Search

The article discusses the establishment of the Global Andrology Forum (GAF) as a collaborative research group aiming to revolutionize the field of andrology. GAF focuses on addressing issues related to men's sexual and reproductive health, promoting overall well-being, and advancing research and clinical practices. The forum has a diverse membership from 85 nations, emphasizing collaboration, leadership, mentorship, adaptability, and access to resources to drive innovation and progress in male reproductive health. GAF has published numerous peer-reviewed papers, organized webinars, and training programs, showcasing its impactful contributions to the field. [Extracted from the article]

Purpose: Non-obstructive azoospermia (NOA) is a common, but complex problem, with multiple therapeutic options and a lack of clear guidelines. Hence, there is considerable controversy and marked variation in the management of NOA. This survey evaluates contemporary global practices related to medical and surgical management for patients with NOA. Materials and Methods: A 56-question online survey covering various aspects of the evaluation and management of NOA was sent to specialists around the globe. This paper analyzes the results of the second half of the survey dealing with the management of NOA. Results have been compared to current guidelines, and expert recommendations have been provided using a Delphi process. Results: Participants from 49 countries submitted 336 valid responses. Hormonal therapy for 3 to 6 months was suggested before surgical sperm retrieval (SSR) by 29.6% and 23.6% of participants for normogonadotropic hypogonadism and hypergonadotropic hypogonadism respectively. The SSR rate was reported as 50.0% by 26.0% to 50.0% of participants. Interestingly, 46.0% reported successful SSR in <10% of men with Klinefelter syndrome and 41.3% routinely recommended preimplantation genetic testing. Varicocele repair prior to SSR is recommended by 57.7%. Half of the respondents (57.4%) reported using ultrasound to identify the most vascularized areas in the testis for SSR. One-third proceed directly to microdissection testicular sperm extraction (mTESE) in every case of NOA while others use a staged approach. After a failed conventional TESE, 23.8% wait for 3 months, while 33.1% wait for 6 months before proceeding to mTESE. The cut-off of follicle-stimulating hormone for positive SSR was reported to be 12–19 IU/mL by 22.5% of participants and 20–40 IU/mL by 27.8%, while 31.8% reported no upper limit. Conclusions: This is the largest survey to date on the real-world medical and surgical management of NOA by reproductive experts. It demonstrates a diverse practice pattern and highlights the need for evidence-based international consensus guidelines. [ABSTRACT FROM AUTHOR]

Purpose: Seminal oxidative stress (OS) is a recognized factor potentially associated with male infertility, but the efficacy of antioxidant (AOX) therapy is controversial and there is no consensus on its utility. Primary outcomes of this study were to investigate the effect of AOX on spontaneous clinical pregnancy, live birth and miscarriage rates in male infertile patients. Secondary outcomes were conventional semen parameters, sperm DNA fragmentation (SDF) and seminal OS. Materials and Methods: Literature search was performed using Scopus, PubMed, Ovid, Embase, and Cochrane databases. Only randomized controlled trials (RCTs) were included and the meta-analysis was conducted according to PRISMA guidelines. Results: We assessed for eligibility 1,307 abstracts, and 45 RCTs were finally included, for a total of 4,332 infertile patients. We found a significantly higher pregnancy rate in patients treated with AOX compared to placebo-treated or untreated controls, without significant inter-study heterogeneity. No effects on live-birth or miscarriage rates were observed in four studies. A significantly higher sperm concentration, sperm progressive motility, sperm total motility, and normal sperm morphology was found in patients compared to controls. We found no effect on SDF in analysis of three eligible studies. Seminal levels of total antioxidant capacity were significantly higher, while seminal malondialdehyde acid was significantly lower in patients than controls. These results did not change after exclusion of studies performed following varicocele repair. Conclusions: The present analysis upgrades the level of evidence favoring a recommendation for using AOX in male infertility to improve the spontaneous pregnancy rate and the conventional sperm parameters. The failure to demonstrate an increase in live-birth rate, despite an increase in pregnancy rates, is due to the very few RCTs specifically assessing the impact of AOX on live-birth rate. Therefore, further RCTs assessing the impact of AOX on live-birth rate and miscarriage rate, and SDF will be helpful. [ABSTRACT FROM AUTHOR]

