Aging Male最新文献

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.

Background: Obstructive sleep apnea (OSA) is linked to various health complications, including erectile dysfunction (ED), which is more prevalent in individuals with OSA. This study explored ED in Korean OSA patients and assessed the impact of continuous positive airway pressure (CPAP) therapy on ED.

Methods: A total of 87 male patients with OSA from four different sleep centers underwent physical measurements and completed sleep and mental health (MH) questionnaires, including the Korean version of the International index of erectile function (IIEF), before and three months after initiating CPAP therapy.

Results: After three months of CPAP therapy, the patients demonstrated a significant improvement in ED as measured on the IIEF. However, the study found no significant correlation between the duration of CPAP use and the improvement in IIEF score. It did identify the SF36 quality of life assessment as a significant factor influencing ED improvement after CPAP.

Conclusions: ED is a prevalent issue that escalates with age and is associated with OSA. CPAP therapy has shown potential in alleviating ED symptoms, particularly in those with underlying psychological conditions, although further research is required to confirm these findings and understand the underlying mechanisms.

Background: Premature ejaculation (PE) is a common concern for men and their partners, but current diagnostic tools mainly focus on men who have vaginal intercourse. The Masturbation Premature Ejaculation Diagnostic Tool (MPEDT) was created to address this gap, but its effectiveness for men who only engage in self-masturbation has not been studied. This research aimed to determine the frequency of self-reported PE patients who do not have vaginal intercourse and to evaluate the diagnostic accuracy of MPEDT for this group.

Method: The study involved 446 male patients aged 18 to 40, and 40 non-self-reported-PE and non-vaginal-intercourse healthy males. Participants completed the MPEDT questionnaire and reported their recent six-months sex frequency.

Result: Among the patients seeking treatment for PE, 21.75% had not engaged in vaginal intercourse in the past six months. Of the PE patients who completed the MPEDT questionnaire (86 patients), 90.7% were diagnosed with masturbatory-PE (MPE). The sensitivity for self-reported MPE and specificity for self-reported non-MPE were 93.02% and 72.5%, respectively.

Discussion: For patients who have not had vaginal intercourse in the past six months but engage in masturbation and seek treatment for PE, the PEDT may not effectively assess their ejaculatory function. The MPEDT, however, can effectively evaluate their ejaculatory function. This study also emphasizes the need for diagnostic tools tailored to this population.

Background: Worldwide, the evidence-based 4Ms framework of the Age-Friendly Health System (AFHS) improves the experience of caring for older adults. This study aimed to examine healthcare professionals' perceptions, attitudes, and behaviors regarding the AFHS and 4Ms before they were implemented.

Methods: This study was a questionnaire-based survey of 252 healthcare professionals in geriatrics and long-term care departments, Rumailah Hospital, Acute Care Services in Hamad General Hospital, and home healthcare services to assess their perceptions, attitudes, and behaviors regarding 4Ms from November 1, 2022, to July 31, 2023.

Results: Most respondents acknowledged the benefits of providing care through AFHS. However, only 62% of respondents reported using the 4Ms framework. The most commonly used types of age-friendly care provided by health care professionals were reviews of high-risk medication use (64.2%) and screening for mobility limitations (55.8%).

Conclusion: The findings suggest that there is a need for more training and education regarding the 4Ms framework for health care providers. This training should focus on specific aspects of the framework, such as how to assess what matters most to older adults; how to manage their mobility, mentation, and medication; and how to coordinate care across settings.

Objectives: To compare the evolution of health-related quality of life (HRQoL) over 6 months of GnRH agonist (GnRHa) therapy among age groups for patients with prostate cancer (PCa).

Patients and methods: PRISME (NCT03516110) was a non-interventional, prospective study conducted in France in patients aged ≥60 years with PCa initiating GnRHa therapy within routine care. HRQoL was evaluated at baseline and after 6 months using the EORTC quality of life in ELDerly cancer patients 14 items (QLQ-ELD14) questionnaire. Cognitive status was assessed using the Mini Mental State Examination (MMSE). Analyses of covariance compared the evolution of the change from baseline of the QLQ-ELD14 scores among age groups.

Results: 814 patients were enrolled (245, 60-70 years; 314, 70-75 years; 252, ≥75 years). Slight or no changes were observed in each QLQ-ELD14 dimension between baseline and 6 months, overall and by age. In the primary effectiveness analysis, there was no difference among age groups in the change from baseline in QLQ-ELD14 scores. Baseline cognitive status was lower in the oldest age group, but there were no changes in all age groups. As expected, sexual function declined in all age groups.

Conclusion: GnRHa therapy influence on HRQoL, cognition and sexuality appeared independent of age.