Eur Urol Suppl 2011;10(2):331 Table 1 shows the mean baseline, 6-month and 24-month scores for each group in the select Fugl-Meyer and TSS domains. Conclusions: Female partners had higher satisfaction with their quality of life outcomes including partner relationship and family life after their male partners received an IPP compared to partners of non-surgically treated men. The scores also indicate that couples who received an IPP were signifcantly more satisfed with their treatment compared to couples receiving other ED therapies. 1073 Penile Prosthesis insertion in gender dysPhoria - long terM results Dente D. 1 , Christopher A.N. 2 , Garaffa G. 2 , Minhas S. 2 , Ralph D.J. 2 1 Policlinico Umberto Primo, Dept. of Urology, Rome, Italy, 2 University College Hospital, Dept. of Andrology, London, United Kingdom introduction & objectives: The aim of this study is to report the results of penile prosthesis implantation in patients with gender dysphoria who have had a previous phalloplasty. Materials & Methods: Between the year 2000 to 2010, 146 patients (age 22 – 59yrs, mean 38.5 yrs) with Gender Dysphoria had a penile prosthesis inserted into their phalloplasty. The types of phalloplasty included the forearm free fap (n= 87), an abdominal phalloplasty (n = 48) and a combination of the above in 11 patients. The prostheses used were the AMS 700CX in 137 pts and the AMS Ambicor in 9 pts. The reservoir component and a single testicular prosthesis had been inserted 3 months earlier. A single cylinder was used in 104 patients and 2 cylinders, when the phallus was bulky, in 42 patients. A vascular graft, impregnated with silver to reduce infection, was used to form a cap and sock around the cylinder to aid with anchorage to the pubis and to reduce the chance of distal erosion. The surgical results and complications were recorded. results: A prosthesis was inserted in all patients without intraoperative complications. After a mean follow up of 20 months (range 7 – 123 months), a successful surgical result was declared with the prosthesis in a good position and the patient being able to cycle the device in 137 patients, although only 69 patients (50%) were having sexual intercourse. The revision rate was 31% to include: infection in 23 patients (16%), erosion 9 pts ( 6%), mechanical failure 33 pts (24%) and elective readjustment of components in 28 patients. Some patients had multiple revisions. Conclusions: The insertion of a penile prosthesis into a phalloplasty technically allows enough rigidity to have penetrative sexual intercourse. However the patients must be informed of the shorter device life expectancy and the high complication and revision rate. 1074 Penile low intensity shoCk waves – a new non-invasive alternative for ed Patients not resPonding to Pde5i's Vardi Y., Appel B., Massarwa O., Sprecher E., Gruenwald I. Rambam Healthcare Campus, Dept. of Neuro-Urology, Haifa, Israel introduction & objectives: Low Intensity Shock Wave Therapy (LI-ESWT) was shown to have a benefcial effect on ED patients responding to PDE5i's when applied locally to the penis. This pilot study aimed to determine the ability of this modality to convert non responders to responders capable of having sexual intercourse Materials & Methods: We included severe ED patients (60% diabetic, 85% with cardiovascular disease) that failed to achieve intercourse during PDE5i therapy (score 0-2 on the rigidity scale (RS)). Each subject underwent a full baseline assessment of erectile and sexual function (during PDE5i treatment) using validated questionnaires and objective penile endothelial function testing (FMD). Treatment included 2 sessions / week for 3 weeks, repeated after a 3-week no- treatment interval. At each session LI-ESWT was applied on the penile shaft and crus for 3 minutes in 5 different penile anatomical sites (intensity of 0.09 mj/mm 2 , 300 shocks / site). Patients were followed for one (FU1) and two (FU2) months post treatment in which the frst follow-up was without PDE5i's and the second was with active on-demand PDE5i therapy. The same baseline assessment was repeated in both visits. Main endpoints for success were changes in IIEF-ED Domain score (IIEF-ED) , and ability to penetrate (changes in RS above 2). results: Twenty-nine subjects nonresponsive to PDE5i therapy aged 41-78 (mean age 62.8) had a mean baseline IIEF-ED score of 8.8±1.1 (mean±sem). At FU1 their IIEF-ED score improved to 12.3 ±1.1.(P=0.035). At FU2 (on active PDE5i treatment) the mean IIEF-ED increased to 18.6±1.1 (a rise of 9.7 points from baseline, p< 0.0001). Sixty three percent were able to achieve vaginal penetration ( RS of 3 and above (p<0.0016) and 8 subjects were normalized at FU2 . All FMD parameters increased (p=0.0001) and were signifcantly associated with IIEF-ED scores (P<0.05). No adverse events were reported. Conclusions: LI-ESWT applied to the penis is a new modality that can be used to effectively treat a subgroup of ED patients who failed PDE5i therapy. It enabled 68% of these patients to have full intercourse and 30% to function even without medication. This study further emphasizes the clinical benefts encompassed in using penile shock wave energy for severe ED patients. A placebo controlled study is mandatory in order to validate these preliminary results. 