The swelling ability of kappa-carrageenan (KC) hydrogels was investigated in simulated body fluid (SBF). The SBF mimics the ionic concentrations in the vasa deferentia of human males. The study clarifies if these hydrogels can be adjusted to occlude the vasa deferentia by swelling. For this purpose, swelling to twice the initial volume is desirable. In this study, hydrogels of different primary potassium concentrations, biopolymer concentrations and ethanol-exchanged gels, were immersed in SBF either directly or after drying (pre-dried). We measured the absolute and relative swelling degree, and the swelling rates of the gels. Extensive pre-drying leads to irreversible gel densification and absolute swelling magnitudes decrease. We found that immersion into the SBF also leads to potassium ion accumulation, and network restructuring in the hydrogels. This markedly increases the storage moduli of the gel networks. The ion content in the gel structures also directly affects the swelling speed, the fastest swelling occurred in ethanol-exchanged and pre-dried gels. We found that by pre-drying and potassium content adjustment, swelling of the hydrogels is sufficient to render KC hydrogels as a possible candidate for the occlusion of the vasa deferentia. [ABSTRACT FROM AUTHOR]

Background: Male sex is related to increased COVID-19 severity and fatality although confirmed infections are similarly distributed between men and women. The aim of this retrospective analysis was to investigate the impact of sex hormones on disease progression and immune activation in men with COVID-19. Patients and Methods: We studied for effects of sex hormones on disease severity and immune activation in 377 patients (230 men, 147 women) with PCR-confirmed SARS-CoV-2 infections hospitalized at the Innsbruck University Hospital between February and December 2020. Results: Men had more severe COVID-19 with concomitant higher immune system activation upon hospital admission when compared to women. Men with a severe course of infection had lower serum total testosterone (tT) levels whereas luteinizing hormone (LH) and estradiol (E2) levels were within the normal range. tT deficiency was associated with elevated CRP (rs = - 0.567, p < 0.001), IL-6 levels (rs = - 0.563, p < 0.001), lower cholesterol levels (rs = 0.407, p < 0.001) and an increased morbidity and mortality. Men with tT levels < 100 ng/dL had a more than eighteen-fold higher in-hospital mortality risk (OR 18.243 [95%CI 2.301 – 144.639], p = 0.006) compared to men with tT levels > 230 ng/dL. Moreover, while morbidity and mortality showed a positive correlation with E2 levels at admission, we detected a negative correlation with the tT/E2 ratio upon hospital admission. Conclusion: Hospitalized men with COVID-19 present with rather low testosterone levels linked to more advanced immune activation, severe clinical manifestations translating into an increased risk for ICU admission or death. The underlying mechanisms remain elusive but may include infection driven hypogonadism as well as inflammation mediated cholesterol reduction causing gonadotropin suppression and impaired androgen formation. Finally, in elderly late onset hypogonadism might also contribute to lower testosterone levels. [ABSTRACT FROM AUTHOR]

Objective: The literature on eating disorders in older males is still very limited. We assessed the relationship between aging male symptomatology and eating behavior in middle-aged and older men.Method: We distributed anonymous questionnaires to men aged 40-75 years living in or near Innsbruck, Austria, covering demographic items, current eating disorder symptoms (as defined by DSM-5), and associated measures of eating pathology, body image, and sports activity (including exercise addiction). We also administered the Aging Males' Symptoms scale (AMS), and classified respondents as "high-AMS" (AMS score ≥37; N = 82) or "low-AMS" (AMS score <37; N = 386).Results: High-AMS men reported a significantly higher mean current BMI, a greater prevalence of eating disorder symptoms, higher scores on the Eating Disorder Examination Questionnaire, greater risk of exercise addiction, and more negative body image than low-AMS men.Discussion: We found a marked association between aging-male symptomatology and eating-disorder symptomatology in aging men. Our findings suggest that clinicians should carefully inquire about eating disorder symptoms in men aged 40 and above reporting aging-male symptomatology. Importantly, several men in the study reported "purging" via excessive exercise (as opposed to the more common methods of vomiting or use of laxatives or diuretics), and therefore this should be a subject of inquiry in clinical evaluations. To pursue these findings, subsequent studies of eating disorders in older men should consider assessing endocrinological measures, particularly testosterone levels, and should use longitudinal designs. [ABSTRACT FROM AUTHOR]

