Basic and Clinical Andrology最新文献

Background: The tunica albuginea is a key anatomical structure supporting penile implants. Several factors can lead to anatomical penile defects, contributing to penile prosthesis malfunction.The aim is to describe the consequences of malleable penile implant fractures, their contribution to tunica albuginea defects, and management outcomes.

Results: All patients underwent malleable device surgery were reviwed retrospectively in our center. We included three patients with malleable penile implant disruption. Two patients underwent concomitant plication corporoplasty (PC) with device replacemen and one patient with device replacement only that showed intact tunica albuginea. The mean age at revision was 71.3 years. All patients achieved device stability and reported successful vaginal penetartion after PC and device replacement, with a median follow-up of 28 months.

Conclusions: Malleable penile device fractures are extremely rare findings. They can cause tunica albuginea disruption and tears, compromising penile penetration and device stability. Device replacement combined with PC is an essential component of successful vaginal pentration.

Background: Social media has rapidly evolved into a primary source of health-related information. For men with concerns regarding their sexual health or fertility, consulting the internet is often felt to be an accessible first-step in exploring their symptoms. Medical misinformation and over-generalisation online remain a significant concern amongst medical professionals, particularly in the current social media era of virality and sensationalism. This narrative review aims to explore the growing intersection between social media and andrology, with insights into the current medical media landscape and the opportunity to enhance health promotion.

Methods: The search strategy applied core search terms central to the scope of the review (such as "social media" and "andrology") in combination with condition-specific terms (such as "erectile dysfunction" or "testosterone") using Boolean operators to identify relevant literature within PubMed, which served as the primary electronic database, as well as online websites and social media platforms.

Results: Social media consumption is on the rise, with users consuming over two hours daily on average worldwide. Amongst posts, there has been a shift towards highly engaging short-form video content, which is particularly popular with young adults. Social media algorithms reinforce consumption patterns by continuously delivering content based on user engagement: the more an individual interacts with a topic or creator, the more related content appears, creating a self-sustaining feedback loop; this principle underpins the concept of virality and risks the rapid dissemination of inaccuracies online. Key men's health topics such as infertility, erectile dysfunction, testosterone supplementation and semen retention are popular amongst social media posts, amassing millions-to-billions of views depending on the platform. Amongst these posts, there is a high degree of misinformation. Clinicians should be confident in navigating the possible challenges associated with social media.

Conclusion: Whilst the growing presence of urologists online may have the potential to counter health-related misinformation, there are barriers inherent to social media platforms that limit the reach and impact of expert voices at present. To leverage the opportunity that social media offers, urologists are required to modernise their approach to communication in order to ensure that accurate health information is both accessible and engaging.

Background: We conducted a double-blind, randomized controlled trial to evaluate the effect of early administration of tadalafil (5 mg once daily) on persistent storage lower urinary tract symptoms (LUTS) and erectile function following transurethral resection of the prostate (TURP). All enrolled patients underwent TURP and were randomly assigned to one of two groups: Group A received tadalafil (5 mg once daily) postoperatively, while Group B received a placebo. Erectile function was assessed using the International Index of Erectile Function-5 (IIEF-5) questionnaire, and LUTS were evaluated using the International Prostate Symptom Score (IPSS). The study was conducted at a tertiary care hospital between May 2021 and October 2022.

