Basic and Clinical Andrology

Comparison of precision of a paperless electronic input method versus the conventional paper form in an andrology laboratory: a prospective study
Lam KKW, Tsang PCK, Chan CCY, Ng EPK, Cheung TM, Li RHW, Ng EHY and Yeung WSB
Manual counting for semen analysis is recommended by the World Health Organization. Technicians performing this usually record their results on a paper worksheet and then enter the data into an electronic laboratory information system. One disadvantage of this approach is the chance of post-analytical transcription errors, which can be reduced by checking the computer entries before reporting by another technician. Such practice inevitably increases the running cost and delays the reporting time. The present study was to establish a paperless electronic data entry system for semen analysis and compare its precision with the conventional paper method. During semen analysis, readings on the cell counter were video recorded. The precision of the paper record entries was determined by comparing them with the corresponding video records. Patient characteristics and semen analysis results were input directly into an in-house developed data entry system via a tablet computer immediately after analysis. The same set of data was also handwritten on a paper form and was subsequently input into a standard computerized database according to routine practice. The agreement of the data entries between the two systems was then compared.
A new approach for hemodynamics of varicoceles: blood flow patterns based on contrast-enhanced ultrasound
Zou P, Fan G, Li Z, Tao Y, Jia C, Liang H, Tian R, Shi Q, Hu J and Wu R
Hemodynamic alterations in the spermatic vein are implicated in infertility among patients with varicocele (VC). Contrast-enhanced ultrasound (CEUS), a powerful tool for hemodynamic analysis, remains unexplored for VC. This study aimed to demonstrate the feasibility of using CEUS to evaluate spermatic vein hemodynamics in patients with VC and establish a clear correlation between specific hemodynamic patterns and impaired semen parameters. This study included 165 patients with left-sided VC and 50 healthy volunteers. All participants underwent CEUS of the spermatic veins, along with maximum venous diameter and testicular volume measurements and serum sex hormone levels and routine semen analyses. The sperm DNA fragmentation index was measured in 146 patients with VC and 37 healthy controls.
The protective effects of active ingredients from acrorus tatarinowii on sperm and their molecular mechanisms
Lu Z, Zhao H, Wang H, Wang X and Sun Z
To investigate the therapeutic potential of Acrorus tatarinowii in oligoasthenozoospermia and its related mechanism through modulation of the BCL2/Bax/Caspase3 signaling pathway.
Future perspectives for PDE5 inhibitors bridging the gap between cardiovascular health and psychological status
Sansone A, Guida E, Dolci S, Frangione V, Asso A, Bellia G and Jannini EA
The serendipitous discovery that inhibiting type 5 phosphodiesterase (PDE5) using sildenafil, a potent PDE5 inhibitor (PDE5i) initially developed for cardioprotection, introduced the possibility of orally managing erectile dysfunction (ED) led to an increase in research data, which are currently considered groundbreaking for the new discipline of sexual medicine. Findings from a number of laboratories and clinics around the world unanimously demonstrated the following: (i) the major cause of ED is directly or indirectly related to cardiovascular disease (CVD); (ii) ED and CVDs share the same risk factors, which are related mainly to lifestyle choices; (iii) the first therapeutic approach to both ED and CVDs is to transform harmful lifestyles into virtuous lifestyles; and (iv) PDE5is in general, particularly sildenafil, are very safe, if not protective, for use in CVD patients. However, the use of PDE5is has faced several challenges. Many patients and some healthcare providers (HCPs) often share the misconception that using these drugs can increase the risk of CVD. Some patients might desire to fulfill the unmet need for privacy linked to the stigma of being treated for ED or might be enticed by the idea of buying drugs online, either because of shame or cheaper prices, without knowing the risks associated with counterfeit drugs. The aim of this narrative revision of the current literature is to demonstrate that (i) the orodispersible film of sildenafil is safe from a CV perspective; (ii) it is a discreet formulation that respects the need for privacy; and (iii) it is virtually the unique PDE5i formulation too expensive to produce outside the correct channels, making it impossible to be counterfeit.
Idiopathic recurrent ischemic priapism: a review of current literature and an algorithmic approach to evaluation and management
Yarak N, El Khoury J, Coloby P, Bart S and Abdessater M
Stuttering priapism is characterized by recurrent, self-limited episodes of penile erection lasting from a few minutes to a maximum of three hours, often resolving spontaneously. These episodes can occur with or without sexual stimulation. If not treated promptly and effectively, stuttering priapism can severely impact a patient's quality of life, leading to significant psychological distress and anxiety related to sexual performance. Although it has been associated with various hematological disorders and pharmacological treatments, many cases of stuttering priapism remain idiopathic, meaning they have no identifiable cause. Currently, no conclusive randomized clinical trials exist on the management of idiopathic stuttering priapism. This study aims to review the existing literature on the pathophysiology and management of idiopathic stuttering priapism and propose an algorithm to assist physicians in its evaluation and treatment.
