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Hubbard L, Rambhatla A, Colpi GM. Differentiation between nonobstructive azoospermia and obstructive azoospermia: then and now. Asian J Androl 2024:00129336-990000000-00247. [PMID: 39268812 DOI: 10.4103/aja202475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Accepted: 07/02/2024] [Indexed: 09/15/2024] Open
Abstract
Male infertility has seen an increase in prevalence with cases of azoospermia estimated to affect 10%-15% of infertile men. Confirmation of azoospermia subsequently necessitates an early causal differentiation between obstructive azoospermia (OA) and nonobstructive azoospermia (NOA). Although less common when compared to NOA, OA can represent upward 20%-40% of cases of azoospermia. While there are a multitude of etiologies responsible for causing NOA and OA, correctly distinguishing between the two types of azoospermia has profound implications in managing the infertile male. This review represents an amalgamation of the current guidelines and literature which will supply the reproductive physician with a diagnostic armamentarium to properly distinguish between NOA and OA, therefore providing the best possible care to the infertile couple.
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Affiliation(s)
- Logan Hubbard
- Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI 48202-3450, USA
| | - Amarnath Rambhatla
- Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI 48202-3450, USA
| | - Giovanni M Colpi
- Andrology and IVF Center, Next Fertility Procrea, Lugano 6900, Switzerland
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Ni D, Xu J, Liu K, Wu N, You B, Yang B, Dai Y. Curcumin ameliorates pyroptosis in diabetic seminal vesicles by upregulating TRPV6. Andrology 2024. [PMID: 38966878 DOI: 10.1111/andr.13687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 06/10/2024] [Accepted: 06/14/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Diabetes damages the seminal vesicle tissues leading to a decrease in seminal fluid secretion, so investigations are ongoing to identify specific therapeutic approaches to address diabetes-induced damage to seminal vesicles. OBJECTIVE This study investigated the secretory dysfunction of seminal vesicles and how curcumin can ameliorate this dysfunction. MATERIALS AND METHODS First, 40 diabetic males (DM group) and 40 nondiabetic males (control group) underwent seminal vesicle ultrasound evaluation and ejaculate volume measurements. Then, the effects of curcumin on seminal vesicle function were investigated in a diabetic rat model. Fifty 8-week-old SPF-grade SD rats were categorized into five groups: control, DM (diabetes mellitus), low-dose CUR (curcumin 50 mg/kg/d), medium-dose CUR (curcumin 100 mg/kg/d), and high-dose CUR (curcumin 150 mg/kg/d). After a month-long diet with varying curcumin doses, key parameters such as body weight, blood glucose levels, seminal vesicle volume, and seminal fluid secretion were measured. Transcriptome sequencing was performed to assess differences in gene expression and structural changes in rat seminal vesicle tissues were examined by HE staining. Finally, human seminal vesicle cell lines were cultured and divided into five groups (HG-CON, HG-CUR-5 µM, HG-CUR-10 µM, HG-CUR-20 µM, and HG-CUR-50 µM) to measure the fructose levels in the seminal vesicle cell culture fluids and evaluate the expression of CASP1, GSDMD, and TRPV6. Post TRPV6 interference, variations in the gene expression of CASP1, GSDMD, and TRPV6 were monitored. RESULTS Diabetic patients exhibited a notable reduction in seminal vesicle volume and ejaculate volume compared with the control group, with a direct correlation between the decrease in ejaculate and seminal vesicle volume. Animal studies demonstrated that curcumin supplementation significantly augmented seminal vesicle volume in diabetic rats and notably improved their seminal vesicle secretory dysfunction, particularly in the high-dose curcumin group. Transcriptome sequencing and experimental verification pinpointed the differential expression of TPRV6 and pyroptosis-associated genes (CASP1, GSDMD), with reduced TRPV6 expression but increased markers of pyroptosis (CASP1 and GSDMD) in diabetic rats. Curcumin treatment reversed these effects with an increase in TRPV6 and a decrease in GSDMD and CASP1. Cell transfection experiments indicated that TRPV6 downregulation increased GSDMD and CASP1 gene expression. CONCLUSION Curcumin effectively activates TRPV6, thereby diminishing pyroptosis in the seminal vesicle tissues of diabetic rats. This activation not only leads to an increase in the seminal vesicle volume but also significantly ameliorates the seminal vesicle secretory dysfunction in diabetic rats.
