effect of Body Weight Reduction on Serum Total Testosterone: Comparative Study of Metabolic Syndrome and Non–Metabolic Syndrome You D, Song G, Han K, Ahn T Dept. of Urology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea Introduction and Objectives: Several studies have confirmed the significant inverse correlation between testosterone and obesity and testosterone lowering is associated with important clinical disorders such as metabolic syndrome. The purpose of the present study is to compare the effects of body weight reduction on serum testosterone in metabolic syndrome (MS) and non-metabolic syndrome (NMS). Materials and Methods: We retrospectively reviewed the records of 626 study patients who visited our health promotion center and had their serum testosterone checked at least twice between February 2006 and December 2011. The metabolic syndrome was diagnosed using the modified NCEP definition with the Asian-specific waist circumference cutoff (> 90cm for men). We classified the 626 patients as follows: group I: weight reduction in MS; group II: no weight reduction in MS; group III: weight reduction in NMS; and group IV: no weight reduction in NMS. Results: The mean follow-up period of all patients was 26.5±14.8 months, and the mean patient age at the first screening was 53.7±7.7 years. A total, of 186 study patients (30%) were diagnosed with MS and there were no differences between the MS group and the NMS group in the mean patient age or followup period’s length. There were 108(58%) weight reduction patients in the MS group and 245(56%) in the NMS group. S57 MODERATED POSTERS The mean testosterone levels of both initial and last times were significantly lower in the MS group compared to NMS group (4.53 Vs. 5.06ng/ml; p=0.001, 4.63 Vs. 5.08ng/ml; p<0.001). During the follow-up period, in group I the testosterone level was increased 0.27±1.37ng/ ml, although in group II the testosterone level was decreased 0.17±1.67ng/ml (p=0.042) and the men in group I lost on average 2.2±0.2Kg of body weight but in group II they gained 2.3±3.2Kg. In group III, the testosterone level increased 0.20±1.83ng/ml and in group IV it decreased 0.20±2.06ng/ml (p=0.032) and the men in group III lost on average 1.6±1.5Kg of body weight but in group IV they gained 1.8±1.7Kg. Conclusion: Life style change like weight reduction could increase the level of testosterone not only in NMS population but also in the men with MS. MP-03.11 The Association between Androgenic Hormone Levels and the Risk of Developing Coronary Artery Disease (CAD) Pourmand G1, Allameh F1, Mehrsai A1, Bozorgi A2, Nekuie S3, Namdari F1 1 Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran; 2Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran; 3Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Introduction and Objectives: To evaluate the relationship between the serum levels of androgens and CAD in an Iranian population. Materials and Methods: Male individuals who were admitted to Tehran Heart Center and Sina Hospital were categorized into CAD and control groups based on selective coronary angiography. Baseline demographic data, including age, BMI, diabetes, and a history of hypertension were recorded in the data collection form. Patients were also assessed for their serum levels of total testosterone, free testosterone, estradiol, Dehydroepiandrosterone S58 Sulfate (DHEA-S), and Sex Hormone Binding Globulin (SHBG). Data analysis was carried out chi-square and ANOVA tests as well as logistic regression analysis. Results: Two hundred patients were in the CAD group and 135 individuals were in the control group. In the CAD group, 69 had single-vessel disease, 49 had twovessel disease, and 82 had three-vessel disease. Statistically significant differences were observed between the individuals in the two groups with respect to age (P<0.0001), diabetes (P<0.0001), and a history of hypertension (P=0.018). The serum levels of free testosterone (P=0.048) and DHEA-S (P<0.0001) were significantly higher in the control group than in the CAD group; however, the serum level of SHBG was higher in the CAD group than in the control group (P=0.007). Results of the logistic regression analysis indicated that only age (P=0.036) and diabetes (P=0.004) had significant relationships with CAD. Conclusion: Although the serum levels of some of the androgens were significantly different between the two groups, no association was found between androgenic hormone levels and the risk of CAD, due mainly to the effect of age and diabetes. MP-03.12 New Low-profile Flat Reservoir for Inflatable Penile Prostheses (IPP): Preliminary Implant Data Amend B1, Rojas-Cruz C2, Kruck S1, Gakis G1, Bedke J1, Stenzl A1, Ruiz-Castane E2, Sievert K1 1 University Hospital, Tuebingen, Germany; 2Fundacio Puigvert Urology and Nephrology Institute, Barcelona, Spain Introduction and Objectives: Hydraulic penile prosthesis implantation remains the treatment option in patients with severe erectile dysfunction (ED). When the IPP is placed, in combination with a lowprofile reservoir, it provides an opportunity for easier placement for patient-specific requirements and reduces the risk of intraabdominal organ injury. We report the preliminary results of newly-released flat reservoir (Conceal®) placement. Materials and Methods: A total of 14 patients with ED, who had failed previous conservative therapy, received the 3-piece IPP (AMS700®) combined with Conceal® through a penoscrotal incision. Traditional (intra-abdominal/retropubic) or extra-abdominal wall (ectopic) placement was decided as a result of previous abdominal surgery. Results: Mean age of patients was 3373 (mean 60.6, SD±10.5) years. Mean procedure time ranged between 45-93 (mean 62, SD±17.4) minutes. Seven patients underwent laparoscopic/robotic radical prostatectomy, 3 open-radical prostatectomy, one cystectomy with peritonectomy, one bilateral herniorraphy and the final two were diabetic without any prior surgery. The patient BMI ranged from 17.2-32.6 (mean 27.2, SD±3.8). Thirteen reservoirs were placed in the extraperitoneal space and 1 retropubic. The one in the Retzius’s space was filled with 60ml and all ectopic ones were filled with 50-75 (mean 63.9, SD±5.3) ml. No implant or other related complications were noted within the mean follow-up of 12.6m. Four of 13 patients with ectopic placement reported a palpable reservoir after penile prosthesis desufflation. All reservoirs were fully functional and 89% of all patients (traditional and ectopic) were very satisfied without body-image concern; the others were satisfied (one after laparoscopic, one after robot assisted radical prostatectomy). Additional investigations revealed that the low-profile reservoir maintained its flat shape up to a filling volume of 75 ml. Conclusion: Although the new flat reservoir was FDA-approved only for intra-abdominal/retropubic placement, an ectopic implantation can avoid complications especially in patients with lower abdominal surgeries. The early results demonstrated excellent functional outcome and patient satisfaction if the needed filling volume is kept below 76ml. UROLOGY 82 (3 Supplement 1), September 2013
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