S318
groups when compared to the Ctrl group. There was a reduction
of sinusoidal space of 34.7% and 22.4% in the BPH and
BPH+T groups compared to the Ctrl group.
Conclusions: Rats with pre-disposition to arterial hypertension
and BPH presented changes in the morphology of the corpus
cavernosum. Treatment with Tribulus terrestris did not alter the
morphology of the corpus cavernosum neither in control rats nor
in hypertensive rats.
Financial support: This study received grants from CNPq,
FAPERJ and CAPES.
Disclosure: Work supported by industry: no.
528
TREATMENT OF CHRONIC RECURRENT
BACTERIAL PROSTATITIS WITH MULTIPLE
DRUG RESISTANCE TO ANTIBACTERIAL
AGENTS
Ibishev, K.S.1; Krainiy, P.A.1; Krakhotkin, D.V.1;
Magomedov, R.G.1
1
Rostov State Medical University, Department of urology, Rostov-on-
Don, Russia
Objective: To conduct analysis of clinical and laboratory
indicators course of chronic recurrent bacterial prostatitis with
multidrug resistance.
Materials and Methods: We conducted the analysis of exami-
nation and treatment of 35 patients in aged 35±2,5 years with
chronic recurrent bacterial prostatitis(CRBP) . In evaluation
symptoms of chronic bacterial prostatitis were used question-
naires National Institute of Health-Chronic Prostatitis Symptom
index (NIH-CPSI) and International Prostate Symptom Score
(IPSS). We performed physical examination, digital rectal
examination, standard laboratory tests, uroflowmetry, transrectal
ultrasound investigation of prostate.
Results: During evaluation of severity symptoms of CRBP was
established: mean value of scale NIH-CPSI in study group was
19,5±0,8 herewith predominated pain syndrome in 100%
patients and lower urinary tracts symptoms registrated in 45 %.
In history for last year in all patients was more than 2 relapses of
disease. In microscopic investigation of prostatic secretion the
level of leucocytes was 142,9±10,5 and bacteriological study in
majority cases (90%) showed bacterial mixed infection with
average contamination Lg 5,0 CFU/ml. In 60% patients in the
prostatic secretion were identified two-companent association
bacteria and in 30% patients were registrated three-component
associative relationships. In etiological structure microorganisms
isolated for CRBP predominated non-clostridial bacteria (60%),
coagulase-negative staphylococci (50%),coryneform bacteria
(40%) and representatives of family Enterobacteriaceae(40%).
Less commonly E. faecalis was determined in prostatic secretion
and in sporadic cases isolated Streptococcus sp. Antibiotic
susceptibility testing showed that in 77,1% was sensitivity to
carbapenems and in 28,5% to aminoglycosides. Estimation of
immunological parameters of prostatic secretion showed signifi-
cant increase mean value proinflammatory interleukins:IL-1e
199,5+1,0 pg/ml and IL-8 e 322, 5+1,0 pg/ml, moderated
Proceedings of the 21st World Meeting on Sexual Medicine
increase of mean value proinflammatory IL-6 e 33,5±1,0 pg/ml
and mean value of proinflammatory IL-4 matched to upper limit
of norm e 6,09 ±1,0 pg/ml .Given multidrug resistance and
disturbance of immunological parameters patients received the
combined therapy including the herbal medicine (Canephron N
duration of treatment 3 months) and interferon therapy (Viferon
duration of treatment 20 days). During evaluation results of
treatment relapse of disease after 12 months noted in 28,5%
patients.
Conclusions: In patients with CRBP in prostatic secretion pre-
dominates non-clostridial anaerobes and coagulase-negative
staphylococci which were previously considered controversial
etiological agents of prostatitis.These findings suggests about
increase concentration of proinflammatory cytokins( levels IL-1
and IL-8) in the prostatic secretion in patients with CRBP,
which possibly can be used as prognostic markers of severity
course of chronic bacterial prostatitis. As alternative therapy can
be used herbal medicine and interferon therapy
Disclosure: Work supported by industry: no.
