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1. Controversy and Consensus on Indications for Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations

Author

Agarwal, A, Farkouh, A, Saleh, R, Abdel-Meguid Hamoda, TA-A, Harraz, AM, Kavoussi, P, Arafa, M, Salvio, G, Rambhatla, A, Toprak, T, Gül, M, Phuoc, NHV, Boitrelle, F, Birowo, P, Ghayda, RA, Cannarella, R, Kuroda, S, Durairajanayagam, D, Zini, A, Wyns, C, Sarikaya, S, Tremellen, K, Mostafa, T, Sokolakis, I, Evenson, DP, Henkel, R, Zohdy, W, Chung, E, Ziouziou, I, Falcone, M, Russo, GI, Al-Hashimi, M, Calogero, AE, Ko, E, Colpi, G, Lewis, S, Serefoglu, EC, Bahar, F, Martinez, M, Nguyen, Q, Ambar, RF, Bakircioglu, ME, Kandil, H, Mogharabian, N, Sabbaghian, M, Taniguchi, H, Tsujimura, A, Sajadi, H, Ibrahim, W, Atmoko, W, Vogiatzi, P, Gunes, S, Gilani, MAS, Roychoudhury, S, Güngör, ND, Hakim, L, Adriansjah, R, Kothari, P, Jindal, S, Amar, E, Park, HJ, Long, TQT, Homa, S, Karthikeyan, VS, Zilaitiene, B, Rosas, IM, Marino, A, Pescatori, E, Ozer, C, Akhavizadegan, H, Garrido, N, Busetto, GM, Adamyan, A, Al-Marhoon, M, Elbardisi, H, Dolati, P, Darbandi, M, Darbandi, S, Balercia, G, Pinggera, G-M, Micic, S, Ho, CCK, Moussa, M, Preto, M, Zenoaga-Barbăroșie, C, Smith, RP, Kosgi, R, Rosette, JDL, El-Sakka, AI, Abumelha, SM, Mierzwa, TC, Ong, TA, Banihani, SA, Bowa, K, Fukuhara, S, Boeri, L, Danacıoğlu, YO, Gokalp, F, Selim, OM, Cho, C-L, Tadros, NN, Ugur, MR, Ozkent, MS, Chiu, P, Kalkanli, A, Khalafalla, K, Vishwakarma, RB, Finocchi, F, Andreadakis, S, Giulioni, C, Çeker, G, Ceyhan, E, Malhotra, V, Yilmaz, M, Timpano, M, Barrett, TL, Kim, SHK, Ahn, S-T, Giacone, F, Palani, A, Duarsa, GWK, Kadioglu, A, Gadda, F, Zylbersztejn, DS, Aydos, K, Kulaksız, D, Gupte, D, Calik, G, Karna, KK, Drakopoulos, P, Baser, A, Kumar, V, Molina, JMC, Rajmil, O, Ferreira, RH, Leonardi, S, Avoyan, A, Sogutdelen, E, Franco, G, Ramsay, J, Ramirez, L, Shah, R, Global Andrology Forum, Agarwal, Ashok, Farkouh, Ala'A, Saleh, Ramadan, Abdel-Meguid Hamoda, Taha Abo-Almagd, Harraz, Ahmed M, Kavoussi, Parviz, Arafa, Mohamed, Salvio, Gianmaria, Rambhatla, Amarnath, Toprak, Tuncay, Gül, Murat, Phuoc, Nguyen Ho Vinh, Boitrelle, Florence, Birowo, Ponco, Ghayda, Ramy Abou, Cannarella, Rossella, Kuroda, Shinnosuke, Durairajanayagam, Damayanthi, Zini, Armand, Wyns, Christine, Sarikaya, Selcuk, Tremellen, Kelton, Mostafa, Taymour, Sokolakis, Ioanni, Evenson, Donald P, Henkel, Ralf, Zohdy, Wael, Chung, Eric, Ziouziou, Imad, Falcone, Marco, Russo, Giorgio I, Al-Hashimi, Manaf, Calogero, Aldo E, Ko, Edmund, Colpi, Giovanni, Lewis, Sheena, Serefoglu, Ege Can, Bahar, Fahmi, Martinez, Marlon, Nguyen, Quang, Ambar, Rafael F, Bakircioglu, Mustafa Emre, Kandil, Hussein, Mogharabian, Nasser, Sabbaghian, Marjan, Taniguchi, Hisanori, Tsujimura, Akira, Sajadi, Hesamoddin, Ibrahim, Wael, Atmoko, Widi, Vogiatzi, Paraskevi, Gunes, Sezgin, Gilani, Mohammad Ali Sadighi, Roychoudhury, Shubhadeep, Güngör, Nur Dokuzeylül, Hakim, Lukman, Adriansjah, Ricky, Kothari, Priyank, Jindal, Sunil, Amar, Edouard, Park, Hyun Jun, Long, Tran Quang Tien, Homa, Sheryl, Karthikeyan, Vilvapathy Senguttuvan, Zilaitiene, Birute, Rosas, Israel Maldonado, Marino, Angelo, Pescatori, Edoardo, Ozer, Cevahir, Akhavizadegan, Hamed, Garrido, Nicola, Busetto, Gian Maria, Adamyan, Aram, Al-Marhoon, Mohamed, Elbardisi, Haitham, Dolati, Parisa, Darbandi, Mahsa, Darbandi, Sara, Balercia, Giancarlo, Pinggera, Germar-Michael, Micic, Sava, Ho, Christopher Chee Kong, Moussa, Mohamad, Preto, Mirko, Zenoaga-Barbăroșie, Cătălina, Smith, Ryan P, Kosgi, Raghavender, Rosette, Jean de la, El-Sakka, Ahmed I, Abumelha, Saad Mohammed, Mierzwa, Tiago Cesar, Ong, Teng Aik, Banihani, Saleem A, Bowa, Kasonde, Fukuhara, Shinichiro, Boeri, Luca, Danacıoğlu, Yavuz Onur, Gokalp, Fatih, Selim, Osama Mohamed, Cho, Chak-Lam, Tadros, Nicholas N, Ugur, Muhammet Rasit, Ozkent, Mehmet Serkan, Chiu, Peter, Kalkanli, Arif, Khalafalla, Kareim, Vishwakarma, Ranjit B, Finocchi, Federica, Andreadakis, Sotiri, Giulioni, Carlo, Çeker, Gökhan, Ceyhan, Erman, Malhotra, Vineet, Yilmaz, Mehmet, Timpano, Massimiliano, Barrett, Trenton L, Kim, Shannon Hee Kyung, Ahn, Sun-Tae, Giacone, Filippo, Palani, Ayad, Duarsa, Gede Wirya Kusuma, Kadioglu, Ate, Gadda, Franco, Zylbersztejn, Daniel Suslik, Aydos, Kaan, Kulaksız, Deniz, Gupte, Deepak, Calik, Gokhan, Karna, Keshab Kumar, Drakopoulos, Panagioti, Baser, Aykut, Kumar, Vijay, Molina, Juan Manuel Corral, Rajmil, Osvaldo, Ferreira, Raphael H, Leonardi, Sofia, Avoyan, Armen, Sogutdelen, Emrullah, Franco, Giorgio, Ramsay, Jonathan, Ramirez, Liliana, Shah, Rupin, and Rocco, Lucia

Subjects
Male infertility, Practice guideline, Delphi method, DNA fragmentation, Survey, Sperm
Abstract

PURPOSE: Sperm DNA fragmentation (SDF) testing was recently added to the sixth edition of the World Health Organization laboratory manual for the examination and processing of human semen. Many conditions and risk factors have been associated with elevated SDF; therefore, it is important to identify the population of infertile men who might benefit from this test. The purpose of this study was to investigate global practices related to indications for SDF testing, compare the relevant professional society guideline recommendations, and provide expert recommendations. MATERIALS AND METHODS: Clinicians managing male infertility were invited to take part in a global online survey on SDF clinical practices. This was conducted following the CHERRIES checklist criteria. The responses were compared to professional society guideline recommendations related to SDF and the appropriate available evidence. Expert recommendations on indications for SDF testing were then formulated, and the Delphi method was used to reach consensus. RESULTS: The survey was completed by 436 experts from 55 countries. Almost 75% of respondents test for SDF in all or some men with unexplained or idiopathic infertility, 39% order it routinely in the work-up of recurrent pregnancy loss (RPL), and 62.2% investigate SDF in smokers. While 47% of reproductive urologists test SDF to support the decision for varicocele repair surgery when conventional semen parameters are normal, significantly fewer general urologists (23%; p=0.008) do the same. Nearly 70% would assess SDF before assisted reproductive technologies (ART), either always or for certain conditions. Recurrent ART failure is a common indication for SDF testing. Very few society recommendations were found regarding SDF testing. CONCLUSIONS: This article presents the largest global survey on the indications for SDF testing in infertile men, and demonstrates diverse practices. Furthermore, it highlights the paucity of professional society guideline recommendations. Expert recommendations are proposed to help guide clinicians.

