Introduction On June 24, 2022, the U.S. Supreme Court’s landmark decision on DOBBS v. JACKSON WOMEN'S HEALTH ORGANIZATION leaves abortion rights or restrictions to be defined at the state level. The following week several news outlets reported that urologists across the country are experiencing significant increases in clinical encounters for individuals interested in undergoing a vasectomy. Objective To explore the impact of changes to federal protection of abortion rights on the number of individuals seeking vasectomies at two high-impact academic centers and their correlation with Google Web searches. Methods A cross-sectional analysis of Google web searches from 1/1/2004-6/30/2022 was performed for the key term ‘vasectomy’ utilizing Google Trends®. One primary outcome was relative search interest in the key term ‘vasectomy’ prior and after the overturn of ROE v. WADE. We calculated the coefficients of determination for the linear search trend of this term. In parallel, cross-sectional analyses were performed utilizing databases from the electronic medical records of two high-impact university hospitals (‘Hospital-1’ and ‘Hospital-2’). in the U.S. focusing on patient encounters for vasectomy consultation coded as ‘vasectomy / vasectomy consult / vasectomy planning/ vasectomy education.’ The observation interval included 06/01/2022 - 06/30/2022. Correlation coefficients were calculated using SPSS. Results Web searches for the term ‘vasectomy’ increased 3.6 times the average number of searches for ‘vasectomy’ during the week following the U.S. Supreme Court’s decision on abortion, and it marked the most the term had ever been searched since Google began tracking its searches in 2004. Similarly, office visits for vasectomy consultations for Hospital-1 and Hospital-2 increased by factors of 2.4 and 6.0, respectively. Internet searches for ‘vasectomy’ and the number of clinic vasectomy consultations demonstrated correlation values of r = 0.96 and r = 0.89 for Hospital-1 and Hospital-2, respectively. Conclusions Online search interest as well as clinical encounters for vasectomy consultation have increased over the past 30 days coincidentally with - and perhaps as a consequence of - the overturn of ROE v. WADE. Our study has demonstrated marked correlation between the increase in Google searches and office visits for vasectomy consultation. This may mark a watershed moment in the adoption of vasectomy for male contraception. Disclosure No

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patients were counselled regarding the impact of TT on spermatogenesis and encouraged to discontinue TT if possible. During VR, vasal and epididymal fluid (as indicated) was sampled and each aspirate underwent microscopic evaluation for sperm presence and quality and was categorized as: motile sperm/intact-non-motile sperm/sperm parts/ no sperm. Rates of sperm presence/absence in the vasal/epididymal fluid, frequency of VV/VE, post-operative patency (presence of motile sperm) and semen parameters were compared among patients on TT vs. clinically-matched patients not using TT at the time of VR.RESULTS: Among the 2622 VRs reviewed, 54 men (2%) reported using TT at the time of their VR. Despite its impact on spermatogenesis, intra-operative microscopic analysis of the reproductive fluid (vasal or epididymal) identified the presence of sperm in 95% (51/54) of patients. Testis biopsy confirmed sperm production among 3 patients with absence of sperm within the vasal or epididymal fluid. Rates of VV or VE, did not significantly differ among men using TT at the time of VR compared to nonusers. Post-operative patency rates (TT:78 % vs. No TT:94%) and mean total motile sperm counts (TMC) were lower among patients using TT at the time of VR (7.9 vs. 28.3, p[0.02).CONCLUSIONS: Use of TT at the time of VR does not appear to impact rates of intra-operative microscopic identification of sperm within the reproductive fluid or the indication for VV/VE. Postoperative patency rates and total motile sperm counts may be lowered by use of TT. Moreover, the determination to the etiology azoospermia post-operatively (production vs. obstruction) may be clouded by the use of TT during VR.

INTRODUCTION AND OBJECTIVE:The only FDA-approved medical therapy for Peyronie's Disease involves use of intralesional collagenase injection. Platelet-derived therapies have acquired increased popularity in different areas in medicine due to their potential ability in tissue regeneration. In PD, autologous platelet rich plasma (PRP) may be an emerging viable treatment. Our hypothesis is that PRP can be safely used in PD, with minimal adverse events. Therefore, we are conducting a randomized, placebo controlled, cross over study to test it.METHODS: We analyzed data of a cohort of men from the ongoing trial treated with PRP vs placebo at our center from Apr-2021 to Oct-2022. Patients received two 0.5 ml injections of PRP obtained using an autologous platelet separator (Arthrex Angel, Arthrex Inc.) or placebo directly into the dominant plaque, separated by two weeks. Patients were examined immediately after the procedure and assessed with Visual Analogue Pain Scale, and at follow-up for complications. Patients are then followed three-months post-injections, at which point they cross over into the other treatment arm for two more injections. Patients undergo goniometer measurement, IIEF-15 and PDQ questionnaire assessment, prior to crossover. (NCT04512287) RESULTS: We report data from the 29 men who completed all injections. No minor or major adverse events such as penile bruising, swelling, edema, allergy, or penile fracture were reported. No patients experienced complications at follow-up. No worsening curvature was seen in men at later evaluations.CONCLUSIONS: From our data accumulated thus far in our ongoing randomized placebo-controlled trial with PRP for PD, PRP appears to be a safe and feasible treatment modality. Our study is the first one in the USA evaluating men with PRP for PD and we believe data from our study will be important for evaluating PRP as an additional medical treatment modality for PD.

INTRODUCTION AND OBJECTIVE: Racial and ethnic disparities in prostate cancer (PCa) mortality are partially mediated by inequities in quality of care. Intermediate-and high-risk PCa can be treated with either surgery or radiation. We sought to assess the magnitude of race-based differences in cancer-specific survival between these treatment modalities.METHODS: NHB and non-Hispanic White (NHW) men with localized intermediate-and high-risk PCa, treated with surgery or radiation between 2004 and 2015 in the Surveillance, Epidemiology and End Results database were included in the study. Follow up was to December 2018. Unadjusted Kaplan-Meier curves and adjusted Fine-Gray competing-risks regression analyses with other cause of death as competing event, were employed to compare cancerspecific survival by race and treatment modality. A model with an interaction term between race and treatment was used to assess whether the type of treatment amplified or attenuated the effect of race on prostate cancer-specific mortality (PCSM).RESULTS: 15,178 (20,1%) NHB and 60,225 (79.9%) NHW men were included in the study. NHB men had a higher cumulative incidence of PCSM (p[0.005 by log-rank test) and were significantly less likely to be treated with surgery than NHW men (aOR:0.53, 95% CIs:0.51e0.55, p<0.001). In the adjusted models, NHB men were not significantly more likely to die for PCa compared to NHW men (aHR:1.11, p[0.123); while radiation was associated with a significantly higher odds of PCSM (aHR:2.03, 95% CIs:1.79-2.31, p<0.001) compared to surgery. Finally, the interaction between race and treatment on PCSM was not significant (pint [0.073), meaning that no race-based differences in PCSM were found within each treatment modality. Indeed, we found no significant difference in PCSM when comparing NHB vs. NHW men treated with surgery (aHR:1.25, 95%CIs:0.97e1.63, p[0.086) or radiation (aHR:0.95, 95%CI:0.82e1.11, p[056).CONCLUSIONS: NHB and NHW men managed with the same treatment achieved similar PCa survival outcomes in a large national cancer registry. The higher tendency for NHB men to receive radiation was similar in magnitude to the difference in cancer survival between racial and ethnic groups.