Aging Male最新文献

Introduction: Hypogonadism, while common, can be devastating with long-term ramifications. There are multiple treatment options, but most are burdensome leading to poor compliance. Administration of testosterone (T) pellets offers consistent blood levels based on the implantation of pellets that dissolve over months. Guidelines for pellet dosing has been absent and often men are overdosed with T. The goal of the study was to evaluate the effect of pellet dose versus surface area on blood levels over 3 months in healthy men.

Methods: One group of men were administered small individual pellets that resulted in higher surface than the other group, but at a lower dose.

Results: Within 2 weeks the T levels had risen over two times the baseline level in both groups, but the cohort administered the lowest T dose (but highest surface area) had the greatest response whether calculated as peak change or when analyzed according to age-adjusted values. Increasing the pellet surface area resulted in fewer extrusions, no adverse events, and higher serum T levels compared to subjects that received a higher dose with a lower surface area.

Conclusion: Presently there appears to be no negative consequences of administering T pellets using methods that maximize the total pellet surface area.

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.

Background: Erectile dysfunction (ED) is on the rise globally, affecting people's lives. This article uses Mendelian randomization (MR) to analyze the causal relationship between clinical indicators and ED, and explores the potential metabolic mechanisms involved.

Method: Two-sample MR analysis was performed to analyze the causal relationships between 1,400 metabolites and clinical data and ED for revealing its potential metabolic mechanisms using GWAS (Genome-wide association studies) data. The stability of MR analysis was assessed using sensitivity analysis. We then used clinical data to confirm the MR analysis results.

Results: The research results indicated that elevated lymphocyte count (LC) can lead to ED risks. To confirm that LC and ED are causally related, we gathered clinical data. We further revealed potential metabolic mechanisms and found that LC can not only reduce the metabolite 4-methylcatechol sulfate levels, lowering the metabolite 4-methylcatechol sulfate levels to increase the risk of ED, and can also increase the metabolite X-24801 levels, raising the metabolite X-24801 levels to increase the risk of ED.

Conclusions: A rise in LC could raise the risks of ED by negatively regulating the metabolite 4-methylcatechol sulfate levels and positively controlling the metabolite X-24801 levels.HighlightsThis article uses Mendelian randomization analysis to determine the causal relationship between lymphocyte count and erectile dysfunction, and uses sensitivity analysis to determine its stabilityRevealed the potential mechanism by which lymphocyte count increases the risk of erectile dysfunctionCollecting clinical data validated the results of Mendelian randomization analysisAt present, the methods and efficacy of treating erectile dysfunction in clinical practice are limited. This study provides new ideas for clinical diagnosis and treatment of erectile dysfunction.

Infertility is a pressing reproductive health issue in modern society, with male factors accounting for approximately 50% of all cases. However, most research on male infertility has primarily focused on the testis, often ignoring the critical role of the prostate. As the largest male reproductive gland, the prostate plays a vital role in semen quality. Prostatic fluid, a major component of semen, significantly influences sperm function and overall male fertility. Prostatitis, the most common prostate disorder among men, particularly with advancing age, can severely impair reproductive health. This article aims to explore the fundamental physiological functions of the prostate, the etiology of prostatitis, and its impact on sperm health. It also discusses potential treatment strategies for prostatitis. Through this review, we hope to deepen understanding of the prostate's crucial role in male infertility.

Purpose: This study aimed to assess the efficacy and safety of early pelvic floor rehabilitation bioelectrical stimulation (BES) in postpartum stress urinary incontinence (SUI).

Methods: a total of 120 patients with postpartum SUI were divided into two groups: normal group and combined group. The normal group received conventional pelvic floor muscle training (PFMT), and the combined group received pelvic floor rehabilitation BES based on the normal group. International consultation on incontinence questionnaire short form, female sexual function index, pelvic floor muscle strength, and urine pad test were used. Pelvic floor function and urodynamic level were detected. Serum estradiol, luteinizing hormone, and progesterone were detected.

Results: The clinical effective rate of the normal group and the combined group was 68.3% and 96.7%, and the complication rate was 30.0% and 10.0%, respectively. Compared to the normal group, the female sexual function index score and pelvic floor muscle strength were significantly increased, and the urine leakage and incontinence questionnaire short form score were significantly decreased in the combined group 12 weeks later.

Conclusion: PFMT plus rehabilitation BES can visibly improve the vaginal function, pelvic floor function, and urodynamics of patients with postpartum SUI.