Published
2023

2. Male Oxidative Stress Infertility (MOSI): Proposed Terminology and Clinical Practice Guidelines for Management of Idiopathic Male Infertility

Author

Agarwal, A, Parekh, N, Selvam, MKP, Henkel, R, Shah, R, Homa, ST, Ramasamy, R, Ko, E, Tremellen, K, Esteves, S, Majzoub, A, Alvarez, JG, Gardner, DK, Jayasena, CN, Ramsay, JW, Cho, C-L, Saleh, R, Sakkas, D, Hotaling, JM, Lundy, SD, Vij, S, Marmar, J, Gosalvez, J, Sabanegh, E, Park, HJ, Zini, A, Kavoussi, P, Micic, S, Smith, R, Busetto, GM, Bakircioglu, ME, Haidl, G, Balercia, G, Garrido Puchalt, N, Ben-Khalifa, M, Tadros, N, Kirkman-Browne, J, Moskovtsev, S, Huang, X, Borges, E, Franken, D, Bar-Chama, N, Morimoto, Y, Tomita, K, Srini, VS, Ombelet, W, Baldi, E, Muratori, M, Yumura, Y, La Vignera, S, Kosgi, R, Martinez, MP, Evenson, DP, Zylbersztejn, DS, Roque, M, Cocuzza, M, Vieira, M, Ben-Meir, A, Orvieto, R, Levitas, E, Wiser, A, Arafa, M, Malhotra, V, Parekattil, SJ, Elbardisi, H, Carvalho, L, Dada, R, Sifer, C, Talwar, P, Gudeloglu, A, Mahmoud, AMA, Terras, K, Yazbeck, C, Nebojsa, B, Durairajanayagam, D, Mounir, A, Kahn, LG, Baskaran, S, Pai, RD, Paoli, D, Leisegang, K, Moein, M-R, Malik, S, Yaman, O, Samanta, L, Bayane, F, Jindal, SK, Kendirci, M, Altay, B, Perovic, D, Harlev, A, Agarwal, A, Parekh, N, Selvam, MKP, Henkel, R, Shah, R, Homa, ST, Ramasamy, R, Ko, E, Tremellen, K, Esteves, S, Majzoub, A, Alvarez, JG, Gardner, DK, Jayasena, CN, Ramsay, JW, Cho, C-L, Saleh, R, Sakkas, D, Hotaling, JM, Lundy, SD, Vij, S, Marmar, J, Gosalvez, J, Sabanegh, E, Park, HJ, Zini, A, Kavoussi, P, Micic, S, Smith, R, Busetto, GM, Bakircioglu, ME, Haidl, G, Balercia, G, Garrido Puchalt, N, Ben-Khalifa, M, Tadros, N, Kirkman-Browne, J, Moskovtsev, S, Huang, X, Borges, E, Franken, D, Bar-Chama, N, Morimoto, Y, Tomita, K, Srini, VS, Ombelet, W, Baldi, E, Muratori, M, Yumura, Y, La Vignera, S, Kosgi, R, Martinez, MP, Evenson, DP, Zylbersztejn, DS, Roque, M, Cocuzza, M, Vieira, M, Ben-Meir, A, Orvieto, R, Levitas, E, Wiser, A, Arafa, M, Malhotra, V, Parekattil, SJ, Elbardisi, H, Carvalho, L, Dada, R, Sifer, C, Talwar, P, Gudeloglu, A, Mahmoud, AMA, Terras, K, Yazbeck, C, Nebojsa, B, Durairajanayagam, D, Mounir, A, Kahn, LG, Baskaran, S, Pai, RD, Paoli, D, Leisegang, K, Moein, M-R, Malik, S, Yaman, O, Samanta, L, Bayane, F, Jindal, SK, Kendirci, M, Altay, B, Perovic, D, and Harlev, A

Abstract

Despite advances in the field of male reproductive health, idiopathic male infertility, in which a man has altered semen characteristics without an identifiable cause and there is no female factor infertility, remains a challenging condition to diagnose and manage. Increasing evidence suggests that oxidative stress (OS) plays an independent role in the etiology of male infertility, with 30% to 80% of infertile men having elevated seminal reactive oxygen species levels. OS can negatively affect fertility via a number of pathways, including interference with capacitation and possible damage to sperm membrane and DNA, which may impair the sperm's potential to fertilize an egg and develop into a healthy embryo. Adequate evaluation of male reproductive potential should therefore include an assessment of sperm OS. We propose the term Male Oxidative Stress Infertility, or MOSI, as a novel descriptor for infertile men with abnormal semen characteristics and OS, including many patients who were previously classified as having idiopathic male infertility. Oxidation-reduction potential (ORP) can be a useful clinical biomarker for the classification of MOSI, as it takes into account the levels of both oxidants and reductants (antioxidants). Current treatment protocols for OS, including the use of antioxidants, are not evidence-based and have the potential for complications and increased healthcare-related expenditures. Utilizing an easy, reproducible, and cost-effective test to measure ORP may provide a more targeted, reliable approach for administering antioxidant therapy while minimizing the risk of antioxidant overdose. With the increasing awareness and understanding of MOSI as a distinct male infertility diagnosis, future research endeavors can facilitate the development of evidence-based treatments that target its underlying cause.

Published
2019

22. Consensus and Diversity in the Management of Varicocele for Male Infertility: Results of a Global Practice Survey and Comparison with Guidelines and Recommendations

