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Introduction Donor robotic partial hepatectomy is evolving as a low morbidity method for liver transplantation. However, we have noticed that two of our patients complained of de novo sexual dysfunction following their surgery. Factors that may lead to the dysfunction are liver dysfunction and stress. Objective We set out to objectively evaluate the impact of robotic partial hepatectomy on sexual function in sexually active men. Methods This prospective study involved a cohort of married men with no prior sexual dysfunction who consecutively presented for a liver donation from Jan 2021 to Mar 2022. Robotic partial hepatectomy was performed using three ports and a Da Vinci XI system, and a small Pfannenstiel incision was used to deliver the specimen. We performed a preoperative assessment of sexual function using the IIEF-15 questionnaire [1], liver function using the CLDQ-29 questionnaire [2], and perceived stress PSS-14 questionnaire [3]. Lab investigations included hormonal profile, liver function, and renal function. The postoperative assessment was repeated after three months. Continuous data were compared using paired t-test. References: 1. Rosen RC, et al (1997) Urology 49:822–830 2. Younossi ZM, et al (1999) Gut 45:295–300. 3. Cohen S, et al (1983) J Health Soc Behav. 24:385-96. Results Twenty-eight male donors, with a median age of 31.5 SD 6.2 range 19-42 years, and BMI of 24.2 SD 4.2 range 17.9-33.1 kg were studied. At baseline, all had no sexual dysfunction, liver disease, or comorbidities. Preoperative median morning testosterone was 15.8 SD 4.1 range 10.6-26.6 nmol/L. All patients had normal hepatic and renal function. Three months postoperatively, no patient-reported sexual dysfunction. There was no significant difference in the IIEF-15 erectile function domain pre and postoperative, respectively (mean 27.2 SD 5.3 and 27.7 SD 5.4, p = 0.162). There was no significant change in the desire, orgasmic, or satisfaction domains. There was no significant change in the average CLDQ-29 score (6.9 SD 0.33 and 6.9 SD 0.33, p=0.378) or its domains of abdominal symptoms, fatigue, systemic symptoms, activity, emotional function, and worry. There was no significant change in the stress level before and after surgery, with PSS-14 total scores of 21.6 SD 6.6 and 21.5 SD 6.7, p=0.739, respectively. Conclusions In this small prospective cohort, we did not find a significant association between donor robotic partial hepatectomy and the development of sexual dysfunction. However, a study involving a larger number of patients may reveal more subtle changes in sexual function and underlying mechanisms. Disclosure No

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Percutaneous nephrolithotomy (PCNL) is a difficult treatment for treating kidney stones, especially when there are orthopedic or skeletal abnormalities. Here, in a 19-year-old male, we describe a two-step PCNL with a case of caudal regression syndrome (CRS) and a pelvic kidney, with an extremely deformed neurogenic bladder on intermittent catheterization. Our conclusion is that PCNL may be done safely with minimum morbidity in patients with caudal regression syndrome by utilizing adult equipment for heavy stone burdens, allowing full and rapid stone removal.