Results: A total of 195 patients were enrolled and randomized into two groups: Group A (n = 103), which received tadalafil 5 mg once daily, and Group B (n = 92), which received a placebo. The mean ± standard deviation (SD) scores for the International Index of Erectile Function (IIEF-5) in Group A at 1, 3, and 6 months post-TURP were 11.59 ± 1.90, 19.80 ± 1.12, and 20.97 ± 0.72, respectively. In Group B, the corresponding scores were 4.88 ± 0.82, 12.86 ± 1.56, and 15.32 ± 1.28. These differences were statistically significant (P < 0.001). Similarly, the mean ± SD values for the International Prostate Symptom Score (IPSS) in Group A at 1, 3, and 6 months post-TURP were 7.31 ± 1.66, 4.46 ± 0.97, and 2.33 ± 0.69, respectively, compared to 9.62 ± 3.34, 5.40 ± 1.98, and 2.83 ± 1.27 in Group B (P < 0.001). Regarding storage symptom subscores, Group A demonstrated preoperative and postoperative mean ± SD values of 8.63 ± 1.82, 3.05 ± 0.78, 1.63 ± 0.49, and 0.92 ± 0.67 at preoperative, 1, 3, and 6 months, respectively. In contrast, Group B showed corresponding values of 3.22 ± 0.72, 2.48 ± 0.50, and 1.69 ± 0.47. These differences were also statistically significant (P < 0.001).

Conclusion: Tadalafil 5 mg daily as monotherapy following TURP can lead to early improvement in erectile function; however, its effect on persistent storage lower urinary tract symptoms (LUTS) post-TURP appears to be modest.

Trial registration: Our study has been approved by local ethical committee Kafrelsheikh university(MKSU50-3-1) on 20/5/2021 and by clinical trials (NCT06788704) on 25/1/2025.

Background: Elaboration of alternative therapeutic modality is needed, which should be safer, less costly and with no side effects. Functional Magnetic Stimulator (FMS) is a technique that was approved by the US Food and Drug Administration in 1998. We aimed to evaluate the efficacy of FMS in treating different causes of erectile dysfunction (ED).

Results: The mean baseline 15 items of the international index of erectile function (IIEF-15) scores of groups A (arteriogenic ED), B (veno-occlusive ED) and C (psychogenic ED) were 12.8 ± 2.6, 16.2 ± 3.3 and 27.5 ± 3.7, respectively. The mean post sessions IIEF-15 scores of groups A, B and C were 23.4 ± 4.1, 31.5 ± 3.5, 49.2 ± 3.5, respectively. The mean baseline domains of erectile function (EF) scores of groups A, B and C were 3.8 ± 2, 5.8 ± 3.5 and 11.5 ± 3.1, respectively. The mean post sessions domains of EF scores of groups A, B and C were 10.6 ± 3.1, 15 ± 3.6 and 24.8 ± 2.9, respectively. The mean baseline domains of orgasmic function scores of groups A, B and C were 3.3 ± 0.9, 3.9 ± 0.5 and 4.8 ± 0.4, respectively. The mean post sessions domains of orgasmic function scores of groups A, B and C were 4.8 ± 0.8 5.9 ± 1.0 and 8.6 ± 0.5, respectively. The mean baseline domains of sexual desire scores of groups A, B and C were 2.6 ± 0.6, 3.1 ± 0.7 and 4.8 ± 0.7, respectively. The mean post sessions domains of sexual desire scores of groups A, B and C were 3.6 ± 0.5, 4.4 ± 0.7 and 6.6 ± 0.6, respectively. The mean baseline domains of intercourse satisfaction scores of groups A, B and C were 1.9 ± 0.5, 2.4 ± 0.6 and 4.1 ± 0.6, respectively. The mean post sessions domains of intercourse satisfaction scores of groups A, B and C were 2.6 ± 0.5, 3.6 ± 0.5 and 5.5 ± 0.6, respectively. The baseline domains of overall satisfaction scores of groups A, B and C were 1.1 ± 0.3, 1.1 ± 0.3 and 2.4 ± 0.7, respectively. The mean post sessions domains of overall satisfaction scores of groups A, B and C were 2 ± 0.7, 2.7 ± 0.7 and 3.8 ± 0.7, respectively.

Conclusions: All patients showed significant improvement regarding domains of the IIEF-15 especially psychogenic cases following the sessions of FMS. Future studies should demonstrate the impact of these sessions on the response of poor responders to phosphodiesterase inhibitors and intracorporeal injections.