Author

Shah, Rupin, Agarwal, Ashok, Kavoussi, Parviz, Rambhatla, Amarnath, Saleh, Ramadan, Cannarella, Rossella, Harraz, Ahmed M., Boitrelle, Florence, Kuroda, Shinnosuke, Hamoda, Taha Abo-Almagd Abdel-Meguid, Zini, Armand, Ko, Edmund, Çalık, Gökhan, Toprak, Tuncay, Kandil, Hussein, Gül, Murat, Bakırcıoğlu, Mustafa Emre, Parekh, Neel, Russo, Giorgio Ivan, Tadros, Nicholas, Kadıoğlu, Ateş, Arafa, Mohamed, Chung, Eric, Rajmil, Osvaldo, Dimitriadis, Fotios, Malhotra, Vineet, Salvio, Gianmaria, Henkel, Ralf, Le, Tan V., Sogutdelen, Emrullah, Vij, Sarah, Alarbid, Abdullah, Güdeloğlu, Ahmet, Tsujimura, Akira, Calogero, Aldo E., El Meliegy, Amr, Crafa, Andrea, Kalkanlı, Arif, Baser, Aykut, Hazır, Berk, Giulioni, Carlo, Cho, Chak-Lam, Ho, Christopher C.K., Salzano, Ciro, Zylbersztejn, Daniel Suslik, Tien, Dung Mai Ba, Pescatori, Edoardo, Borges, Edson, Saïs-Hamza, Eminej, Huyghe, Eric, Ceyhan, Erman, Caroppo, Ettore, Castiglioni, Fabrizio, Bahar, Fahmi, Gökalp, Fatih, Lombardo, Francesco, Gadda, Franco, Duarsa, Gede Wirya Kusuma, Pinggera, Germar-Michael, Busetto, Gian Maria, Balercia, Giancarlo, Cito, Gianmartin, Blecher, Gideon, Franco, Giorgio, Liguori, Giovanni, Elbardisi, Haitham, Keskin, Hakan, Lin, Haocheng, Taniguchi, Hisanori, Park, Hyun Jun, Ziouziou, Imad, de la Rosette, Jean J. M. C. H., Hotaling, Jim, Ramsay, Jonathan, Molina, Juan Manuel Corral, Lo, Ka Lun, Böcü, Kadir, Khalafalla, Kareim, Bowa, Kasonde, Okada, Keisuke, Nagao, Koichi, Chiba, Koji, Hakim, Lukman, Makarounis, Konstantinos, Hehemann, Marah, Peña, Marcelo Rodriguez, Falcone, Marco, Bendayan, Marion, Martinez, Marlon, Timpano, Massimiliano, Altan, Mesut, Fode, Mikkel, Al-Marhoon, Mohamed S., Gilani, Mohammad Ali Sadighi, Soebadi, Mohammad Ayodhia, Gherabi, Nazim, Sofikitis, Nikolaos, Kahraman, Oğuzhan, Birowo, Ponco, Kothari, Priyank, Sindhwani, Puneet, Javed, Qaisar, Ambar, Rafael F., Kosgi, Raghavender, Ghayda, Ramy Abou, Adriansjah, Ricky, Condorelli, Rosita Angela, La Vignera, Sandro, Micic, Sava, Kim, Shannon Hee Kyung, Fukuhara, Shinichiro, Ahn, Sun Tae, Mostafa, Taymour, Ong, Teng Aik, Takeshima, Teppei, Amano, Toshiyasu, Barrett, Trenton, Arslan, Umut, Karthikeyan, Vilvapathy Senguttuvan, Atmoko, Widi, Yumura, Yasushi, Yuan, Yiming, Kato, Yuki, Jezek, Davor, Cheng, Bryan Kwun-Chung, Hatzichristodoulou, Georgios, Dy, Jun, Castañé, Eduard Ruiz, El-Sakka, Ahmed I., Nguyen, Quang, Sarıkaya, Selçuk, Boeri, Luca, Tan, Ronny, Moussa, Mohamad A., El-Assmy, Ahmed, Alali, Hamed, Alhathal, Naif, Osman, Yasser, Perovic, Dragoljub, Sajadi, Hesamoddin, Akhavizadegan, Hamed, Vučinić, Miroslav, Kattan, Said, Kattan, Mohamed S., Mogharabian, Nasser, Phuoc, Nguyen Ho Vinh, Ngoo, Kay Seong, Alkandari, Mohammad H., Alsuhaibani, Shaheed, Sokolakis, Ioannis, Babaei, Mehdi, King, Mak Siu, Diemer, Thorsten, Gava, Marcelo M., Henrique, Raphael, Spinola e Silva, Rodrigo, Paul, Gustavo Marquesine, Mierzwa, Tiago Cesar, Glina, Sidney, Siddiqi, Kashif, Wu, Han, Wurzacher, Jana, Farkouh, Ala'a, Son, Hwancheol, Minhas, Suks, Lee, Joe, Magsanoc, Nikko, Capogrosso, Paolo, Albano, German Jose, Lewis, Sheena E.M., Jayasena, Channa N., Alvarez, Juan G., Teo, Colin, Smith, Ryan P., Chua, Jo Ben M., Jensen, Christian Fuglesang S., Parekattil, Sijo, Finelli, Renata, Durairajanayagam, Damayanthi, Karna, Keshab Kumar, Ahmed, Abdelkareem, Evenson, Don, Umemoto, Yukihiro, Puigvert, Ana, Çeker, Gökhan, Colpi, Giovanni M., Rolitsky, Sarah, Bouzouita, Abderrazak, Shokeir, Ahmed, Aşçı, Ahmet, Bouker, Amin, Adamyan, Aram, Avoyan, Armen E., Palani, Ayad, Aghamajidi, Azin, Eze, Balantine, Noegroho, Bambang Sasongko, Purnomo, Basuki, Erkan, Bircan Kolbaşı, Zilaitiene, Birute, Kulaksız, Deniz, Kafetzis, Dimitrios, Lee, Dong Sup, Stember, Doron, Evgeni, Evangelini, Alhajeri, Faisal, Finocchi, Federica, Colombo, Fulvio, Tsangaris, George, Sallam, Hassan N., Acosta, Herik, Rosas, Israel Maldonado, Kirkman-Brown, Jackson, Shin, Jae Il, Sonksen, Jens, Dong, Jie, Marmar, Joel, Moreno-Sepulveda, Jose, Seo, Ju Tae, Aydos, Kaan, Kesari, Kavindra Kumar, Trost, Landon, Jenkins, Lawrence, Rocco, Lucia, Darbandi, Mahsa, Simopoulou, Mara, Alves, Marco, Sabbaghian, Marjan, Tavalaee, Marziyeh, Razi, Mazdak, Duran, Mesut Berkan, Nago, Mitsuru, Elkhouly, Mohamed, Khalili, Mohamed, Nasr-Esfahani, Mohammad Hossein, Kamath, Mohan S., Uğur, Muhammet Raşit, Park, Nam Cheol, Cruz, Natalio, Garrido, Nicolas, Sodeifi, Niloofar, Al Khalidi, Noora, Shoshany, Ohad, Satyagraha, Paksi, Drakopoulos, Panagiotos, Vogiatzi, Paraskevi, Dolati, Parisa, Das, Partha, Chiu, Peter Ka-Fung, Tsioulou, Petroula A., Patel, Premal, Singh, Rajender, Kaiyal, Raneen Sawaid, Santos, Ferreira, Dada, Rima, Brodjonegoro, Sakti, Banihani, Saleem Ali, Schon, Samantha, Darbandi, Sara, Güneş, Sezgin, Homa, Sheryl, Mutambirwa, Shingai, Roychoudhury, Shubhadeep, Diaz, Sofia Ines Leonardi, Gopalakrishnan, Sreelatha, Krawetz, Stephen, Jindal, Sunil, Avidor-Reiss, Tomer, Lin, Tsung Yen, Kumar, Vijay, Ibrahim, Wael, Kerkeni, Walid, Woo, Wongi, Morimoto, Yoshiharu, Cheng, Yu-Sheng, Shah, Rupin, Agarwal, Ashok, Kavoussi, Parviz, Rambhatla, Amarnath, Saleh, Ramadan, Cannarella, Rossella, Harraz, Ahmed M., Boitrelle, Florence, Kuroda, Shinnosuke, Hamoda, Taha Abo-Almagd Abdel-Meguid, Zini, Armand, Ko, Edmund, Calik, Gokhan, Toprak, Tuncay, Kandil, Hussein, Gül, Murat, Bakırcıoğlu, Mustafa Emre, Parekh, Neel, Russo, Giorgio Ivan, Tadros, Nichola, Kadioglu, Ate, Arafa, Mohamed, Chung, Eric, Rajmil, Osvaldo, Dimitriadis, Fotio, Malhotra, Vineet, Salvio, Gianmaria, Henkel, Ralf, Le, Tan V., Sogutdelen, Emrullah, Vij, Sarah, Alarbid, Abdullah, Gudeloglu, Ahmet, Tsujimura, Akira, Calogero, Aldo E., Meliegy, Amr El, Crafa, Andrea, Kalkanli, Arif, Baser, Aykut, Hazir, Berk, Giulioni, Carlo, Cho, Chak-Lam, Ho, Christopher C. K., Salzano, Ciro, Zylbersztejn, Daniel Suslik, Tien, Dung Mai Ba, Pescatori, Edoardo, Borges, Edson, Serefoglu, Ege Can, Sas-Hamza, Emine, Huyghe, Eric, Ceyhan, Erman, Caroppo, Ettore, Castiglioni, Fabrizio, Bahar, Fahmi, Gokalp, Fatih, Lombardo, Francesco, Gadda, Franco, Duarsa, Gede Wirya Kusuma, Pinggera, Germar-Michael, Busetto, Gian