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Introduction: Clitoral priapism is persistent clitoral engorgement without sexual stimulation. Presentation is sparse, and therefore limited treatment options have been investigated., Aim: We present a case report of a 34-year-old female presenting with persistent nonischemic clitoral priapism 5 years after aggressive clitoral stimulation., Methods: Patient underwent six weekly Li-ESWT sessions at frequency 4 Hz, energy 0.11 mJ for 2000 shocks per session. Assessment included physical examination of clitoral glans engorgement and retraction, global response assessment (GRA) score, need for topical phenylephrine, and ability to achieve orgasm., Results: At the end of the therapy, examination revealed complete resolution of priapism with a normal-appearing clitoris fully retracted behind the clitoral hood. The patient reported no longer requiring topical phenylephrine, a significant improvement in GRA, and the ability to achieve orgasm., Conclusion: We present a case of nonischemic clitoral priapism resolved with Li-ESWT. More investigation regarding the utilization of Li-ESWT in the treatment of clitoral priapism is highly encouraged., Competing Interests: Dr. Kenneth Peters is a consultant for Thermaquil Inc, Urovant, Collamedix, Iota Bioscience, and Uromedical and is an equity owner of UroMedical. Dr. Priya Padmanabhan is a PI for Medtronic, coinvestigator for Cook Medical and Urovant, and has received honoraria from Axonics. The remaining authors have no conflict of interest., (© The Author(s) 2024. Published by Oxford University Press on behalf of The International Society for Sexual Medicine.)

Purpose: Neurogenic lower urinary tract dysfunction (NLUTD) is highly prevalent among patients with neurologic disorders. Some studies have demonstrated that implantable neuromodulation can improve symptoms of NLUTD. We seek to describe our experience with sacral and pudendal neuromodulation in patients with NLUTD., Methods: A retrospective chart review of patients with "neurogenic bladder" ICD-9/10 (International Classification of Diseases, Ninth Revision/10th Revision) code was performed at a single institution. This included patients from 2008 to 2020 who underwent stage 1 neuromodulation trial. Demographic and clinical information was collected, including neurologic diagnosis, the character of patients' voiding symptoms, the presence or absence of fecal incontinence, the need for intermittent catheterization, and whether patients had sufficient (>50%) improvement in their symptoms to undergo stage 2 implantable pulse generator (IPG) placement., Results: We identified 82 patients with neurologic diagnoses who underwent stage 1 neuromodulation. The most common diagnoses were diabetic cystopathy (17.07%), spinal surgery (17.07%), and spinal cord injury (12.20%). The most commonly reported symptoms were urinary urgency, and urge urinary incontinence. Overall, 59 patients (71.95%) advanced to stage 2 IPG placement including 72% of patients with sacral leads and 76% with pudendal leads., Conclusion: Neuromodulation is feasible and effective in the treatment of NLUTD. Further investigation into its utilization is warranted.

Over the past decade, there has been a growing appreciation of metascience issues in psychological science. Using data collected from 2615 posters presented at the 2021 biennial meeting of the Society for Research in Child Development, this article examines the use of transparent research practices to increase rigor and reproducibility as well as generalizability through greater inclusivity of diverse samples. Research presented through poster presentations was heavily skewed toward quantitative studies featuring American researchers using Western hemisphere samples. Sharing of data/materials, preregistrations, and replications were uncommon. During a time when governments are increasingly requiring more open practices and access, this research provides an important baseline by which developmental science can benchmark progress toward the goals of greater inclusivity and openness., (© 2023 The Authors. Child Development © 2023 Society for Research in Child Development.)

Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest.

Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest.