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Affiliation(s)
- Dawei Ni
- Department of Andrology, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China
- Department of Urology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, China
| | - Jie Xu
- Department of Ultrasound, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, China
| | - Kun Liu
- Department of Urology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, China
| | - Ning Wu
- Department of Andrology, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China
| | - Bin You
- Department of Andrology, Guoyang County Traditional Chinese Medicine Hospital in Bozhou City, Anhui Province, China
| | - Baibing Yang
- Department of Andrology, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yutian Dai
- Department of Andrology, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China
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Punjani N, Alawamlh OAH, Kim SJ, Salter CA, Wald G, Feliciano M, Williams N, Dudley V, Goldstein M. Changes in Semen Analysis over Time: A Temporal Trend Analysis of 20 Years of Subfertile Non-Azoospermic Men. World J Mens Health 2023; 41:382-389. [PMID: 35791300 PMCID: PMC10042654 DOI: 10.5534/wjmh.210201] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 01/04/2022] [Accepted: 01/17/2022] [Indexed: 11/15/2022] Open
Abstract
PURPOSE To examine trends of population-level semen quality over a 20-year period. MATERIALS AND METHODS We performed a retrospective review of data from the andrology lab of a high volume tertiary hospital. All men with semen samples between 2000 and 2019 were included and men with azoospermia were excluded. Semen parameters were reported using the World Health Organization (WHO) 4th edition. The primary outcome of interest was changes in semen parameters over time. Generalized least squares (GLS) with restricted cubic splines were used to estimate average-monthly measurements, adjusting for age and abstinence period. Contrasts of the estimated averages based on GLS between the first and last months of collection were calculated. RESULTS A total of 8,990 semen samples from subfertile non-azoospermic men were included in our study. Semen volume decreased over time and estimate average at the beginning and end were statistically different (p<0.001). Similarly sperm morphology decreased over time, with a statistically significant difference between estimated averages from start to finish (p<0.001). Semen pH appeared to be increasing over time, but this difference was not significant over time (p=0.060). Sperm concentration and count displayed an increase around 2003 to 2005, but otherwise remained fairly constant over time (p=0.100 and p=0.054, respectively). Sperm motility appeared to decrease over time (p<0.001). CONCLUSIONS In a large sample of patients presenting to a single institution for fertility assessment, some aspects of semen quality declined across more than two decades. An understanding of the etiologies and driving forces of changing semen parameters over time is warranted.
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Affiliation(s)
- Nahid Punjani
- Center for Reproductive Medicine and Surgery, Institute for Reproductive Medicine and Department of Urology, Weill Cornell Medicine, New York, NY, USA
| | - Omar Al-Hussein Alawamlh
- Center for Reproductive Medicine and Surgery, Institute for Reproductive Medicine and Department of Urology, Weill Cornell Medicine, New York, NY, USA
| | - Soo Jeong Kim
- Center for Reproductive Medicine and Surgery, Institute for Reproductive Medicine and Department of Urology, Weill Cornell Medicine, New York, NY, USA
| | - Carolyn A Salter
- Center for Reproductive Medicine and Surgery, Institute for Reproductive Medicine and Department of Urology, Weill Cornell Medicine, New York, NY, USA
| | - Gal Wald
- Center for Reproductive Medicine and Surgery, Institute for Reproductive Medicine and Department of Urology, Weill Cornell Medicine, New York, NY, USA
| | - Miriam Feliciano
- Center for Reproductive Medicine and Surgery, Institute for Reproductive Medicine and Department of Urology, Weill Cornell Medicine, New York, NY, USA
| | - Nicholas Williams
- Department of Biostatistics, Weill Cornell Medicine, New York, NY, USA
| | - Vanessa Dudley
- Center for Reproductive Medicine and Surgery, Institute for Reproductive Medicine and Department of Urology, Weill Cornell Medicine, New York, NY, USA
| | - Marc Goldstein
- Center for Reproductive Medicine and Surgery, Institute for Reproductive Medicine and Department of Urology, Weill Cornell Medicine, New York, NY, USA.