Objective: Study on the effect of targeted drugs on lower urinary tract symptoms (LUTS) in elderly men.

Methods and materials: A retrospective study was conducted on elderly male patients aged 60 and above with pathologically diagnosed renal cell carcinoma who received targeted drug therapy. Analyze the prostate volume, international prostate symptom score (IPSS), physical fitness score, and other indicators of these patients before and after receiving targeted therapy. So as to study the effect of targeted drugs on LUTS.

Results: A total of 47 patients were surveyed, with an average age of 70.32 ± 7.724 years, and age was significantly correlated with worsening of LUTS. The medication duration is 2-49 months; The average duration of medication was 13.72 ± 9.611 months. With the prolongation of targeted drug treatment time, the occurrence and aggravation of LUTS significantly increase.he logistic regression analysis results indicate that age and duration of medication are both risk factors for the deterioration of LUTS.

Conclusions: It should be cause for concern that use of anti-vascular targeting drugs in elderly men may promote the side effects of LUTS.

Objective: To analyze the relationship between changes in central obesity-related indices and cognitive decline in middle-aged and elderly populations.

Methods: Using 2011 and 2015 data from China Health and Retirement Longitudinal Study (CHARLS), 2,144 participants aged ≥45 were included. Changes in 5 indices (body roundness index (BRI), a body shape index (ABSI), weight-adjusted-waist index (WWI), relative fat mass (RFM), conicity index (CI)) over 4 years were calculated. Cognitive function was assessed via episodic memory and mind status. Logistic regression (with sensitivity analysis), restricted cubic spline models (for non-linear relationships/threshold effects), and gender-stratified subgroup analysis were used.

Results: Participants with stable/moderately increased indices had lower cognitive decline risk than those with significant decreases. vs. Q1, Q3 ORs for overall cognitive decline were 0.70 (95%CI:0.55-0.89), 0.77 (0.61-0.98), 0.76 (0.59-0.96), 0.69 (0.54-0.88), 0.78 (0.61-0.98) for the 5 indices. A U-shaped association was found; the association existed in men but not women.

Conclusion: Moderate increase in men's central obesity indices may reduce cognitive decline risk (excessive increase may raise it), suggesting monitoring these indices in middle-aged/elderly men to prevent cognitive decline.

Objective: This study presents a rare instance of retroperitoneal reproductive vascular capillary hemangioma, offering a review and critical discourse on pertinent scholarly works.

Methods: We conducted a detailed follow-up on a patient who received a robot-assisted laparoscopic excision for the said hemangioma. Postoperatively, the patient's clinical data were meticulously monitored, and a thorough analysis of the hemangioma's clinical profile was performed, integrating pathological assessments and immunohistochemical (IHC) findings to formulate innovative diagnostic and therapeutic perspectives.

Results: The pathological report of the patient's left retroperitoneal tumor was a capillary hemangioma with a diameter of 3 cm and a gray-red, solid, soft-cut surface; IHC showed: CD31 (+), CD34 (+), CK-pan (-); The patient was followed up for 2 years without any signs of recurrence or metastasis.

Conclusions: Initial diagnostic considerations on retroperitoneal tumors should extend to capillary hemangiomas, which are often overlooked and prone to misdiagnosis; The early and judicious examination of retroperitoneal tumors, particularly utilizing abdominal enhanced CT when renal function is adequate, is of paramount importance for tumor localization and preliminary characterization; While hemangiomas are typically benign, the scarcity of retroperitoneal capillary hemangioma cases necessitates broader clinical studies and statistical analysis for a more nuanced understanding of these tumors.

Purpose: Although several reviews have evaluated the use of PDE5 inhibitors (PDE5i) for treating erectile dysfunction (ED), their specific use in middle-aged and old patients has not been fully evaluated. Given that elderly patients with ED often have a complex combination of systemic and sexual health risk factors, the safety and efficacy of PDE5i in such a context are hereby reviewed.

Materials and methods: A thorough examination of existing literature has been conducted on PubMed.

Results: PDE5i has good safety and efficacy, but the situation is more complex for patients with hypogonadism than those with normal testosterone levels, with reduced responsiveness to PDE5i. In this case, combination therapy with testosterone is recommended, safe and effective.

Conclusions: Eliminating or reducing reversible risk factors and controlling or slowing the development of irreversible factors is an important foundation for using PDE5i to treat ED in all patients, especially middle-aged and elderly ones.