Maria, Balercia, Giancarlo, Cito, Gianmartin, Blecher, Gideon, Franco, Giorgio, Liguori, Giovanni, Elbardisi, Haitham, Keskin, Hakan, Lin, Haocheng, Taniguchi, Hisanori, Park, Hyun Jun, Ziouziou, Imad, Rosette, Jean de la, Hotaling, Jim, Ramsay, Jonathan, Molina, Juan Manuel Corral, Lo, Ka Lun, Bocu, Kadir, Khalafalla, Kareim, Bowa, Kasonde, Okada, Keisuke, Nagao, Koichi, Chiba, Koji, Hakim, Lukman, Makarounis, Konstantino, Hehemann, Marah, Peña, Marcelo Rodriguez, Falcone, Marco, Bendayan, Marion, Martinez, Marlon, Timpano, Massimiliano, Altan, Mesut, Fode, Mikkel, Al-Marhoon, Mohamed S., Gilani, Mohammad Ali Sadighi, Soebadi, Mohammad Ayodhia, Gherabi, Nazim, Sofikitis, Nikolao, Kahraman, Oğuzhan, Birowo, Ponco, Kothari, Priyank, Sindhwani, Puneet, Javed, Qaisar, Ambar, Rafael F., Kosgi, Raghavender, Ghayda, Ramy Abou, Adriansjah, Ricky, Condorelli, Rosita Angela, Vignera, Sandro La, Micic, Sava, Kim, Shannon Hee Kyung, Fukuhara, Shinichiro, Ahn, Sun Tae, Mostafa, Taymour, Ong, Teng Aik, Takeshima, Teppei, Amano, Toshiyasu, Barrett, Trenton, Arslan, Umut, Karthikeyan, Vilvapathy Senguttuvan, Atmoko, Widi, Yumura, Yasushi, Yuan, Yiming, Kato, Yuki, Jezek, Davor, Cheng, Bryan Kwun-Chung, Hatzichristodoulou, Georgio, Dy, Jun, Castañé, Eduard Ruiz, El-Sakka, Ahmed I., Nguyen, Quang, Sarikaya, Selcuk, Boeri, Luca, Tan, Ronny, Moussa, Mohamad A., El-Assmy, Ahmed, Alali, Hamed, Alhathal, Naif, Osman, Yasser, Perovic, Dragoljub, Sajadi, Hesamoddin, Akhavizadegan, Hamed, Vučinić, Miroslav, Kattan, Said, Kattan, Mohamed S., Mogharabian, Nasser, Phuoc, Nguyen Ho Vinh, Ngoo, Kay Seong, Alkandari, Mohammad H., Alsuhaibani, Shaheed, Sokolakis, Ioanni, Babaei, Mehdi, King, Mak Siu, Diemer, Thorsten, Gava, Marcelo M., Henrique, Raphael, Silva, Rodrigo Spinola e, Paul, Gustavo Marquesine, Mierzwa, Tiago Cesar, Glina, Sidney, Siddiqi, Kashif, Wu, Han, Wurzacher, Jana, Farkouh, Ala’A, Son, Hwancheol, Minhas, Suk, Lee, Joe, Magsanoc, Nikko, Capogrosso, Paolo, Albano, German Jose, Lewis, Sheena E. M., Jayasena, Channa N., Alvarez, Juan G., Teo, Colin, Smith, Ryan P., Chua, Jo Ben M., Jensen, Christian Fuglesang S., Parekattil, Sijo, Finelli, Renata, Durairajanayagam, Damayanthi, Karna, Keshab Kumar, Ahmed, Abdelkareem, Evenson, Don, Umemoto, Yukihiro, Puigvert, Ana, Çeker, Gökhan, Forum, Giovanni M Colpi, Shah, R., Agarwal, A., Kavoussi, P., Rambhatla, A., Saleh, R., Cannarella, R., Harraz, A. M., Boitrelle, F., Kuroda, S., Hamoda, T. A. -A. A. -M., Zini, A., Ko, E., Calik, G., Toprak, T., Kandil, H., Gul, M., Bakircioglu, M. E., Parekh, N., Russo, G. I., Tadros, N., Kadioglu, A., Arafa, M., Chung, E., Rajmil, O., Dimitriadis, F., Malhotra, V., Salvio, G., Henkel, R., Le, T. V., Sogutdelen, E., Vij, S., Alarbid, A., Gudeloglu, A., Tsujimura, A., Calogero, A. E., El Meliegy, A., Crafa, A., Kalkanli, A., Baser, A., Hazir, B., Giulioni, C., Cho, C. -L., Ho, C. C. K., Salzano, C., Zylbersztejn, D. S., Tien, D. M. B., Pescatori, E., Borges, E., Serefoglu, E. C., Sais-Hamza, E., Huyghe, E., Ceyhan, E., Caroppo, E., Castiglioni, F., Bahar, F., Gokalp, F., Lombardo, F., Gadda, F., Duarsa, G. W. K., Pinggera, G. -M., Busetto, G. M., Balercia, G., Cito, G., Blecher, G., Franco, G., Liguori, G., Elbardisi, H., Keskin, H., Lin, H., Taniguchi, H., Park, H. J., Ziouziou, I., de la Rosette, J., Hotaling, J., Ramsay, J., Molina, J. M. C., Lo, K. L., Bocu, K., Khalafalla, K., Bowa, K., Okada, K., Nagao, K., Chiba, K., Hakim, L., Makarounis, K., Hehemann, M., Pena, M. R., Falcone, M., Bendayan, M., Martinez, M., Timpano, M., Altan, M., Fode, M., Al-Marhoon, M. S., Gilani, M. A. S., Soebadi, M. A., Gherabi, N., Sofikitis, N., Kahraman, O., Birowo, P., Kothari, P., Sindhwani, P., Javed, Q., Ambar, R. F., Kosgi, R., Ghayda, R. A., Adriansjah, R., Condorelli, R. A., La Vignera, S., Micic, S., Kim, S. H. K., Fukuhara, S., Ahn, S. T., Mostafa, T., Ong, T. A., Takeshima, T., Amano, T., Barrett, T., Arslan, U., Karthikeyan, V. S., Atmoko, W., Yumura, Y., Yuan, Y., Kato, Y., Jezek, D., Cheng, B. K. -C., Hatzichristodoulou, G., Dy, J., Castane, E. R., El-Sakka, A. I., Nguyen, Q., Sarikaya, S., Boeri, L., Tan, R., Moussa, M. A., El-Assmy, A., Alali, H., Alhathal, N., Osman, Y., Perovic, D., Sajadi, H., Akhavizadegan, H., Vucinic, M., Kattan, S., Kattan, M. S., Mogharabian, N., Phuoc, N. H. V., Ngoo, K. S., Alkandari, M. H., Alsuhaibani, S., Sokolakis, I., Babaei, M., King, M. S., Diemer, T., Gava, M. M., Henrique, R., Spinola e Silva, R., Paul, G. M., Mierzwa, T. C., Glina, S., Siddiqi, K., Wu, H., Wurzacher, J., Farkouh, A., Son, H., Minhas, S., Lee, J., Magsanoc, N., Capogrosso, P., Albano, G. J., Lewis, S. E. M., Jayasena, C. N., Alvarez, J. G., Teo, C., Smith, R. P., Chua, J. B. M., Jensen, C. F. S., Parekattil, S., Finelli, R., Durairajanayagam, D., Karna, K. K., Ahmed, A., Evenson, D., Umemoto, Y., Puigvert, A., Ceker, G., Colpi, G. M., Rolitsky, S., Bouzouita, A., Shokeir, A., Asci, A., Bouker, A., Adamyan, A., Avoyan, A. E., Palani, A., Aghamajidi, A., Eze, B., Noegroho, B. S., Purnomo, B., Erkan, B. K., Zilaitiene, B., Kulaksiz, D., Kafetzis, D., Lee, D. S., Stember, D., Evgeni, E., Alhajeri, F., Finocchi, F., Colombo, F., Tsangaris, G., Sallam, H. N., Acosta, H., Rosas, I. M., Kirkman-Brown, J., Shin, J. I., Sonksen, J., Dong, J., Marmar, J., Moreno-Sepulveda, J., Seo, J. T., Aydos, K., Kesari, K. K., Trost, L., Jenkins, L., Rocco, L., Darbandi, M., Simopoulou, M., Alves, M., Sabbaghian, M., Tavalaee, M., Razi, M., Duran, M. B., Nago, M., Elkhouly, M., Khalili, M., Nasr-Esfahani, M. H., Kamath, M. S., Ugur, M. R., Park, N. C., Cruz, N., Garrido, N., Sodeifi, N., Al Khalidi, N., Shoshany, O., Satyagraha, P., Drakopoulos, P., Vogiatzi, P., Dolati, P., Das, P., Chiu, P. K. -F., Tsioulou, P. A., Patel, P., Singh, R., Kaiyal, R. S., Santos, F., Dada, R., Brodjonegoro, S., Banihani, S. A., Schon, S., Darbandi, S., Gunes, S., Homa, S., Mutambirwa, S., Roychoudhury, S., Diaz, S. I. L., Gopalakrishnan, S., Krawetz, S., Jindal, S., Avidor-Reiss, T., Lin, T. Y., Kumar, V., Ibrahim, W., Kerkeni, W., Woo, W., Morimoto, Y., Cheng, Y. -S., and Tıp Fakültesi

