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RESULTS Despite the high heterogeneity of studies and its limitations, the committee released several statements regarding the use of laser-based devices for genitourinary indications. CLINICAL IMPLICATIONS Available data in the clinical setting are still poor, and the impact of these technologies on vaginal symptoms and signs has not been clearly established. STRENGTHS & LIMITATIONS All studies have been evaluated by a panel of experts providing recommendations for clinical practice. CONCLUSION It is too early in the evolution and research of laser-based devices to make decisive recommendations regarding vaginal treatments. There is grave need to carry out randomized controlled trials with proper design for safety reasons, possible harm, and short-/long-term benefits for the different indications studied. BACKGROUND Constructing a sensitive phallus is a key objective in sex affirmation surgery, but still there is a major lack of evidence in outcome analysis of postoperative sensibility of the newly constructed body part. AIM To evaluate the innervation and sensibility of a forearm free-flap neophallus with nerve coaptation by a broad-spectrum follow-up. WM-8014 Histone Acetyltransf inhibitor METHODS The phallic sensibility of 20 transgender individuals who underwent phalloplasty with a free radial forearm flap was evaluated by a standardized multimodal approach, examining 5 main sensory modalities. Measurements were performed in defined areas at the phallus and at the unoperated forearm as a control area. Additionally, all patients were asked to complete a questionnaire about their subjective quality of life and ability to orgasm. OUTCOME This study evaluated the following parameters perception of pressure (Semmes-Weinstein monofilaments) and vibration (C64 Hz tuning fork), static two-point discrimination, sharp-blunt and hot-cold discrimination atis one of the few centers regularly performing phalloplasties in transgender patients, especially preferring the technique of Gottlieb and Levine. This study contributes to the few studies that perform sensory testing at the phallus and is unique in its kind in that it uses a multimodal approach. A limitation of this study is the limited number of cases and the limited validity of vibratory testing. CONCLUSION Confirming a promising tactile sensibility after phalloplasty with a neurovascular radial forearm flap, the next step would be to identify whether this reinnervation effectively develops due to nerve coaptation or spontaneous sprouting. Küenzlen L, Nasim S, van Neerven S, et al. Multimodal Evaluation of Functional Nerve Regeneration in Transgender Individuals After Phalloplasty With a Free Radial Forearm Flap. J Sex Med 2020;XXXXX-XXX. INTRODUCTION Few studies have investigated women's experiences with orgasm and the factors that they cite as important for their orgasmic function and sexual behavior related to foreplay and sexual stimulation. AIM To investigate and describe overall sexual function in a cohort of North American women, with a special focus on orgasmic function, satisfaction, triggers, risk factors, and sexual behavior. METHODS A total of 303 women aged 18-75 years completed a 100-questionnaire survey, which included the Female Sexual Function Index (FSFI) questionnaire and questions on orgasmic function, duration of sexual activity, sexual behaviors and relationship, and the partner's sexual function. Statistical analysis was performed using SPSS to illuminate factors affecting sexual function. OUTCOMES The main outcome measures are FSFI score, satisfaction with sexual life, ability to reach orgasm, orgasm frequency, preferred sexual stimulation, and sexual habits. RESULTS FSFI scores, which were calculated for the 230 women and other factors can be incorporated in the clinical work. STRENGTHS & LIMITATIONS The use of a validated questionnaire and the relative large number of participants are strengths of the study. Limitations are the cross-sectional design, the lack of a sexual distress measure, and a possible selection bias. CONCLUSION Most women in the overall cohort were satisfied overall with their sexual life and partner-related factors, even though 41% (of those who cited a steady sex male partner) were at risk for female sexual dysfunction. Most women did reach orgasm through different kinds of stimulation. Correlation was good between preferred and performed sexual activities and positions. Shaeer O, Skakke D, Giraldi A, et al. Female Orgasm and Overall Sexual Function and Habits A Descriptive Study of a Cohort of U.S. Women. J Sex Med 2020;XXXXX-XXX. OBJECTIVE Developing resident autonomy in the operating room is a complex process and resident established case specific learning goals may increase resident operating room training efficiency. However, little is understood about residents' experience identifying learning goals for a given case. The aim of this study was to explore the essential components contributing to surgery residents' identification of specific learning goals for surgical cases. DESIGN We conducted focus group interviews with general surgery residents across all post-graduate years (PGY) through convenience sampling. Audio recordings of each interview were transcribed and iteratively analyzed. Emerging themes were identified using a framework method. SETTING The study was conducted within the Department of General Surgery at the Ohio State University Medical Center, a tertiary academic medical center. PARTICIPANTS Eight junior (PGY 1-2) and 10 senior (PGY 3-5) residents participated, of whom 10 were female and 8 were male. RESULTS On avon for targeted interventions in the future. OBJECTIVE We examined the impact of video editing and rater expertise in surgical resident evaluation on operative performance ratings of surgical trainees. DESIGN Randomized independent review of