Aging Male最新文献

Background: The goal of this meta-analysis intended to identify the efficacy of platelet-rich plasma (PRP) alone or in combination with low intensity shock wave therapy (Li-SWT) as a therapy for erectile dysfunction (ED).

Methods: This study integrated and analyzed the data using Cochrane method and GRADEpro GDT grading system. The registration number for this study was CRD42024618240.

Result: Seven randomized controlled trials with 660 patients were analyzed. The results indicated that compared with the control group, IIEF score of patients in the PRP group improved significantly at 12-week (p = 0.03) and 24-week (p = 0.0004), while there was no significant difference at 4-week. The PRP group had no significant advantages over the control group in terms of MCID and SEP Q3. For peak systolic velocity, patients in the PRP group demonstrated greater improvement than those in the control group (p < 0.00001). Subgroup analysis revealed that adding PRP regimen can considerably improve IIEF scores of ED patients compared to using Li-SWT alone (p < 0.0001).

Conclusion: PRP demonstrated a better efficacy in treating ED, especially during a follow-up period of 6 months. Compared with using Li-SWT alone, the addition of PRP can considerably improve the IIEF score of ED patients. These findings still required large-scale clinical trials for verification.

Purpose: This study evaluates the effectiveness of artificial urinary sphincter (AUS) implantation following transperineal reanastomosis in men with vesicourethral anastomotic stenosis (VUAS) and stress urinary incontinence (SUI) after radical prostatectomy (RP), focusing on long-term explantation rates and urinary continence.

Methods: Patients treated between 2009 and 2020 were retrospectively analyzed. Those undergoing AUS implantation post-transperineal reanastomosis for recurrent VUAS, excluding cases with prior pelvic irradiation and overactive bladder, were included. Primary outcomes were AUS explantation rates and patient-reported continence. Median follow-up was calculated using reverse Kaplan-Meier estimates, and explantation-free survival illustrated via Kaplan-Meier analyses.

Results: At final follow-up, 19 patients were included at a median follow-up of 79 months. Explantation occurred in 16% (N = 3) of cases, with a median time to explantation of 107 months. No urethral erosion was observed. Explantation-free survival at 2, 5, and 10 years was 100%, 87%, and 73%, respectively. The median number of pads/day decreased significantly postoperatively, with 78% (N = 14) reporting subjective continence and 89% (N = 16) achieving social continence.

Conclusion: AUS implantation following transperineal reanastomosis for VUAS post-RP offers favorable long-term outcomes, with low explantation rates and no erosion, making it a viable management strategy.

Objectives: This study aimed to elucidate the correlation of Visceral Adiposity Index (VAI) with prostate cancer (PCa) among men aged 40 years and older in the United States.

Methods: Analysis included multivariate linear and logistic regression, smoothing curve fitting, and threshold effect evaluation using 2003-2010 National Health and Nutrition Examination Survey (NHANES) data. The stability of this relationship across demographic groups was assessed via subgroup analyses and interaction tests.

Results: Among 2,768 participants, those with elevated VAI displayed lower total prostate-specific antigen (tPSA) levels and reduced PCa risk. Each VAI unit elevation corresponded to a 0.075 ng/mL tPSA reduction [-0.075 (-0.145, -0.005)] and 18.8% PCa risk reduction [0.812 (0.687, 0.960)]. Top-quartile VAI individuals exhibited 0.282 ng/mL reduced tPSA [-0.282 (-0.557, -0.007)] and 49.7% reduced PCa risk [0.503 (0.282, 0.896)] relative to bottom-quartile counterparts. This inverse relationship was more pronounced in men ≥70 years. Moreover, VAI-tPSA in other races demonstrated a U-shaped pattern, with a 2.09 inflection point. At the same time, a Mexican American subgroup exhibited an inverted U-shape for VAI and PCa risk, with a 1.42 inflection point.

Conclusion: In men aged ≥70, VAI indicates an inverse PCa relationship. However, PSA-based PCa screening may be influenced in visceral-obese individuals aged <70.

Background and objectives: Type 2 diabetes mellitus (T2DM) is a common chronic disease in the elderly. Comorbidities, especially neuropathy and retinopathy, significantly increase fall risk in this group. This study aimed to identify fall risk factors in older adults with T2DM.