Subjects
Aging, Consensus, Urology, INGUINAL VARICOCELECTOMY, Disease management, Male infertility, Survey, Varicocele, Consensu, Global Andrology Forum, Endocrinology & Metabolism, NONOBSTRUCTIVE AZOOSPERMIA, ASSISTED REPRODUCTIVE TECHNOLOGY, Male Infertility, Pharmacology (medical), Andrology, IMPAIRED SEMEN QUALITY, EUROPEAN ASSOCIATION, Science & Technology, UROLOGY GUIDELINES, Health Policy, Public Health, Environmental and Occupational Health, Disease Management, Urology & Nephrology, SUBCLINICAL VARICOCELE, Psychiatry and Mental health, Health Care Sciences & Services, MICROSURGICAL SUBINGUINAL VARICOCELECTOMY, Reproductive Medicine, SPERM MORPHOLOGY, UNTREATED VARICOCELE, Life Sciences & Biomedicine
Abstract

Purpose: Varicocele is a common problem among infertile men. Varicocele repair (VR) is frequently performed to improve semen parameters and the chances of pregnancy. However, there is a lack of consensus about the diagnosis, indications for VR and its outcomes. The aim of this study was to explore global practice patterns on the management of varicocele in the context of male infertility. Materials and Methods: Sixty practicing urologists/andrologists from 23 countries contributed 382 multiple-choice-questions pertaining to varicocele management. These were condensed into an online questionnaire that was forwarded to clinicians involved in male infertility management through direct invitation. The results were analyzed for disagreement and agreement in practice patterns and, compared with the latest guidelines of international professional societies (American Urological As- sociation [AUA], American Society for Reproductive Medicine [ASRM], and European Association of Urology [EAU]), and with evidence emerging from recent systematic reviews and meta-analyses. Additionally, an expert opinion on each topic was provided based on the consensus of 16 experts in the field. Results: The questionnaire was answered by 574 clinicians from 59 countries. The majority of respondents were urologists/ uro-andrologists. A wide diversity of opinion was seen in every aspect of varicocele diagnosis, indications for repair, choice of technique, management of sub-clinical varicocele and the role of VR in azoospermia. A significant proportion of the re- sponses were at odds with the recommendations of AUA, ASRM, and EAU. A large number of clinical situations were identi- fied where no guidelines are available. Conclusions: This study is the largest global survey performed to date on the clinical management of varicocele for male in- fertility. It demonstrates: 1) a wide disagreement in the approach to varicocele management, 2) large gaps in the clinical prac- tice guidelines from professional societies, and 3) the need for further studies on several aspects of varicocele management in infertile men.

Published
2022

23. Antisperm Antibody Testing: A Comprehensive Review of Its Role in the Management of Immunological Male Infertility and Results of a Global Survey of Clinical Practices

Author

Sajal Gupta, Rakesh Sharma, Ashok Agarwal, Florence Boitrelle, Renata Finelli, Ala'a Farkouh, Ramadan Saleh, Taha Abo-Almagd Abdel-Meguid, Murat Gül, Birute Zilaitiene, Edmund Ko, Amarnath Rambhatla, Armand Zini, Kristian Leisegang, Shinnosuke Kuroda, Ralf Henkel, Rossella Cannarella, Ayad Palani, Chak-Lam Cho, Christopher C.K. Ho, Daniel Suslik Zylbersztejn, Edoardo Pescatori, Eric Chung, Fotios Dimitriadis, Germar-Michael Pinggera, Gian Maria Busetto, Giancarlo Balercia, Gianmaria Salvio, Giovanni M. Colpi, Gökhan Çeker, Hisanori Taniguchi, Hussein Kandil, Hyun Jun Park, Israel Maldonado Rosas, Jean de la Rosette, Joao Paulo Greco Cardoso, Jonathan Ramsay, Juan Alvarez, Juan Manuel Corral Molina, Kareim Khalafalla, Kasonde Bowa, Kelton Tremellen, Evangelini Evgeni, Lucia Rocco, Marcelo Gabriel Rodriguez Peña, Marjan Sabbaghian, Marlon Martinez, Mohamed Arafa, Mohamed S. Al-Marhoon, Nicholas Tadros, Nicolas Garrido, Osvaldo Rajmil, Pallav Sengupta, Paraskevi Vogiatzi, Parviz Kavoussi, Ponco Birowo, Raghavender Kosgi, Saleem Bani-Hani, Sava Micic, Sijo Parekattil, Sunil Jindal, Tan V. Le, Taymour Mostafa, Tuncay Toprak, Yoshiharu Morimoto, Vineet Malhotra, Azin Aghamajidi, Damayanthi Durairajanayagam, Rupin Shah, Gupta, S., Sharma, R., Agarwal, A., Boitrelle, F., Finelli, R., Farkouh, A., Saleh, R., Abdel-Meguid, T. A. -A., Gul, M., Zilaitiene, B., Ko, E., Rambhatla, A., Zini, A., Leisegang, K., Kuroda, S., Henkel, R., Cannarella, R., Palani, A., Cho, C. -L., Ho, C. C. K., Zylbersztejn, D. S., Pescatori, E., Chung, E., Dimitriadis, F., Pinggera, G. -M., Busetto, G. M., Balercia, G., Salvio, G., Colpi, G. M., Ceker, G., Taniguchi, H., Kandil, H., Park, H. J., Rosas, I. M., de la Rosette, J., Cardoso, J. P. G., Ramsay, J., Alvarez, J., Molina, J. M. C., Khalafalla, K., Bowa, K., Tremellen, K., Evgeni, E., Rocco, L., Pena, M. G. R., Sabbaghian, M., Martinez, M., Arafa, M., Al-Marhoon, M. S., Tadros, N., Garrido, N., Rajmil, O., Sengupta, P., Vogiatzi, P., Kavoussi, P., Birowo, P., Kosgi, R., Bani-Hani, S., Micic, S., Parekattil, S., Jindal, S., Le, T. V., Mostafa, T., Toprak, T., Morimoto, Y., Malhotra, V., Aghamajidi, A., Durairajanayagam, D., and Shah, R.

Subjects
Aging, Urology, Antibodie, DIAGNOSIS, Antibodies, Endocrinology & Metabolism, male, FERTILIZATION, FERTILITY, Pharmacology (medical), Andrology, Survey, PREDNISOLONE TREATMENT, COUPLES, Science & Technology, Health Policy, Public Health, Environmental and Occupational Health, CHRONIC PROSTATITIS, Urology & Nephrology, SEMEN PARAMETERS, Infertility, male, Sperm agglutination, Spermatozoa, digestive system diseases, Psychiatry and Mental health, PREGNANCY RATES, Health Care Sciences & Services, surgical procedures, operative, Reproductive Medicine, Infertility, SPERM AUTOANTIBODIES, Life Sciences & Biomedicine, SUBFERTILE MEN
Abstract

Antisperm antibodies (ASA), as a cause of male infertility, have been detected in infertile males as early as 1954. Multiple causes of ASA production have been identified, and they are due to an abnormal exposure of mature germ cells to the immune system. ASA testing (with mixed anti-globulin reaction, and immunobead binding test) was described in the WHO manual 5th edition and is most recently listed among the extended semen tests in the WHO manual 6th edition. The relationship between ASA and infertility is somewhat complex. The presence of sperm agglutination, while insufficient to diagnose immunological infertility, may indicate the presence of ASA. However, ASA can also be present in the absence of any sperm agglutination. The andrological management of ASA depends on the etiology and individual practices of clinicians. In this article, we provide a comprehensive review of the causes of ASA production, its role in immunological male infertility, clinical indications of ASA testing, and the available therapeutic options. We also provide the details of laboratory procedures for assessment of ASA together with important measures for quality control. Additionally, laboratory and clinical scenarios are presented to guide the reader in the management of ASA and immunological male infertility. Furthermore, we report the results of a recent worldwide survey, conducted to gather information about clinical practices in the management of immunological male infertility.