529
TREATING ERECTILE DYSFUNCTION
WITH A COMBINATION OF LOW-
INTENSITY SHOCK WAVES (LISW) AND
PLATELET-RICH PLASMA (PRP) INJECTIONS
Ruffo, A.1; Stanojevic, N.2; Iacono, F.3; Romis, L.1; Romeo, G.1;
Di Lauro, G.1
1
Hospital Santa Maria delle Grazie, Italy; 2Sava Perovic
Foundation, Serbia; 3University of Naples Federico II, Italy
Objectives: In this study we investigated the effect of a combi-
nation therapy using low-intensity shosk-waves (LISW) and
platelet rich plasma (PRP) injections to treat erectile dysfunction
(ED).
Materials and Methods: 60 patients (pts) with mild to severe
ED were enrolled in this study. Pts were randomly divided in
Group A that underwent 6 weekly sessions of LISW (1500
shocks/session) and Group B that underwent 6 weekly sessions of
LISW + 6 Injections of PRP (1 injection every 2 weeks). Pts were
investigated at baseline and at 6 months after treatment using
IIEF-5 and SEP-Q2 and SEP-Q3.
Results: At 6 months follow-up in Group A : IIEF-5 improved
from 11 to 18, SEP-Q2 from 48% to 62%, SEP-Q3 from 28%
to 48% while in Group B : IIEF-5 improved from 10 to 22,
SEP-Q2 from 52% to 75%, SEP-Q3 from 30% to 62%. No
Side effect were reported
Conclusions: LISW is now acknowledged as a first line treat-
ment for the ED. The PRP is separated from other elements of
the blood with the use of a centrifuge. The process involves the
collection of the patient’s whole blood before undergoing two
stages of centrifugation that separates the PRP from other ele-
ments of the blood. PRP contains several different growth factors
and other cytokines that can stimulate healing of soft tissue and
tissue regeneration.In spite of the several studies previously re-
ported, to date, a standardized protocol for PRP preparation and
application, as well as a standard method for evaluating results
J Sex Med 2018;15:S123eS407
Proceedings of the 21st World Meeting on Sexual Medicine
has not been established. This preliminary data are quite
encouraging. Further studies are needed in order to assess more
precise protocols.
Disclosure: Work supported by industry: no.
530
TOWARDS A GLOBALLY SHARED
TAXONOMY OF THE DIFFERENT
CONDITIONS DIAGNOSED AS
UNCONSUMMATED MARRIAGE
Silvaggi, M.1; Michetti, P.M.2; Fabrizi, A.3; Rossi, R.1;
Tripodi, F.1; Simonelli, C.4
1
Institute of Clinical Sexology, Italy; 2Policlinic Umberto I,
Department of Obstetrics, Gynecology and Urologic Sciences,
Sapienza University of Rome; 3Santa Lucia Foundation, Tor
Vergata University of Rome; 4Sapienza University of Rome,
Department of Psychology
Objective: Sexuality has different meanings and follow different
scripts depending on the country or geographic location and the
dominant culture. The growing globalization and migrations
leaded to marriages between people belonging to different cul-
tures. Moreover, in modern societies there are many migrant
communities that, although integrated, follow faithfully the rules
and values of their culture of origin. For this reason, health care
professionals are progressively exposed to the task of under-
standing and dealing with sexual difficulties that have a lot to do
with the cultural aspects of patients. Very often professionals are
not prepared to face diversity and complexity in relationship, or
describe the problems with imprecise terms. The aim of the
present work is to collect and review data on Unconsummated
Marriage (UCM) all around the world, to identify difference and
similarities, and to suggest a globally shared taxonomy of the
different conditions that go nowadays under the UCM umbrella.
Materials and Methods: A review of published literature on
UCM from different areas of the world was conducted.