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Lotti F, Maggi M. Effects of diabetes mellitus on sperm quality and fertility outcomes: Clinical evidence. Andrology 2023; 11:399-416. [PMID: 36416060 DOI: 10.1111/andr.13342] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/07/2022] [Accepted: 11/11/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Diabetes mellitus is a global epidemic characterized by high morbidity and mortality. Diabetes mellitus can lead to acute and chronic systemic complications. Among them, a negative effect of diabetes mellitus on sperm quality and male/couple fertility has been suggested. However, available studies in diabetes mellitus men evaluated relatively small cohorts with discordant results. OBJECTIVES To evaluate the clinical evidences of the effects of diabetes mellitus on sperm quality and fertility outcomes. METHODS An extensive Medline search was performed identifying studies in the English language. RESULTS The prevalence of diabetes mellitus in infertile men ranges from 0.7% to 1.4%, while the prevalence of infertility in diabetes mellitus men, evaluated in a few studies, ranges from 35% to 51%. Male diabetes mellitus seems to play a negative effect on couple fecundity, while being childless or subfertile men might increase the risk of diabetes mellitus. Available cross-sectional studies investigating semen parameters and male sexual hormones in men with diabetes mellitus are heterogeneous, assessed relatively small cohorts, show often discordant results and frequently are not directly comparable to derive robust conclusions. Two meta-analyses support a negative effect of diabetes mellitus on sperm normal morphology and no effect on sperm total count, with contradictory results regarding other semen parameters. Considering only studies on type 1 diabetes mellitus men, meta-analyses support a negative effect of diabetes mellitus on sperm motility and no effect on sperm total count, with contradictory results regarding other semen parameters. The rate of children observed among type 1 diabetes mellitus men was lower than controls, especially in subjects with a longer diabetes mellitus duration. Couples with a diabetes mellitus male partner undergoing assisted reproduction techniques showed lower pregnancy rates than controls. No study evaluated the impact of diabetes mellitus treatment on semen quality and male fertility. CONCLUSIONS Overall, available data show that diabetes mellitus might impair male reproductive health and couple fertility. However, further larger and full of details studies are needed.
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Affiliation(s)
- Francesco Lotti
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", Andrology, Female Endocrinology, and Gender Incongruence Unit, University of Florence, Florence, Italy
| | - Mario Maggi
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", Endocrinology Unit, Univesity of Florence, Florence, Italy
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Lotti F, Frizza F, Balercia G, Barbonetti A, Behre HM, Calogero AE, Cremers J, Francavilla F, Isidori AM, Kliesch S, La Vignera S, Lenzi A, Marcou M, Pilatz A, Poolamets O, Punab M, Godoy MFP, Quintian C, Rajmil O, Salvio G, Shaeer O, Weidner W, Maseroli E, Cipriani S, Baldi E, Degl'Innocenti S, Danza G, Caldini AL, Terreni A, Boni L, Krausz C, Maggi M. The European Academy of Andrology (EAA) ultrasound study on healthy, fertile men: An overview on male genital tract ultrasound reference ranges. Andrology 2022; 10 Suppl 2:118-132. [PMID: 35930758 PMCID: PMC9828651 DOI: 10.1111/andr.13260] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 07/29/2022] [Accepted: 07/29/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND So far, male genital tract color-Doppler ultrasound (MGT-CDUS) was