Published
2022

24. SARS-CoV-2 pandemic and repercussions for male infertility patients: A proposal for the individualized provision of andrological services

Author

Sandro C. Esteves, Rita Jakubcionyte Laursen, Edouard Amar, Jorge Hallak, Jackson Kirkman-Brown, Marcello Cocuzza, Ranjith Ramasamy, Francesco Lombardo, Armand Zini, Sheena E.M. Lewis, Ahmad Majzoub, Sijo Parekattil, Rita de Cássia Sávio Figueira, John L. Yovich, Romualdo Sciorio, Giovanni M. Colpi, Lars Björndahl, Sunil Jindal, Juan Carlos Alvarez, Pedro Vendeira, Nicolás Garrido, Chak-Lam Cho, Ahmad M. Metwalley, Ashok Agarwal, Peter Humaidan, Fabiola C. Bento, Carlo Alviggi, Esteves, S. C., Lombardo, F., Garrido, N., Alvarez, J., Zini, A., Colpi, G. M., Kirkman-Brown, J., Lewis, S. E. M., Bjorndahl, L., Majzoub, A., Cho, C. -L., Vendeira, P., Hallak, J., Amar, E., Cocuzza, M., Bento, F. C., Figueira, R. C., Sciorio, R., Laursen, R. J., Metwalley, A. M., Jindal, S. K., Parekattil, S., Ramasamy, R., Alviggi, C., Humaidan, P., Yovich, J. L., and Agarwal, A.

Subjects
Male, Endocrinology, Diabetes and Metabolism, male infertility, SARS‐CoV‐2, Health Services Accessibility, Male infertility, azoospermia, opinion, SARS-CoV-2, semen analysis, sperm banking, systemic auto-immune diseases, 0302 clinical medicine, Endocrinology, HYPOGONADOTROPIC HYPOGONADISM, OXIDATIVE STRESS, Andrology, systemic auto‐immune diseases, media_common, 030219 obstetrics & reproductive medicine, medicine.diagnostic_test, MEN, CANCER, Needs assessment, Needs Assessment, Infertility, medicine.medical_specialty, media_common.quotation_subject, Urology, Reproductive medicine, Fertility, Semen analysis, SARS-CoV-2, azoospermia, male infertility, opinion, semen analysis, sperm banking, systemic auto-immune diseases, 03 medical and health sciences, NONOBSTRUCTIVE AZOOSPERMIA, medicine, MANAGEMENT, Humans, SPERMATOGENESIS, Intensive care medicine, Infertility, Male, Azoospermia, Semen analysi, Health Services Needs and Demand, business.industry, COVID-19, Opinion Article, Sperm bank, medicine.disease, Reproductive Medicine, business, FERTILITY PRESERVATION, INFLAMMATORY-BOWEL-DISEASE
Abstract

The prolonged lockdown of health facilities providing non-urgent gamete cryopreservation –as currently recommended by many reproductive medicine entities and regulatory authorities due to the SARS-CoV-2 pandemic will be detrimental for subgroups of male infertility patients. We believe the existing recommendations should be promptly modified and propose that the same permissive approach for sperm banking granted for men with cancer is expanded to other groups of vulnerable patients. These groups include male infertility patients (e.g., azoospermic men and cryptozoospermic) undergoing medical or surgical treatment to improve sperm quantity and quality, as well as males of reproductive age affected by inflammatory and systemic auto-immune diseases who are about to start treatment with gonadotoxic drugs or who are under remission. In both scenarios, the ‘fertility window’ may be transitory; postponing diagnostic semen analysis and sperm banking in these men could compromise the prospects of biological parenthood. Moreover, we provide recommendations on how to continue the provision of andrological services in a considered manner and a safe environment. Our opinion is timely and relevant given the fact that fertility services are currently rated as of low priority in most countries.

Published
2020

25. DETECTION OF PHELLINUS NOXIUS DECAY IN STERCULIA FOETIDA TREE.

Author

Lin, C. J., Chung, C. H., Wu, M. L., and Cho, C. L.

Subjects
*PHELLINUS noxius, *STERCULIA, *NONDESTRUCTIVE testing, *STRESS waves, *WOOD decay, *ACOUSTIC tomography
Abstract

The extent and location of decay in a damaged standing hazel bottle tree (Sterculia foetida) infected with brown root rot (Phellinus noxius) were determined using non-destructive evaluation (NDE) techniques, namely, visual inspection, stress wave tomography, drilling resistance and crushing strength. The stress wave velocity, drilling resistance and crushing strength of the infected tree were lower than those of the uninfected tree. Greater decay and damage as well as weaker strength properties were found near the root and bark of the trunk at the base of the infected tree. Observation in the ield showed that decay and wood deterioration due to brown root rot developed from the root upwards to the trunk and from the bark penetrating inwards to the pith. Various NDE techniques can be used in combination to detect decay in living tree infected with brown root rot. [ABSTRACT FROM AUTHOR]

Published
2013

27. Extraluminal location of a Foley catheter balloon.

Author

Cho CL, Chan WK, Chu RW, and Law IC

Subjects
Aged, Diverticulum surgery, Humans, Male, Tomography, X-Ray Computed, Urinary Bladder diagnostic imaging, Urinary Bladder surgery, Diverticulum diagnostic imaging, Diverticulum etiology, Urinary Bladder abnormalities, Urinary Catheterization adverse effects
Published
2017
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28. Authors' reply.

Author

Cho CL, Leung CL, Chan WK, Chu RW, and Law IC

Published
2016

29. Early postoperative outcome of bipolar transurethral enucleation and resection of the prostate.

Author

Cho CL, Leung CL, Chan WK, Chu RW, and Law IC

Subjects
Aged, Aged, 80 and over, Follow-Up Studies, Hemoglobins analysis, Hong Kong, Humans, Length of Stay, Male, Middle Aged, Postoperative Complications epidemiology, Postoperative Complications etiology, Postoperative Period, Prostate pathology, Prostate surgery, Prostate-Specific Antigen blood, Prostatic Hyperplasia blood, Prostatic Hyperplasia pathology, Transurethral Resection of Prostate adverse effects, Treatment Outcome, Urinary Incontinence epidemiology, Urinary Incontinence etiology, Prostatic Hyperplasia surgery, Transurethral Resection of Prostate methods
Abstract

Objectives: To report the early postoperative outcome of bipolar transurethral enucleation and resection of the prostate. Our results were compared with those published from various centres., Setting: Regional hospital, Hong Kong., Patients: A total of 28 consecutive patients who had undergone bipolar transurethral enucleation and resection of the prostate by a single surgeon between January and June 2014. All patients were evaluated preoperatively by physical examination, digital rectal examination, transrectal ultrasonography, and laboratory studies, including measurement of haemoglobin, sodium, and prostate-specific antigen levels. Patients were assessed perioperatively and at 4 weeks and 3 months postoperatively., Results: The mean resected specimen weight of prostatic adenoma in 28 patients was 48.2 g with a mean enucleation and resection time of 13.6 and 47.7 minutes, respectively. There was a mean decrease in serum prostate-specific antigen by 85.9% (from 6.4 ng/mL to 0.9 ng/mL) postoperatively. Prostate volume was decreased by 68.2% (from 71.9 cm(3) to 22.9 cm(3)) at 4 weeks postoperatively. The mean postoperative haemoglobin drop was 11.5 g/L. The rate of transient urinary incontinence at 3 months was 3.6%. Patients who underwent bipolar transurethral enucleation and resection of the prostate had a short catheterisation time and hospital stay, which is comparable to conventional transurethral resection of the prostate., Conclusions: Bipolar transurethral enucleation and resection of the prostate should become the endourological equivalent to open adenomectomy with fewer complications and short convalescence. The technique of bipolar transurethral enucleation and resection of the prostate can be acquired safely with a relatively short learning curve.