Materials and methods: From January to June 2024, 242 T2DM patients aged 65 and older were followed at the internal medicine outpatient clinic. Fall risk was assessed using the Performance Oriented Mobility Assessment (POMA), Hendrich II Fall Risk Model (HIIFRM), Barthel Activities of Daily Living Index, and Clinical Frailty Scale (CFS).

Results: Among the patients (median age = 70 years), 41.3% had experienced at least one fall in the previous year. Factors, such as age and diabetes duration were associated with falls. Notably, hypoglycemia (aPR: 1.90, p = 0.017), polypharmacy (aPR: 2.39, p = 0.004), osteoarthritis (aPR: 2.48, p = 0.017), (aPR: 1.70, p = 0.025), and malnutrition (aPR: 1.90, p = 0.007) were independently associated with fall risk.

Conclusions: Fall risk in elderly outpatients with T2DM was linked to various factors, including hospitalization, malnutrition, osteoarthritis, polypharmacy, neuropathy, and hypoglycemia. To mitigate this risk, patient-specific care plans are recommended.

Objective: Sexual function preservation is a paramount concern for patients undergoing benign prostatic hyperplasia (BPH) surgery, increasingly recognized by physicians. Blue laser vaporization, a novel approach for BPH treatment, has yet to be thoroughly investigated for its effects on sexual function. This prospective study assesses the impact of blue laser vaporization on sexual function in BPH patients, focusing on patient perceptions.

Methods: This study prospectively enrolled BPH patients undergoing blue laser vaporization at our hospital since January 2023. We evaluated the treatment's effectiveness and its impact on preserving sexual function using standardized questionnaires. These included the International Index of Erectile Function (IIEF-5), the Male Sexual Health Questionnaire for Ejaculatory Dysfunction (MSHQ-EjD), and both the International Consultation on Incontinence Modular Questionnaire for Male Lower Urinary Tract Symptoms (ICIQ-MLUTS) and its sexual function component (ICIQ-MLUTSsex).

Results: We included 67 BPH patients with a median age of 65 years in this study, monitoring them for over three months. The results indicate that blue laser vaporization significantly improved International Prostate Symptom Score, Quality of Life, and ICIQ-MLUTS scores in BPH patients (p < 0.001), along with a reduction in post-void residual volume (p < 0.001). Importantly, there were no significant changes in the IIEF-5 score, MSHQ-EjD score, and ICIQ-MLUTSsex score, indicating preservation of sexual function post-surgery.

Conclusion: Blue laser vaporization effectively alleviates lower urinary tract symptoms in BPH patients while preserving erectile and ejaculatory functions.

Introduction: Infertility is a major public health issue, with male factors alone contributing to 20-30% of cases. Non-obstructive azoospermia (NOA) is the most severe form, and although techniques like microdissection testicular sperm extraction (mTESE) offer hope, it remains challenging due to its uncertain causes. This study investigates the correlation between testicular histopathology and clinical parameters to enhance sperm retrieval (SR) prediction.

Materials and methods: We reviewed 57 azoospermic men from Hanoi Medical University Hospital, recruited between January 2021 and September 2023. Inclusion criteria were confirmed azoospermia and exclusion of known NOA causes. All underwent mTESE with testicular biopsies classified into four histopathological patterns.

Results: The patients' mean age was 31.75 ± 5.19 years. SR was successful in 19.3% (11/57). Higher follicle-stimulating hormone (FSH) levels were noted in SR-positive men (p = 0.02). Sertoli cell-only syndrome (SCOS) was the most common pattern. While we found a significant difference in SR rate between testicular histopathology, multivariate analysis showed no strong association. However, FSH levels were predictive of histopathology patterns.

Conclusions: Idiopathic NOA (iNOA) represents over 60% of azoospermia cases. mTESE remains the gold standard, and FSH levels may help predict testicular histopathology patterns and improving patients prognosis of SR outcomes.

Objective: to report a case of familial hypocalciuric hypercalcemia (FHH) in an older patient and highlight the diagnostic challenges in geriatric populations.

Case presentation: We report the diagnosis of FHH in an 88-year-old polypathological patient with hypercalcemia discovered during a check-up for cardiac decompensation. Despite a confusing clinical presentation with gout symptoms, including repeated episodes of knee arthritis, persistent hypercalcemia conducted further investigations. Biological tests excluded primary or hyperparathyroidism and malignancy-related hyperparathyroidism, confirming the diagnosis of FHH through the detection of an inhibitory mutation in the calcium-sensing receptor gene.