Background: Genital warts caused by human papillomavirus, significantly impact male sexual function and quality of life. However, the extent of dysfunction varies across studies, necessitating further investigation. This study aims to assess sexual dysfunction and quality of life in men with GWs.

Results: A cross-sectional study was conducted among men diagnosed with GWs. Sexual function was evaluated using the International Index of Erectile Function while the Dermatology Life Quality Index measured quality-of-life impairment. Data were analyzed to determine the severity and distribution of dysfunction across domains. Erectile dysfunction was prevalent, with a mean International Index of Erectile Function score of 14.3 ± 4.2, indicating moderate dysfunction. Orgasmic satisfaction (5.8 ± 2.1) and overall satisfaction (6.5 ± 2.4) were also moderately affected. Quality of life was significantly impaired, with 36.7% experiencing moderate impact, 26.7% reporting a very large impact, and 8% suffering an extreme impact.

Conclusion: Genital warts contribute to substantial sexual dysfunction and diminished quality of life. The results highlight the need for routine sexual health assessments and psychological support. Integrating medical and psychosocial care may improve patient outcomes.

Background: Congenital bilateral absence of the vas deferens (CBAVD) is a rare condition associated with male infertility. CBAVD is often accompanied by other genitourinary anomalies, including abnormalities or agenesis of the seminal vesicles and kidneys. While it is expected that CBAVD always coexists with seminal vesicle agenesis due to a shared embryologic origin, some studies report the presence of seminal vesicles in certain CBAVD patients. This study aims to assess the status of seminal vesicles in CBAVD patients and explore the relationship between seminal vesicle presence and semen parameters.

Methods: In this multi-center, retrospective cross-sectional study, we reviewed data from 47 CBAVD patients diagnosed between 1994 and 2024. Data collected included demographic information (age, height, weight, BMI), physical examination findings (vas palpation), and imaging results (trans-rectal ultrasound for seminal vesicle status, abdominal and pelvic ultrasound for kidney status). Laboratory data included serum FSH, LH, and testosterone levels, as well as semen analysis results (pH, fructose, and volume). Patients were classified into three groups based on seminal vesicle status: bilateral agenesis, unilateral agenesis, and bilateral presence.

Results: Among the 47 CBAVD patients, 29 had bilateral agenesis of the seminal vesicles, 9 had unilateral agenesis, and 9 had bilateral presence. No significant differences were found between the groups regarding weight, height, BMI, or serum levels of LH, FSH, and testosterone. Additionally, semen analysis revealed that 89.4% of patients had abnormal pH, 93.6% had abnormal volume, and all patients had abnormal semen fructose. There were no significant differences between the groups in semen pH, fructose, or volume.

Conclusion: Our findings suggest that the presence or absence of seminal vesicles in CBAVD patients does not significantly affect semen parameters. This may be due to dysfunction of the seminal vesicles in those with a present organ.

Background: The embryological development of the testicles and their descent to the scrotum is multifactorial process, and the role of the internal inguinal ring has not yet been clarified. In this study, we aimed to assess the role of the internal inguinal ring in this process by comparing the inguinal and abdominal orchiectomy specimens histopathologically. The patients were classified according to localization of the undescended testicle as group 1 (n = 11), consisting of abdominal-localized individuals, and group 2 (n = 40), composed of inguinal-localized individuals. Data regarding age, side of the undescended testicle, testicular volume, spermatic cord length, testosterone level, semen analysis, and histopathological reports of undescended testicles in both groups were analyzed and compared.

Results: The median age of groups 1 and 2 was twenty-one. The median testicular volume was significantly lower in group 1 than in group 2 (p = 0.002). In addition, progressive motility and normal sperm morphology rates were substantially higher in group 2 than in group 1 (p = 0.019 vs p = 0.029). There was no difference between the groups in terms of analyses of histopathological parameters performed in testis tissue. (p > 0.05).

Conclusions: Although testicular volume, sperm motility, and normal morphology rates were lower in abdominal testes, no significant differences were found in histopathological parameters between the groups.