Published
2015
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30. Robot-assisted versus standard laparoscopic partial nephrectomy: comparison of perioperative outcomes from a single institution.

Author

Cho CL, Ho KL, Chu SS, and Tam PC

Subjects
Adult, Aged, Female, Humans, Kidney Neoplasms pathology, Laparoscopy adverse effects, Male, Middle Aged, Nephrectomy adverse effects, Postoperative Complications etiology, Retrospective Studies, Kidney Neoplasms surgery, Laparoscopy methods, Nephrectomy methods, Robotics
Abstract

Objective: To evaluate the perioperative outcomes of robot-assisted laparoscopic partial nephrectomy and standard laparoscopic partial nephrectomy in a teaching hospital., Design: Retrospective study., Setting: Division of Urology, Department of Surgery, Queen Mary and Tung Wah hospitals, Hong Kong., Patients: The first 10 consecutive patients who had robot-assisted laparoscopic partial nephrectomy for renal tumours between January 2008 and September 2009 with prospective data collection were evaluated. Their outcomes were compared with the last 10 consecutive patients in our database, who had standard laparoscopic partial nephrectomy between November 2004 and October 2007., Main Outcome Measures: Demographics, tumour characteristics, perioperative outcomes, renal function, and pathological outcomes., Results: There were no differences between the groups with regard to age (63 vs 56 years; P=0.313) and tumour size (2.7 vs 2.8 cm; P=0.895). No significant difference was found between the two groups with respect to the operating room time (376 vs 361 min; P=0.722), estimated blood loss (329 vs 328 mL; P=0.994), and length of hospital stay (7 vs 14 days; P=0.213). A statistically significant shorter mean warm ischaemic time for the robot-assisted group was noted (31 vs 40 minutes; P=0.032). Respective renal functional outcomes as shown by the difference between day 0 and day 60 serum creatinine levels were comparable (+10 vs +7 mmol/L; P=0.605). In both groups, there were no intra-operative complications or instances of surgical margin tumour involvement. Three patients endured postoperative complications in the standard laparoscopic group (a perinephric haematoma, urine leakage, and lymph leakage) compared with one in the robot-assisted group (a perinephric haematoma). These complications all resolved with conservative treatment., Conclusions: Robot-assisted laparoscopic partial nephrectomy is a technically feasible alternative to standard laparoscopic partial nephrectomy, and provides comparable results. Robot-assisted laparoscopic partial nephrectomy appears to offer the advantage of decreased warm ischaemic time. Longer follow-up is required to assess renal function and oncological outcomes. Further experience and randomised trials are necessary to compare robot-assisted with standard laparoscopic partial nephrectomy.

Published
2011

31. Superselective embolisation of bilateral superior vesical arteries for management of haemorrhagic cystitis.

Author

Cho CL, Lai MH, So HS, Kwok KK, Chan JC, and Velayudhan V

Subjects
Adult, Humans, Male, Middle Aged, Cystitis therapy, Embolization, Therapeutic methods, Hemorrhage therapy, Urinary Bladder blood supply
Abstract

Bladder haemorrhage is common and sometimes life-threatening. Management options include bladder irrigation and supportive transfusion, intravesical instillation, endourological intervention, and surgical intervention which has poor success and high morbidity rates. Percutaneous arterial embolisation offers another minimally invasive option. We report two patients with severe haemorrhagic cystitis treated with superselective embolisation of bilateral superior vesical arteries. The technique is safe and effective for achieving immediate control of refractory bladder haemorrhage. The long-term efficacy of the procedure requires further investigation.

Published
2008

32. Splenic laceration after endoscopic retrograde cholangiopancreatography.

Author

Cho CL, Yuen KK, Yuen CH, Chong LC, and Chu RW

Subjects
Constriction, Pathologic diagnosis, Constriction, Pathologic surgery, Extravasation of Diagnostic and Therapeutic Materials diagnosis, Extravasation of Diagnostic and Therapeutic Materials etiology, Extravasation of Diagnostic and Therapeutic Materials surgery, Female, Hemoperitoneum diagnosis, Hemoperitoneum etiology, Hemoperitoneum surgery, Humans, Lacerations diagnosis, Lacerations surgery, Liver Function Tests, Middle Aged, Splenectomy, Tomography, X-Ray Computed, Cholangiopancreatography, Endoscopic Retrograde adverse effects, Lacerations etiology, Pancreatic Ducts, Pancreatitis, Chronic diagnosis, Spleen injuries
Abstract

Endoscopic retrograde cholangiopancreatography has been part of clinical practice for over 35 years. The procedure itself carries risks. Most complications associated with the procedure have been described in the literature. Splenic injury is an extremely rare complication after endoscopic retrograde cholangiopancreatography and only nine such cases have been reported to our knowledge since 1988. We report on a patient who presented with abdominal pain and was found to have abnormal liver function and a dilated pancreatic duct. An endoscopic retrograde cholangiopancreatography was performed and a splenic laceration was noted subsequently. As this operation is an increasingly important diagnostic and therapeutic modality for pancreatico-biliary disease, clinicians must be aware of this complication in order to make an early diagnosis and begin appropriate management.

Published
2008

33. Differential telomerase expression and telomere length in primary intracranial tumors.

Author

Chen HJ, Cho CL, Liang CL, Chen L, Chang HW, Lu K, and Lee TC

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Brain Neoplasms enzymology, Brain Neoplasms mortality, Child, Child, Preschool, Female, Humans, Male, Middle Aged, Brain Neoplasms genetics, Telomerase metabolism, Telomere
Abstract

Background: Telomerase activity and telomere length have been shown to be involved in controlling cell proliferation and regulating cell senescence. The authors examined telomerase activity and telomere length in intracranial tumors to determine the clinicopathological behavior of primary intracranial tumors with respect to telomerase expression and alteration of telomere length., Methods: Telomerase activity was examined in 139 brain tumor samples. Telomere length was examined in 138 of the 139 samples. These tumors included 61 meningiomas, 27 schwannomas, 19 high-grade neuroepithelial tumors, and 32 low-grade neuroepithelial tumors. Telomerase activity was measured with a telomerase polymerase chain reaction, enzyme-linked immunosolvent assay kit. Telomere length was examined by Southern blot analysis for the terminal restriction fragment length., Results: Telomerase activity was detected in 39.2% (20/51) of the neuroepithelial tumors. Detection rates were 47.4% (9/19) for anaplastic astrocytomas and glioblastomas and 34.4% (11/32) for low-grade neuroepithelial tumors. However, detectable telomerase activity was found in 30.8% (4/13) of atypical or malignant meningiomas, but was not detected in any schwannomas. There was a highly significant difference in the telomerase detection rate in neuroepithelial or non-neuroepithelial tumors (p = 0.001). Telomere elongation was found in 11.7% (7/60) of all meningiomas, 46.1% (6/13) of atypical or malignant meningiomas, and 14.8% (4/27) of schwannomas. Elongation of telomere length was detected in 12.6% (11/87) of the cases and 23.5% (12/51) in neuroepithelial tumors. This difference was also significant (p < 0.05). Telomere length was reduced in the majority, (75%, 3/4) of malignant or atypical meningiomas with detectable telomerase activity, but only 45% (9/20) of the neuroepithelial tumors., Conclusion: These results indicate that telomerase activation may be a critical step in the pathogenesis of intracranial tumors. Telomere length elongation also indicates a high potential for malignant behavior in these tumors.