Conclusion: This case suggests to clinicians the possibility of FHH in older patients with unexplained hypercalcemia. In geriatric patients, the diagnosis is complicated because of the poly-pathology: here hypercalcemia was associated with a confusing gout crisis, which was triggered by diuretic treatment for heart failure.

Background: Erectile dysfunction (ED) is a common disorder that significantly impacts quality of life, and phosphodiesterase type 5 inhibitors (PDE5is) such as tadalafil are one of the primary treatments. However, some patients remain unresponsive, necessitating further investigation.

Objective: To investigate the association between systemic inflammatory response index (SIRI) and tadalafil unresponsiveness in erectile dysfunction patients.

Methods: A total of 106 male patients who applied to the Andrology outpatient clinic with ED complaints between January and June 2024 were included in the study. Patients were started on daily tadalafil 5 mg therapy, and response was assessed after one month using the International Index of Erectile Function Erectile Function domain (IIEF-EF). SIRI values, calculated using neutrophil, monocyte, and lymphocyte counts, were compared between tadalafil-responsive and unresponsive groups.

Results: Tadalafil unresponsiveness was observed in 48.1% of patients. Non-responders had significantly higher mean age(57.44 ± 12.52 vs. 47.22 ± 11.49, p < 0.001), BMI(27.22 ± 3.17 vs. 25.85 ± 2.92, p = 0.023), and SIRI values(1.33 ± 0.82 vs. 1.02 ± 0.40, p = 0.016) compared to responders. Multivariate analysis identified age(OR = 1,641, p = 0.001) and SIRI(OR = 2.420, p = 0.014) as independent predictors of tadalafil failure. ROC curve analysis revealed a SIRI cutoff of 1.03 (AUC = 0.617) with 69.1% sensitivity and 61.2% specificity.

Conclusion: Findings suggest that systemic inflammation plays a key role in ED pathophysiology and may impair PDE5i efficacy.

Background: The aim of this study was to examine the relationship between the type/frequency of consuming beverages and ED among men in America.

Methods: We used data on erectile function and the frequency of beverage consumption from the National Health and Nutrition Examination Survey (NHANES) 2003-2004. Associations between ED and beverage consumption were analyzed using univariate and multivariate logistic regression. We also stratified by age and adjusted for potential confounders using propensity score matching (PSM).

Results: After fully adjusting for covariates, logistic regression showed that regular grape juice consumption (≥ 5 times/week) was related to a lower prevalence of ED (OR = 0.21, 95% CI: 0.08-0.54, p = 0.001). Subgroup analyses found that this correlation remained significant for those over 40 years of age (all p < 0.05). After PSM adjustment, the association between grape juice consumption and ED remained statistically significant (OR = 0.12, 95% CI: 0.03-0.44, p = 0.001). Various beverage types, encompassing tomato, orange, apple, pineapple, and lemonade juices, as well as soft drinks, exhibited a correlation with ED in the initial univariate regression analysis.

Conclusions: In men, regular intake of grape juice (≥ 5 times/week) was associated with a lower prevalence of ED, which was particularly significant in men over 40 years of age.

Purpose: The quantitatively measured sperm DNA damage and disturbed chromatin condensation indexes (%DNA fragmentation index [DFI%] and %high DNA staining index [%HDS]) and their relationships with sperm quality in normospermic men with unexplained infertility were investigated. The aim was also highlighting the impact of age on both DFI and CMA3 staining and on sperm quality, and their associations with male infertility.

Methods: In this retrospective study, conventional semen tests, including sperm motility and morphological evaluations and DFI and disturbed chromatin condensation indexes (DFI, CMA3) were performed according to the World Health Organization (WHO) 2021 criteria. DFI and CMA3 were evaluated using sperm chromatin dispersion (SCD) and chromomycin A3 (CMA3) staining assays and then correlation and regression analysis were done.

Results: By analyzing SCD and CMA3 results, notable differences were found in sperm parameters among different DFI and CMA3 groups (all p < 0.05). It was found that in the male fertility quality sperm concentration, progressive (PR)/non-progressive (NP) motility, immobility, and morphology were significantly associated with sperm DFI and CMA3, but not with age (p < 0.05).

Conclusions: Sperm molecular index DFI and CMA3 negatively affect male fertility quality through semen parameters (sperm concentration, motility, and morphology). SCD and CMA3 indexes show a significant negative correlation with sperm quality in normospermic males, which highlights its role in the assessment of male fertility potential and molecular evaluation of infertility treatment.