1075 exPeriMental evidenCe that a CoMbination of sgC stiMulator bay 60-4552 and Pde5 inhibitor vardenafil Might salvage Patients with insuffiCient resPonse to Pde5 inhibitors after Cavernous nerve injury Oudot A. 1 , Behr-Roussel D. 1 , Poirier S. 1 , Sandner P. 2 , Bernabé J. 1 , Giuliano F. 3 1 Pelvipharm, Orsay, France, 2 Bayer Schering Pharma, Dept of Global Drug Discovery, Wuppertal, Germany, 3 EA4501, Université Versailles Saint Quentin en Yvelines, Garches, France introduction & objectives: Radical prostatectomy (RP) is frequently responsible for erectile dysfunction (ED). Post-RP patients often show insuffcient response to PDE5 inhibitor based ED-therapy. This study was undertaken to evaluate the acute effects of the soluble guanylate cyclase (sGC) stimulator, BAY 60-4552 and vardenafl administered alone or in combination on erectile responses to electrical stimulation of the cavernous nerve (ES-CN) in rats with cavernous nerve (CN) crush injury-induced ED. Materials & Methods: Male Sprague-Dawley rats underwent laparotomy (sham, n=10) or bilateral CN crush injury (n=57). After 3 weeks of recovery, erectile function was evaluated in urethane-anesthetized rats following ES-CN at different frequencies. The acute effects of intravenous (iv) injection of vehicle, vardenafl 0.03 mg/kg, BAY 60-4552 0.03 mg/kg or 0.3 mg/kg, or a BAY 60-4552 0.03 mg/kg + vardenafl 0.03 mg/kg combination were evaluated in CN crushed rats. results: Bilateral CN crush injury followed by a 3-week recovery period decreased erectile responses to ES-CN by about 50%. In CN crushed rats, both iv vardenafl 0.03 mg/kg and BAY 60-4552 at the tested dosings (0.03 or 0.3 mg/kg) increased erectile responses to ES-CN to the same extent: ΔICP/MAP at 10Hz ES-CN was 20.9±1.3 % after iv vehicle, 25.3±3.3 % (P<0.001) after iv vardenafl, and 26.3±4.9 % and 26.6±5.2 % after BAY 60-4552 0.03 mg/kg (P<0.01) and 0.3 mg/kg (P<0.001) respectively. The combined iv administration of vardenafl and BAY 60-4552 in CN crushed rats exerted additive effects and totally restored erectile responses to ES- CN equivalent to sham rats (ΔICP/MAP at 10Hz ES-CN : 34.0±4.4 % after BAY 60-4552/vardenafl combination vs 39.2±3.7 % in sham rats, ns). Conclusions: The present study supports the concept that the combined administration of a sGC stimulator, BAY 60-4552 and vardenafl provides synergistic benefcial effects and might therefore salvage patients with insuffcient response to PDE5 inhibitors after RP. Poster session 90 sCreening, aCtive surveillanCe and the Prostate Monday, 21 March, 15.45-17.15, hall e2 1076 radiCal ProstateCtoMy after Previous turP and surgiCal Margins: results of a ProsPeCtive MultiCenter italian survey Simonato A. 1 , Gacci M. 2 , Ennas M. 1 , Varca V. 1 , Maffezzini M. 3 , Imbimbo C. 4 , Gontero P. 5 , De Cobelli O. 6 , Carini M. 2 , Martorana G. 7 , Nicita G. 8 , Mirone V. 4 , G. 1 Carmignani MIRROR study-LUNA Foundation, Italy 1 Luciano Giuliani, Dept. of Urology, Genoa, Italy, 2 University of Florence, Careggi Hospital, Dept. of Urology, Florence, Italy, 3 Galliera Hospital, Dept. of Urology, Genoa, Italy, 4 Federico II University, Dept. of Urology, Naples, Italy, 5 University of Turin, Dept. of Urology, Turin, Italy, 6 European Institution of Oncology, Dept. of Urology, Milan, Italy, 7 University of Bologna, Dept. of Urology, Bologna, Italy, 8 University of Florence, Dept. of Urology, Florence, Italy introduction & objectives: The aim of present study is to assess incidence, location, and prognostic factors for positive surgical margins (PSM) in patients treated with radical prostatectomy after previous endoscopic prostate surgery. Materials & Methods: 2408 men treated with RP for prostate cancer were consecutively enrolled in a multicenter national survey. A positive surgical margin (PSM) was defned as neoplastic cells reaching contact with the inked surface. We analyzed overall PSM incidence, the number (single or multiple) and the site (apex, bladder neck, left, right and posterior) of PSM by a Spearman correlation coeffcient, logistic regression and unpaired samples T test. results: We identifed 702 patients with PSM (29%): 464 (66%) with a solitary PSM, while 238 (34%) with multiple PSM. As expected, clinical stage (p=0.000), bioptical Gleason score (p=0.001) and number of positive cores at biopsy (p=0.000) were the most signifcant predictive factors for PSM. In the overall PSM outcomes, there is no correlation between TURP and PSM (Coeff.: 0.33; p=0.101). With a stratifcation in TURP group and non-TURP group, we have observed statistically signifcant differences between location of PSM: TURP seems to reduce the risk of PSM at the apex (Coeff. -0.43, p=0.036) and improve the risk at the bladder neck (Coeff: 0.40, p=0.049). Unpaired samples T test confrmed these data: apex: 14% PSM without TURP vs 5% PSM with TURP, p=0.036; bladder neck: 2% PSM without TURP vs 5% PSM with TURP, p=0.049. The two categories of patients were similar according to PSA, Gleason score, and pathological stages. In patients with TURP we found a lower rate of nerve-sparing techniques performed than in