not standardized. Recently, the European Academy of Andrology (EAA) published the results of a multicenter study assessing the CDUS characteristics of healthy-fertile men (HFM) to obtain normative parameters. OBJECTIVES To report the EAA US study (i) standard operating procedures (SOPs) for assessing MGT-CDUS, (ii) main MGT-CDUS normative parameters, and (iii) compare the EAA and previously published "normal" CDUS values. METHODS A cohort of 248 HFM (35.3 ± 5.9 years) was studied, evaluating MGT-CDUS before and after ejaculation following SOPs. RESULTS SOPs for MGT-CDUS assessment are summarized here. All subjects underwent scrotal CDUS and 188 men underwent transrectal ultrasound before and after ejaculation. The main CDUS reference ranges and characteristics of the HFM-MGT are reported here. The mean testicular volume was ∼17 mL. The lower limit for right and left testis was 12 and 11 mL, defining testicular hypotrophy. The upper limit for epididymal head, body, tail, and vas deferens was 11.5, 5, 6, and 4.5 mm, respectively. Testicular and epididymal arterial reference ranges are reported. The EAA varicocoele classification is reported. CDUS-varicocoele was detected in ∼37% of men. Prostate mean volume was ∼25 mL, while lower and upper limits were 15 and 35 mL, defining hypotrophy and enlargement, respectively. Prostate arterial reference ranges are reported. Prostate calcifications and inhomogeneity were frequent; midline prostatic cysts were rare and small. Ejaculatory duct abnormalities were absent. The upper limit for periprostatic venous plexus was 4.5 mm. Lower and upper limits of seminal vesicles (SV) anterior-posterior diameter were 6 and 16 mm, defining hypotrophy or dilation, respectively. Seminal vesicle volume and ejection fraction reference ranges are reported. SV-US abnormalities were rare. Deferential ampullas upper limit was 6 mm. A discussion on the EAA and previously published "normal" CDUS values is reported here. CONCLUSIONS The EAA findings will help in reproductive and general male health management.
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Affiliation(s)
- Francesco Lotti
- Andrology, Female Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”University of FlorenceFlorenceItaly
| | - Francesca Frizza
- Andrology, Female Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”University of FlorenceFlorenceItaly
| | - Giancarlo Balercia
- Endocrinology Unit, Ospedali Riuniti AnconaPolytechnic University of MarcheAnconaItaly
| | - Arcangelo Barbonetti
- Andrology Unit, Department of Life, Health and Environmental SciencesUniversity of L'AquilaL'AquilaItaly
| | - Hermann M. Behre
- Center for Reproductive Medicine and AndrologyMartin Luther University Halle‐WittenbergHalleGermany
| | - Aldo E. Calogero
- Department of Clinical and Experimental MedicineUniversity of CataniaCataniaItaly
| | - Jann‐Frederik Cremers
- Department of Clinical and Surgical Andrology, Centre of Reproductive Medicine and AndrologyMünster University HospitalMünsterGermany
| | - Felice Francavilla
- Andrology Unit, Department of Life, Health and Environmental SciencesUniversity of L'AquilaL'AquilaItaly
| | - Andrea M. Isidori
- Department of Experimental MedicineSapienza University of RomeRomeItaly
| | - Sabine Kliesch
- Department of Clinical and Surgical Andrology, Centre of Reproductive Medicine and AndrologyMünster University HospitalMünsterGermany
| | - Sandro La Vignera
- Department of Clinical and Experimental MedicineUniversity of CataniaCataniaItaly
| | - Andrea Lenzi
- Department of Experimental MedicineSapienza University of RomeRomeItaly
| | - Marios Marcou
- Center for Reproductive Medicine and AndrologyMartin Luther University Halle‐WittenbergHalleGermany
| | - Adrian Pilatz
- Department of Urology, Pediatric Urology and AndrologyJustus Liebig UniversityGiessenGermany