Background: Varicocele is a major male infertility issue, and Malva sylvestris shows promise as a treatment due to its antioxidant properties. The present study evaluated the protective effects of Malva sylvestris on testicular health, sperm quality, and oxidative stress-related gene expression. Adult male Wistar rats were randomly assigned into five groups (n = 8): the control group, the varicocele model group, the varicocele group with partial occlusion of the left renal vein treated with 750 or 1500 mg/kg Malva sylvestris for 21 days, and a surgical sham group. The epididymal content and Histological analyses of animals testicular tissue were examined to evaluate fertility parameters, and qRT-PCR was employed to determine the expression of SIRT1, FOXO1, NRF2, NF-κB, and TGF-β genes.

Results: Varicocele leads to the induction of apoptosis, the occurrence of DNA damage, a reduction in SIRT1 and FOXO1, and an increase in NRF2, TGF-β, and NF-κB gene expression. According to Histological morphometric analysis, treatment with Malva sylvestris showed the increased thickness of Mean Seminiferous Tubule Diameter and Epithelial Thickness in the spermatogenic epithelium, as well as the presence of a greater number of germ cells and mature sperm. In this study, Malva sylvestris treatment showed antioxidative effects since it upregulated the expression of SIRT1 and FOXO1 genes and downregulated the expression of NF-κB, NRF2, and TGF-β genes.

Conclusion: Based on the findings, Malva sylvestris as cytoprotective agent modulate key antioxidant pathways, including upregulation of SIRT1 and FOXO1 (linked to cellular repair and OS resistance) and downregulation of pro-inflammatory mediators; then, Malva sylvestris as a promising natural antioxidant for managing varicocele-related infertility, offering a potential adjunct or alternative to conventional therapies.

Background: Peyronie's disease progresses through acute (inflammatory) and chronic (fibrotic) phases. Objective biomarkers for phase differentiation are lacking. Neutrophil-to-eosinophil ratio has been evaluated as an inflammatory marker in PD and reported as an important marker in the inflammatory phase. We evaluated the Hemoglobin, Albumin, Lymphocyte, and Platelet score as a non-invasive indicator of Peyronie's Disease phases.

Results: A retrospective cohort of 216 Peyronie's disease patients were analyzed. Blood parameters were collected at diagnosis (acute phase) and follow-up (chronic phase) in 112 patiens. Hemoglobin, Albumin, Lymphocyte, and Platelet scores were compared using receiver operating characteristic curves and paired t-tests. Hemoglobin, Albumin, Lymphocyte, and Platelet scores increased significantly from 36.8 ± 8.2 (acute) to 47.5 ± 10.4 (chronic) in 112 paired patients (p <0.001). Receiver operating characteristic analysis identified a cutoff of>41.2 for chronic phase detection (area under the curve = 0.83, sensitivity 76%, specificity 71%, positive predictive value 73.9%).

Conclusion: The Hemoglobin, Albumin, Lymphocyte, and Platelet score is a cost-effective tool for differentiating Peyronie's Disease phases, aiding clinical decision-making.

Background: Varicocele adversely affects male fertility by impairing semen quality, yet there remains no unified approach that combines advanced imaging and laboratory markers for clinical stratification. To develop a uniform clinical stratification system, we conducted a review of the literature across major databases.

Results: Shear wave elastography thresholds above 5.235 kPa and spermatic vein diameters exceeding 2.5 mm on color Doppler ultrasound demonstrated strong, independent correlations with decreased sperm concentration, motility, and morphology. Among laboratory tests, elevated follicle-stimulating hormone, low inhibin B, and others were consistently linked to poorer semen quality. Biomarkers such as cysteine-rich secretory protein 3 showed potential.

Conclusions: We propose a multimodal stratification framework integrating evidence‑based cutoffs for shear wave elastography and color Doppler ultrasound with key laboratory indices. Adoption of standardized protocols and consensus guidelines will facilitate personalized diagnosis, improve prognostic accuracy, and guide management of varicocele‑decreased semen quality.