Objective: To describe the parental origin and the mechanism of formation of an 47,XY,idic(X)(p11.2) karyotype in a patient with Klinefelter syndrome. Design: Case report. Setting: A university hospital. Patient(s): A 36-year-old man with primary infertility. Intervention(s): Genotype–phenotype correlation and microsatellite marker-mediated haplotype analysis subsequent to whole genome amplification of microdissected chromosomes. Main Outcome Measure(s): Genotype–phenotype correlation, mechanism of formation, and parental origin. Result(s): Maternal origin of the isochromosome and the normal X chromosome and loss of maternal heterozygosity for all informative Xq markers on the isochromosome and in each case, the presence of the other maternal allele on the normal homologue was shown. Comparative analysis of the clinical features of 17 additional cases and of 1 case with a 46,XY/47,XY,i(X)(q10) karyotype reported in the literature revealed a phenotype very similar to the clinical findings in patients with a 47,XXY karyotype. Conclusion(s): The molecular results in our patient indicate a maternal origin of a true dicentric isochromosome and most likely postzygotic formation subsequent to a nondisjunction in maternal meiosis II. With the exception of the final height the phenotype of Klinefelter syndrome appears not to be the consequence of trisomy of the pseudoautosomal region on Xp. [Copyright &y& Elsevier]

Abstract: The annual incidence of stone formation is increased in the industrialised world. Extracorporeal shockwave lithotripsy is a non-invasive effective treatment of upper urinary tract stones. This study is aimed to evaluate changes of renal blood flow in patients undergoing extracorporeal shock wave lithotripsy (ESWL) by arterial spin labeling (ASL) MR imaging, contrast enhanced dynamic MR imaging, and renal resistive index (RI). Thirteen patients with nephrolithiasis were examined using MR imaging and Doppler ultrasound 12h before and 12h after ESWL. ASL sequence was done for both kidneys and followed by contrast enhanced MR imaging. In addition RI Doppler ultrasound measurements were performed. A significant increase in RI (p <0.001) was found in both treated and untreated kidneys. ASL MR imaging also showed significant changes in both kidneys (p <0.001). Contrast enhanced dynamic MR imaging did not show significant changes in the kidneys. ESWL causes changes in RI and ASL MR imaging, which seem to reflect changes in renal blood flow. [ABSTRACT FROM AUTHOR]

The article presents the results of a randomized controlled trial comparing the efficacy of autologous myoblasts and fibroblasts versus collagen in the treatment of stress urinary incontinence in women. Studies had shown that transurethral injections of autologus myoblasts can help regenerate the rhabdosphincter and that fibroblasts can be used in the reconstruction of the urethral submucosa. After 12-months follow-up, 38 of the 42 women treated with autologous cells were continent compared with two in 21 given conventional treatment. The article notes that long-term, multicenter follow-up results are needed.

Abstract: The lower transverse abdominal incision, as described by Hermann Johannes Pfannenstiel, cutting both skin and fascia in a transverse fashion was popularized in 1900. Nerve pain syndromes included invalidating pain involving neuroma formation or scar encasement of the ilioinguinal or iliohypogastric nerves. We report a case of a female patient who developed severe pain at the lateral wound edges of a Pfannenstiel incision. The diagnosis of pain of nerve origin was made by infiltration of local anesthetic, after which the pain immediately vanished temporarily. Only complete excision of the scar and involved part of the nerve stopped the pain. [Copyright &y& Elsevier]