intraoperative video. SETTING Operative video was captured at a single, tertiary hospital in Boston, MA. PARTICIPANTS Six common general surgery procedures were video recorded of 6 attending-trainee dyads. Full-length and condensed versions (n = 12 videos) were then reviewed by 13 independent surgeon raters (5 evaluation experts, 8 nonexperts) using a crossed design. Trainee performance was rated using the Operative Performance Rating Scale, System for Improving and Measuring Procedural Learning (SIMPL) Performance scale, the Zwisch scale, and ten Cate scale. These ratings were then standardized before being compared using Bayesian mixed models with raters and videos treated as random effects. RESULTS Editing had no effect on the Operative Performance Rating Scale Overall Performance (-0.10, p = 0.30), SIMPL Performance (0.13, p = 0.71), Zwisch (-0.12, p = 0.27), and ten Cate scale (-0.13, p = 0.29). Additionally, rater expertise (evaluation expert vs. nonexpert) had no effect on the same scales (-0.16 (p = 0.32), 0.18 (p = 0.74), 0.25 (p = 0.81), and 0.25 (p = 0.17). CONCLUSIONS There is little difference in operative performance assessment scores when raters use condensed videos or when raters who are not experts in surgical resident evaluation are used. Future validation studies of operative performance assessment scales may be facilitated by using nonexpert surgeon raters viewing videos condensed using a standardized protocol. BACKGROUND Progressive autonomy leading to conditional independence is necessary to achieve competence in surgical skills and decision making. Trust and transparency are ethical imperatives, but practices vary regarding the extent of disclosure of specific resident roles. We tested whether a standardized preoperative script would improve patient acceptance of resident involvement in perioperative care. METHODS Patients admitted to a resident-run acute care general surgery service between October 2017 and October 2018 were enrolled in an IRB-approved study. During the first half of the rotation (control), operative consent was obtained according to individual practice without specified explanation of resident roles. During the second half (intervention), the senior resident read a short semistructured script specifically explaining team roles and responsibilities, including the degree of resident independence and supervision by attendings. On postoperative day 3, patients completed a survey assessing understanding of their surgical care. RESULTS Sixty-two patients under the care of 10 rotating chief residents were enrolled; 46 patients completed the survey, 23 in each arm (74% response rate). Ten patients in the control arm (43%) compared to only 3 (13%) in the intervention arm indicated that residents should not be allowed to perform portions of operations (odds ratio 4.94, p = 0.047). Patients in the intervention arm felt that care team roles were more adequately explained to them before their operation (p = 0.002). There was no difference in the number of patients naming a resident as "their doctor." CONCLUSIONS Use of a short script specifying resident roles improves patient acceptance of trainee participation in perioperative care. OBJECTIVES To evaluate the ability of students to reproduce the skills acquired on a prostate biopsy simulator in a real-life situation. DESIGN A prospective randomized controlled study was conducted. Medical students with no experience of prostate biopsy were randomized between arm A « conventional training » and arm B « simulator-enhanced training. » The training was performed for both groups on the simulator. The students in arm B were provided with visual and numerical feedback. The transfer of skills was assessed by recording the position of the 12 biopsies performed by each student on an unembalmed human cadaver using a 3D ultrasound mapping device. SETTING The study was conducted in an academic urology department and the cadaver experiments in the adjoining anatomy laboratory. RESULTS Twenty-four students were included, and 22 completed the study. The median score obtained on the simulator at the end of the training was 57% (53-61) for arm A and 66% (59-71) for arm B. The median score obtained on the cadaver by students trained with the simulator was 75% (60-80), statistically superior to the score obtained by students trained conventionally of 45% (30-60), p less then 0.0001. The median score obtained by all students when performing biopsies in a real-life situation was 63% (50-80) versus 60% (56-70) for their last training on the simulator. CONCLUSION These results support the transfer of skills acquired on the simulator, and the superiority of a training curriculum integrating simulation, and performance feedback. INTRODUCTION In 2009, girls-only HPV16/18 vaccination was introduced in the Netherlands which has achieved 46-61% uptake. Heterosexual men have benefitted from herd protection, but it is unknown whether men who have sex with men (MSM) also benefit from herd effects of the girls-only HPV16/18 vaccination program. Because MSM bear a high HPV-related disease burden, countries might consider targeted vaccination for MSM. To study possible herd effects and prior HPV exposure at a potential moment of vaccination, we assessed trends in the HPV prevalence and proportions (sero)negative for the various vaccine types among young MSM visiting sexual health centers (SHCs). METHODS We used data from MSM included in PASSYON study years 2009-2017. In this biennial cross-sectional study among visitors of SHCs aged 16-24 years, MSM provided a penile and anal swab for HPV DNA testing (including vaccine types HPV6/11/16/18/31/33/45/52/58) and blood for HPV antibody testing (HPV16/18/31/33/45/52/58). RESULTS In total 575 MSM were included, with a median of 22 years of age and 15 lifetime sex partners and 3.
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