Correction: Stigma and its associations with self-confidence and sexual relations in 4 types of premature ejaculation
Liu J, Bao T, Wang Q, Jiang H and Zhang X
The role of acupuncture in treating premature ejaculation and its probable neurobiological mechanism
Wang A, Wang H, Ma D, Chang H, Zhao Z, Luo D and Wang F
Premature ejaculation (PE) is one of the most common diseases in andrology and leads to serious male sexual dysfunction. Although several targeted oral drug therapies are used to treat PE, they often face challenges related to imprecise targeting and adverse effects. Acupuncture has shown potential in prolonging ejaculation time and improving couples' sexual quality of life. This review aims to summarize the benefits of acupuncture in treating PE and explore its probable neurobiological mechanisms.
Pathogenesis of acephalic spermatozoa syndrome caused by PMFBP1 mutation
Xia H, Zhang J, Mao W, Yi K, Wang T and Liao L
Acephalic spermatozoa syndrome is a rare but severe type of teratozoospermia. The familial trait of acephalic spermatozoa syndrome suggests that genetic factors play an important role. However, known mutations account for only some acephalic spermatozoa syndrome patients, and more studies are needed to elucidate its pathogenesis. The current study aimed to elucidate the pathogenesis of acephalic spermatozoa syndrome caused by PMFBP1 mutation.
The annulus: composition, role and importance in sperm flagellum biogenesis and male fertility
Whitfield M
The annulus is an electron-dense ring structure that surrounds the axoneme and compartmentalizes the sperm flagellum into two parts: the midpiece and the principal piece. The function of the annulus as a diffusion barrier in the mature spermatozoon is now well described but its function during spermiogenesis remains unclear. The intriguing spatio-temporal dynamics of the annulus during spermiogenesis and its position at the interface of the two main flagellar compartments have been highlighted for more than 50 years, and suggest a major role in this process. During the last decade, numerous studies contributed in establishing a repertoire of proteins known to be located at the annulus. Mutant mouse models of invalidation of these proteins have provided essential information and clues for novel hypotheses regarding the functions and regulation of this structure. Importantly, the recent identification in humans of homozygous mutations of genes coding for annulus proteins and leading to sterility have reinforced the importance of this ring structure for sperm physiology and male fertility. This review provides a comprehensive description of all the knowledge obtained in the last several years regarding the annulus composition and functions, both in mice and in humans.
Primary ciliary dyskinesia as a rare cause of male infertility: case report and literature overview
Novák J, Horáková L, Puchmajerová A, Vik V, Krátká Z and Thon V
Primary ciliary dyskinesia (PCD) is a heterogenous disease caused by mutations of miscellaneous genes which physiologically play an important role in proper structure and/or function of various cellular cilia including sperm flagella. Besides male infertility, the typical phenotypes, based on decreased mucociliary clearance, are lifelong respiratory issues, i.e., chronic bronchitis leading to bronchiectasis, chronic rhinosinusitis, and chronic otitis media. Moreover, since motile cilia are important during embryological development in the sense of direction of gut rotation, 50% of affected individuals develop situs inversus - so-called Kartagener's syndrome.
Vascular hemodynamic effects of penile revascularization surgery and the role of resistive index in follow-up
Akdemir F and Kayigil Ö
To evaluate the effects of penile revascularization surgery on penile vascular hemodynamics and to assess the utility of the resistive index (RI) as an objective parameter for postoperative patient follow-up.
SARS-CoV-2 in semen: a multicenter prospective study and literature review
Cochetti G, Del Zingaro M, Maiolino G, Paladini A, Mearini M, Schiavina R, Bianchi L, De Angelis L, Panciarola M, Camilloni B, Brunocilla E and Mearini E
Despite numerous efforts to demonstrate the presence of the SARS-CoV-2 in semen of affected males, no clear evidence exists. We conducted a multicenter prospective study on adult patients with a confirmed diagnosis of SARS-CoV-2 including patients with active infection (Active Group) and with a history of COVID-19 disease at least of 6 months (Recovered Group). An RT-PCR test for SARS-CoV-2 and a semen analysis were performed on the semen of the enrolled patients. Genital/sexual symptoms were investigated in both groups. In the active infection group, urinary and sexual functions were assessed in the active phase and after 6 months. Finally, the literature on the detection of SARS-CoV-2 in semen was reviewed non-systematically.
Is testicular microlithiasis associated with decreased semen parameters? a systematic review
Wilson HG, Birch BR and Rees RW
Testicular microlithiasis (TM) is characterised by microcalcifications in the testes and has been associated with infertility. This has led to studies of semen analysis in men with the condition. This systematic review aimed to compare semen parameters in men with TM and those without. Men with classic TM (≥ 5 microcalcifications per sonographic image) were also compared to those with limited TM (< 5 microcalcifications per sonographic image). Additionally, testicular volume and hormone levels were analysed as secondary outcomes. This review was carried out according to PRISMA guidelines and registered on PROSPERO. The quality of included studies was assessed using the Newcastle-Ottawa Scale.