Results: Substantial difference emerged among Middle Eastern
(MES) Western (WS) and Eastern society (ES). In MES, sexu-
ality is allowed only in marriage, in WS sexuality and relationship
are not strongly linked, while in ES it is possible to find both
conditions depending on the country and whether the area is
metropolitan or rural. This could suggest that the term uncon-
summated “marriage” is unable to cover the phenomenon in
such different countries. Moreover, the mean time before the
consultation, causal attribution and prevalence are very different
in such societies.
Conclusions: We found that the term “First attempt intercourse
dysfunction (FAID)” could be better to describe male and female
difficulties related either to ignorance about sexuality or state/
performance anxiety and mainly characterized by short time prior
consultation. On the other hand, where individual difficulties are
involved creating a couple sexual dysfunction, mainly charac-
terized by long time to consultation, we suggest a new term as
“Unconsummated relationship” (UCR)”.
Disclosure: Work supported by industry: no.
J Sex Med 2018;15:S123eS407
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531
IMPROVEMENT OF ERECTILE FUNCTION
BY INTRACAVERNOUS INJECTION OF
HEPATOCYTE GROWTH FACTOR IN A RAT
MODEL OF ERECTILE DYSFUNCTION
AFTER CAVERNOUS NERVE INJURY
Yoo, S.1; Park, J.1; Son, H.1; Kim, S.W.2; Paick, J.-S.2;
Cho, M.C.1
1
Seoul National University Boramae Medical Center, Korea, South;
2
Seoul National University, College of Medicine
Objective(s): We investigated whether intracavernous injection
of hGF, a potent angiogenic factor, could improve erectile
dysfunction in a rat model of erectile dysfunction after cavernous
nerve (CN) injury.
Material and Method(s): Sixty 12-week-old male SD rats were
divided into five groups as follows: sham control treated with
intracavernous injection of saline vehicle (S group), bilateral CN
injury treated with intracavernous injection of saline vehicle
(I group), bilateral CN injury treated with intracavernous
injection of 125 mg hGF (L group), bilateral CN injury treated
with intracavernous injection of 250 mg hGF (M group), and
bilateral CN injury treated with intracavernous injection of 500
mg hGF (H group). In each group, the hGF or saline vehicle was
administrated intracavernously once shortly after CN injury or
sham surgery. Erectile function was evaluated by electro-
stimulation (2.0 V or 4.0 V, 15 Hz, 0.2 ms) and papaverine test
at 2 weeks postoperatively.
Result(s): At postoperative 2 weeks, maximum intracavernous
pressure (ICP) / mean arterial pressure (MAP) and area under
curve (AUC) / MAP in the I group was significantly decreased at
all stimulation conditions (2.0 V and 4.0 V) than those in the S
group. Although the erectile responses in the L, M, and H groups
were significantly improved, ICP / MAP at 2.0 V stimulation in
the L, M, and H groups was 48.3%, 41.3%, and 56.1%
compared to that in the S group, respectively. In addition, AUC /
MAP in the L, M, and H group was 11.6%, 16.1%, and 22.8%
compared to that in S group, respectively. Although ICP / MAP
and AUC / MAP at 4.0 V stimulation in the L, M, and H groups
were significantly improved in the L, M, and H groups compared
to those in the I group, partial improvements in ICP / MAP
(L group: 41.8%, M group: 44.7%, and H group: 56.6%) and
AUC/ MAP (L group: 12.2%, M group: 21.9%, H group:
30.6%) compared to those in the S group was observed,
respectively. In terms of papaverine test, ICP in the L, M, and H
groups were significantly improved compared to that in the
I group, although ICP after papaverine injection was 78.0% in
the L group, 58.7% in the M group, and 80.8% in the H group
compared with that in the S group.
Conclusion(s): Erectile function was partially improved in a dose
dependent manner by immediate intracavernous injection of
hGF after CN injury. Further studies are needed to explore
whether a combination of hGF with anti-apoptotic agents or
anti-fibrotic agents can restore erectile function to control values.
Disclosure: Work supported by industry: yes, by Viromed
(no industry support in study design or execution).