Published
2001

34. Diagnostic usefulness of telomerase activity in nasopharyngeal carcinoma.

Author

Hwang CF, Su CY, Kou SC, Huang SC, Leung SW, Huang CM, and Cho CL

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Enzyme Activation, Female, HeLa Cells, Humans, Lymphoid Tissue enzymology, Male, Middle Aged, Nasopharyngeal Neoplasms pathology, Nasopharyngeal Neoplasms radiotherapy, Nasopharynx enzymology, Neoplasm Staging, Repetitive Sequences, Nucleic Acid, Nasopharyngeal Neoplasms enzymology, Telomerase metabolism
Abstract

Telomeres are specialized structures at the ends of eukaryotic chromosomes which are composed of simple repetitive G-rich hexameric sequences. Activation of telomerase, a ribonucleoprotein that synthesizes telomeric DNA, is found in most malignant tumors. However, little data is available concerning the correlation between telomerase activity and NPC (nasopharyngeal carcinoma). In this study, telomerase activation was determined using the TRAP (telomerase repeat amplification protocol) assay in 62 nasopharyngeal biopsies (25 NPC, 25 non-malignant nasopharyngeal lymphoid tissues, 12 post-irradiated nasopharyngeal tissues). The results showed that strong telomerase activity was present in both NPC and non-malignant nasopharyngeal biopsies. Post-irradiated nasopharyngeal samples had a significantly lower telomerase activity than NPC and non-malignant nasopharyngeal lymphoid tissues. It is well known that nasopharyngeal tissue is infiltrated by numerous lymphocytes, which might retain telomerase activity. Therefore, the finding that the telomerase activation was lowest in post-irradiated nasopharyngeal tissues is reasonable because of the destruction of activated lymphocytes and NPC by radiation. NPC biopsies with positive lymph node involvement exhibited higher levels of telomerase compared to those without lymph node involvement. Our data indicate a positive association between telomerase activity and tumor potential for lymphatic spreading in limited local tumors. In addition, telomerase activity may be useful as a diagnostic marker in the detection of tumor cells in recurrent NPC, but not in primary NPC.

Published
2000
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35. Effect of acetic acid on telomerase activity in cervical intraepithelial neoplasia.

Author

ChangChien CC, Lin H, Leung SW, Hsu CY, and Cho CL

Subjects
Colposcopy methods, Female, HeLa Cells drug effects, Humans, Acetic Acid pharmacology, Telomerase drug effects, Telomerase metabolism, Uterine Cervical Neoplasms enzymology, Uterine Cervical Dysplasia enzymology
Abstract

Objective: To evaluate whether the telomerase activity in CIN lesions can be affected by a chemical solution of acetic acid, which is required to apply to the cervix prior to colposcopy-directed biopsy., Materials and Methods: Thirty-five patients with histologically confirmed high-grade squamous intraepithelial lesions of the cervix entered the study. Two specimens were collected from each patient, one before and one after the cervix was swabbed with 5% acetic acid. The standard telomeric repeat assay protocol (TRAP) was used to examine telomerase activity in these fresh frozen tissue samples. Normal cervical tissues from 10 control individuals were also examined for the presence of telomerase activity. A total of 80 specimens was analyzed., Results: Telomerase activity was detectable in 27 of 35 (77.1%) fresh tissue samples, 15 of 35 (42.9%) tissue samples swabbed with 5% acetic acid, and 0 of 10 (0%) normal cervical tissue samples, respectively. Twelve samples became telomerase negative after 5% acetic acid applied. Among the 15 telomerase-positive tissue samples swabbed with 5% acetic acid, 12 had relative weak telomerase activity compared to corresponding fresh tissue samples, the other 3 remained the same. Therefore, it is concluded that telomerase activity was affected by 5% acetic acid in 24 of 27 (88.9%) samples. Telomerase activity in HeLa cell line was also inhibited by 5% acetic acid., Conclusion: We reported a relative high percentage of telomerase expression in high-grade CIN lesions when compared with previous reports. If detection of telomerase activity is to become a tool for diagnosis and prognosis of cervical neoplasias, applying acetic acid prior to colposcopy-directed biopsy that is submitted for telomerase assay should be avoided in order to increase the detection rate., (Copyright 1998 Academic Press.)

Published
1998
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36. Loss of expression of the p16 gene is frequent in malignant skin tumors.

Author

Chang TG, Wang J, Chen LW, Hsu CY, Chang HW, Chen JS, and Cho CL

Subjects
Adenocarcinoma genetics, Carcinoma, Basal Cell genetics, Carcinoma, Squamous Cell genetics, Carrier Proteins analysis, Cyclin-Dependent Kinase Inhibitor p16, Hemangiosarcoma genetics, Humans, Immunohistochemistry, Melanoma genetics, Neurilemmoma genetics, Polymerase Chain Reaction, RNA, Messenger analysis, RNA, Messenger biosynthesis, Skin Neoplasms metabolism, Skin Neoplasms pathology, Carrier Proteins biosynthesis, Genes, Tumor Suppressor, Skin Neoplasms genetics
Abstract

Expression of the p16 gene from 30 malignant skin tumors has been surveyed by immunohistochemical assay. Gene point mutations were detected by DNA direct sequencing and the mRNA level of gene expression was measured by RT-PCR. A silent point mutation of the p16 gene was found in only one patient. However, loss of expression of the p16 gene was noticed in 23 of 29 samples (79.3%). Correlation between loss of expression of the p16 gene and metastasis is significant (p = 0.0036). These findings suggest that loss of expression of the p16 gene may play a critical role in tumor progression of malignant skin tumors.

Published
1997
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37. Cloning and expression of human homolog HSMT3 to yeast SMT3 suppressor of MIF2 mutations in a centromere protein gene.

Author

Mannen H, Tseng HM, Cho CL, and Li SS

Subjects
Amino Acid Sequence, Animals, Base Sequence, Centromere chemistry, Cloning, Molecular, DNA, Complementary genetics, Fungal Proteins genetics, Gene Expression, Humans, Mitosis, Molecular Sequence Data, RNA, Messenger genetics, Saccharomyces cerevisiae genetics, Sequence Alignment, Sequence Homology, Amino Acid, Swine, Proteins genetics, Repressor Proteins genetics, Saccharomyces cerevisiae Proteins, Small Ubiquitin-Related Modifier Proteins
Abstract

A human HSMT3 cDNA encoding a homolog of the yeast SMT3, a suppressor of MIF2 mutations in a centromere protein gene, was identified and sequenced. The sequence of 95 amino acids deduced from the human HSMT3 cDNA exhibited 51.1% identity and 69.6% similarity to the yeast Smt3p sequence. The HSMT3 transcripts of 1.35Kb were found to be abundantly expressed in various human tissues.

Published
1996
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38. RB virus: a strain of Friend virus that produces a 'Friend virus-like' disease in Fv-2rr mice.

Author

Geib RW, Seaward MB, Stevens ML, Cho CL, and Majumdar M

Subjects
Animals, Antibodies, Viral immunology, Cell Line, Disease Susceptibility, Friend murine leukemia virus growth & development, Friend murine leukemia virus immunology, Genetic Variation, Hematocrit, Liver microbiology, Liver pathology, Mice, Mice, Inbred BALB C, Spleen microbiology, Spleen pathology, Friend murine leukemia virus pathogenicity, Leukemia, Experimental pathology, Viral Envelope Proteins physiology
Abstract

RB virus is a newly derived strain of Friend virus that was adapted to produce a 'Friend-like' disease in mice that are genetically resistant to wild-type Friend virus. RB virus was produced by passing high titers of the wild-type Friend virus (Lilly-Steeves polycythemia-producing strain) through adult Fv-2rr mice. Titration of the defective spleen focus-forming virus indicated RB virus infected similar numbers of Fv-2ss or Fv-2rr target cells. Analysis of the spleens from mice infected with RB virus indicated that RB induced the early stage of Friend disease (erythroid proliferation) in both Fv-2rr and Fv-2ss mice. Fv-2ss mice infected with RB virus developed the classical Friend disease within 3 weeks. In contrast, the percentage of Fv-2rr mice developing the 'Friend-like' disease after infection with RB virus never exceeded 60%. The latency period of RBV in Fv-2rr mice was strain dependent. D2.R16 (Fv-2rr) developed the syndrome more rapidly than C57BL/6 (Fv-2rr). RB virus retained the capacity to transform erythroprogenitor cells from both Fv-2ss and Fv-2rr animals. Cells infected with RB virus consistently produced a modified SFFV envelope protein, gp48.

Published
1989
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