Purpose of Review: Microscopic hematuria and overactive bladder are two common urologic conditions. The objective of this review is to provide an overview of current literature as well as highlight important guidelines that will aid physicians in the diagnostic workup of microscopic hematuria in patients experiencing symptoms of overactive bladder., Recent Findings: Updated microscopic hematuria guidelines provide a structured and appropriate workup for women based on risk factors, which stratifies patients to prevent unnecessary procedures and imaging. Women presenting with microscopic hematuria in the setting of overactive bladder should undergo microscopic hematuria workup according to their risk stratification while receiving appropriate treatment for their overactive bladder. The physician should consider the presence of irritative voiding symptoms during the investigation and management of microscopic hematuria in patients with overactive bladder and should not delay overactive bladder treatment due to the presence of microscopic hematuria., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objective: To investigate whether penile pathologies are presented diversely in urologic textbooks and identify areas where more diverse presentation is warranted., Methods: Photographic depictions of penile pathologies in 9 urologic textbooks were assigned a Fitzpatrick skin phototype and constitutive skin color. Fitzpatrick skin phototypes ranged from I to VI, and constitutive skin colors were light, fair, medium, and dark. Fitzpatrick skin phototypes I-III were deemed nonskin of color, and IV-VI considered skin of color. Figures were classified based on pathology presented: infectious benign or sexually transmitted infection (STI), noninfectious benign, or malignant. Chi-square and odds ratios were used to compare skin color ranges across pathologic categories and determine where a figure depicting skin color would most likely be encountered., Results: Within 116 figures meeting inclusion criteria, 15 (51.7%) infectious/STI pathologies displayed skin of color, while 10 (27.8%) noninfectious benign and 7 (13.7%) malignant pathologies displayed skin of color. Within 85 diagnostic images, 15 (51.7%) images of infections/STIs, 10 (28.6%) noninfectious benign, and 4 (19.0%) malignant pathologies presented skin of color (P < 0.01). Overall, images of patients with skin of color were more likely depictions of infections/STIs than any other pathology (P < .001, OR = 2.26)., Conclusion: There is a lack of depictions of malignant and noninfectious benign penile pathology on the skin of color. This may contribute to continued disparities in the diagnosis and treatment of penile pathologies., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Objective: To apply the American Urogynecological Society (AUGS)/American College of Obstetricians and Gynecologists (ACOG) recommendations of foregoing workup in patients under 50 years of age with less than 25 red cells per high-powered field, to a cohort of asymptomatic microscopic hematuria (AMH) patients, and assess diagnostic accuracy, sensitivity, specificity, positive, and negative predictive value compared to the American Urologic Association (AUA) guidelines., Methods: Retrospective review of female patients who underwent AMH evaluation from 2012 to 2015. The number of patients who would have avoided workup following the AUGS/ACOG recommendations was determined. Sensitivity, specificity, positive- and negative-predictive value and accuracy of the AUGS/ACOG recommendations compared to AUA guidelines were determined., Results: Six hundred twenty women underwent AMH workup with 265 women undergoing full workup as per the AUA guidelines. Applying the AUGS/ACOG recommendations to this cohort would not have resulted in missed malignant diagnoses. Two tumors were found, both in patients who had undergone complete workup, and for whom AUGS/ACOG recommends workup. Following the AUGS/ACOG recommendations would have avoided workup in 126/620 of all women and 44/265 women who underwent the full AUA workup. In looking at findings of malignancy, the AUGS/ACOG workup had a sensitivity of 100% and a negative predictive value of 100% as compared to the AUA guidelines., Conclusion: AUA guidelines may over screen female low risk AMH patients. Extensive workup in a low risk group of female patients does not result in increased cancer diagnoses. Perhaps a more nuanced approach could result in fewer workups without compromising cancer detection., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Objective: To quantify the representation of women urologists as invited speakers at the AUA Annual Meeting., Methods: Programs for the AUA Annual Meeting were reviewed from 2017 to 2019. Topics of sessions and genders of moderators and panelists were collected. Percentages of women urologists as well as topics of sessions were compared between years., Results: Women urologists comprised 60 of 467 moderators (12.8%) and 63 of 614 panelists (10.3%). Sessions about infection had the most women urologist moderators while oncology had the least. Sessions about FPMRS has the most women urologists as panelists. Male urologists were more likely to be full professors compared to women urologists. While the percentage of female panelists fluctuated, the percentage of female moderators decreased each year., Conclusion: Although the proportion of women to men in urology is increasing, the number and proportion of woman urologist panelists and moderators at the annual AUA meeting does not reflect this trend. It is important to recognize and correct this discrepancy, as well as to increase visibility of women and others underrepresented in the field., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Policing the legality and normalcy of service members' sexual lives was a contentious process for military courts throughout the 1950s, 1960s, and early 1970s that resulted in the inconsistent enforcement of the homosexual exclusion policy. Military personnel of all ranks and occupations harbored a variety of attitudes and beliefs about homosexuality that challenged the legitimacy and uniformity of the military's legal assault on sexual deviance. Over half of the active duty personnel originally accused of homosexual tendencies received either sentence reductions or sentence reversals as a result of this highly contested process by which official military policy was translated into practice via courts-martial. Paradoxically, the very policies that discriminated against alleged homosexual service members generated legal avenues through which gays and lesbians exercised their rights to due process, and, ultimately, their rights as American citizens embodied in the repeal of the Don't Ask, Don't Tell policy. Rather than being an ideologically homophobic monolith, the Cold War American military rocked with contestation over an exclusion policy that attempted--unsuccessfully--to eliminate all gay and lesbian service members.

Study Objective: We sought to determine socioeconomic and demographic factors that predict frequent emergency department (ED) use among asthmatics in Southeastern Pennsylvania., Design: Retrospective cohort study using the 2004 Philadelphia Health Management Corporation's Southeastern Pennsylvania Household Health Survey., Setting and Participants: Health behaviors were surveyed using telephone interviews (random-digit dialing) in Bucks, Montgomery, Delaware, Philadelphia, and Chester counties. Response rate was 30%., Results: Of 13,342 respondents, 1,799 (13%) stated that they had asthma. The mean reported visits in 12 months were as follows: clinic--1.2 (SD 2.7); doctor's office--4.7 (SD 5.6); ED--0.8; (SD 1.8); overnight hospitalizations--0.4 (SD 0.9). Most (91%) reported that a primary care doctor was their principal source of care, whereas 2% reported the ED as their principal source of care. Frequent ED use (>or=3 visits/12 months) was reported in 180 (10%). Frequent ED use was associated with race, education, diabetes, mental illness, smoking at home, and language barriers (p < 0.001) as well as indicators of severity of illness (clinic visits, office visits, prescription for asthma medication, p < 0.001). Using multivariable logistic regression, predictors of frequent ED use were: prescription for asthma meds (OR 2.3, 95%CI 1.4-3.7), having Medicaid or Medical Assistance (OR 1.7, 95%CI 1.1-2.6), having a high school education or less (OR 1.5, 95%CI 1.0-2.3), number of clinic visits (OR 1.1, 95% CI 1.1-1.1), office visits (OR 1.1, 95%CI 1.1-1.1), number of children living in the house (OR 1.2, 95% CI 1.0-1.3), and living in Philadelphia (OR 2.0, 95% CI 1.3-3.1)., Conclusions: Frequent ED use is associated with demographic factors, geographic factors, and markers of severity of illness. While care guidelines recommend prompt referral to a primary care physician to prevent ED visits, given the level of primary care use in this population, frequent primary care attendance alone may not prevent asthma-related ED visits.