Evaluation of seminal plasma levels of vaspin and visfatin in infertile males with elevated sperm DNA fragmentation index: a comparative study
Amer MK, Youssef NA, GamalEl Din SF, Saied NG, Ahmed MA, Raef A and Ragab A
Sperm DNA fragmentation (SDF) can significantly impact male fertility, especially in cases where there is a substantial level of DNA damage. We aimed in the current study to assess seminal plasma (SP) levels of vaspin and visfatin in infertile men with an elevated SDF index (SDFI ≥ 30%) compared to infertile males with a normal SDFI (SDFI < 30%).
Septum of the penis - dissection, anatomical description and functional relevance
Filipoiu FM, Ion RT, Filipoiu ZF, Tulin AD, Enciu O and Enyedi M
The septum of the penis or the pectiniform septum (from Latina pecten) is a connective structure that separates the two corpora cavernosa of the penis. It is formed through the joining of the circular fibers of the tunica albuginea, which envelops the corpora cavernosa. The septum neither completely separates, nor entirely joins the two corpora cavernosa.
Safety and efficacy of platelet-rich plasma injection for treatment of erectile dysfunction: a prospective randomized controlled study
Ragheb AM, Lotfy AM, Fahmy M and Elmarakbi AA
Affected sexual relationships affect both the quality of life of men and women. Platelet-derived therapies are becoming increasingly popular in various medical and surgical fields because of their ability to aid in tissue healing and vascular remodeling. This study aimed to assess the safety and effectiveness of platelet-rich plasma (PRP) injections in treating patients with erectile dysfunction (ED).
Genetic diagnosis and outcomes of intracytoplasmic sperm injection in South Chinese patients with congenital bilateral aplasia of the vas deferens
Hu H, Zhou Q, Ma Y and Zhang L
Obstructive azoospermia commonly is caused by CBAVD(Congenital Bilateral Aplasia of the Vas Deferens), mainly due to the cystic fibrosis transmembrane conductance regulator (CFTR) and adhesion G protein-coupled receptor G2(ADGRG2) mutations. The genetic landscape for Chinese CBAVD patients is unclear, leading to debates over genetic screening, counseling, and assisted reproduction strategies. This study investigates the prevalence of CFTR and ADGRG2 mutations in a southern Chinese cohort of CBAVD patients and evaluates the impact of CFTR mutations on intracytoplasmic sperm injection (ICSI) outcomes.
Association between low total serum testosterone and body mass index in Australian survivors of testicular cancer: a retrospective analysis
Kim GY, Conduit C, O'Haire S, Chong CY, Baenziger O, Lewin J, Thomas B, Lawrentschuk N, Stockler MR, Olver I, Grimison P and Tran B
Primary hypogonadism is a recognised complication in survivors of testicular cancer. However, secondary hypogonadism can result from other causes that suppress the hypothalamic-pituitary axis, including obesity, high dose glucocorticoids, chronic end organ failure, and diabetes. The aim of this study was to explore low total serum testosterone in Australian survivors of testicular cancer and examine associations with body mass index, age, and prior chemotherapy use.
The storage time of cryopreserved human spermatozoa does not affect pathways involved in fertility
Stigliani S, Amaro A, Reggiani F, Maccarini E, Massarotti C, Lambertini M, Anserini P and Scaruffi P
Cryopreservation of human spermatozoa is a widely used technique in the assisted reproduction technology laboratory for the storage of gametes for later use, for the fertility preservation and for sperm donation programs. Cryopreservation can cause damage to membrane, cytoskeletal, acrosome and increased oxidative stress, sperm DNA damage and transcriptome changes. To assess the impact of storage time on the transcriptome of frozen human spermatozoa, semen samples were collected from 24 normospermic donors of whom 13 had cryostored semen for a short-time (1 week) and 11 had cryostored semen for a long-time (median 9 years).
Secondary azoospermia after a successful natural pregnancy: a primary prospective study
Elahwany A, Alahwany H, Torad H, Ramzy D, Aboelkomsan EAF and GamalEl Din SF
To date, there is a lack of studies conducted on males with secondary azoospermia as a potential cause of male infertility who had previously fathered children through natural conception. The current study aims to investigate the potential causes of secondary azoospermia as a presentation of male infertility as well as the prognostic factors that can impact sperm retrieval rate (SRR) while undergoing microdissection testicular sperm extraction (microTESE).
Changing trends in penile prosthesis implantation in China and an overview of postoperative outcomes from a single center
Zhang C, Bai H, Shi C, Chen H, Li P, Huang Y, Chen H, Zhao F, Yao C, Li Z and Zhi E
Surgical penile prosthesis implantation (PPI) procedures have only recently been introduced to mainland China, with the overall number of such procedures having been conducted to date remaining relatively low. Accordingly, relatively little remains known with respect to the annual trends in PPI. Accordingly, this study was developed with the goal of clarifying these trends across different hospitals in mainland China, while also providing a single-center overview of post-PPI patient outcomes.