| | | | - Margus Punab
- Andrology UnitTartu University HospitalTartuEstonia
| | - Maria Fernanda Peraza Godoy
- Andrology Department, Fundació Puigvert, Universitat Autònoma de BarcelonaInstituto de Investigaciones Biomédicas Sant Pau (IIB‐Sant Pau)BarcelonaSpain
| | - Claudia Quintian
- Andrology Department, Fundació Puigvert, Universitat Autònoma de BarcelonaInstituto de Investigaciones Biomédicas Sant Pau (IIB‐Sant Pau)BarcelonaSpain
| | - Osvaldo Rajmil
- Andrology Department, Fundació Puigvert, Universitat Autònoma de BarcelonaInstituto de Investigaciones Biomédicas Sant Pau (IIB‐Sant Pau)BarcelonaSpain
| | - Gianmaria Salvio
- Endocrinology Unit, Ospedali Riuniti AnconaPolytechnic University of MarcheAnconaItaly
| | - Osama Shaeer
- Department of Andrology, Kasr El Aini Faculty of MedicineCairo UniversityCairoEgypt
| | - Wolfgang Weidner
- Department of Urology, Pediatric Urology and AndrologyJustus Liebig UniversityGiessenGermany
| | - Elisa Maseroli
- Andrology, Female Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”University of FlorenceFlorenceItaly
| | - Sarah Cipriani
- Andrology, Female Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”University of FlorenceFlorenceItaly
| | - Elisabetta Baldi
- Andrology, Female Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”University of FlorenceFlorenceItaly
| | - Selene Degl'Innocenti
- Andrology, Female Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”University of FlorenceFlorenceItaly
| | - Giovanna Danza
- Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”University of FlorenceFlorenceItaly
| | | | | | - Luca Boni
- Clinical Trials Coordinating CenterToscano Cancer InstituteUniversity Hospital CareggiFlorenceItaly
| | - Csilla Krausz
- Andrology, Female Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”University of FlorenceFlorenceItaly
| | - Mario Maggi
- Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”University of FlorenceFlorenceItaly
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Lotti F, Frizza F, Balercia G, Barbonetti A, Behre HM, Calogero AE, Cremers JF, Francavilla F, Isidori AM, Kliesch S, La Vignera S, Lenzi A, Marcou M, Pilatz A, Poolamets O, Punab M, Godoy MFP, Quintian C, Rajmil O, Salvio G, Shaeer O, Weidner W, Maseroli E, Cipriani S, Baldi E, Degl'Innocenti S, Danza G, Caldini AL, Terreni A, Boni L, Krausz C, Maggi M. The European Academy of Andrology (EAA) ultrasound study on healthy, fertile men: Prostate-vesicular transrectal ultrasound reference ranges and associations with clinical, seminal and biochemical characteristics. Andrology 2022; 10:1150-1171. [PMID: 35735741 PMCID: PMC9544532 DOI: 10.1111/andr.13217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 06/01/2022] [Accepted: 06/18/2022] [Indexed: 11/28/2022]
Abstract
Background Transrectal ultrasound (TRUS) parameters are not standardized, especially in men of reproductive age. Hence, the European Academy of Andrology (EAA) promoted a multicenter study to assess the TRUS characteristics of healthy‐fertile men (HFM) to establish normative parameters. Objectives To report and discuss the prostate and seminal vesicles (SV) reference ranges and characteristics in HFM and their associations with clinical, seminal, biochemical parameters. Methods 188 men (35.6 ± 6.0 years) from a cohort of 248 HFM were studied, evaluating, on the same day, clinical, biochemical, seminal, TRUS parameters following Standard Operating Procedures. Results TRUS reference ranges and characteristics of the prostate and SV of HFM are reported herein. The mean PV was ∼25 ml. PV lower and upper limits were 15 and 35 ml, defining prostate hypotrophy and enlargement, respectively. PV was positively associated with age, waistline, current smoking (but not with T levels), seminal volume (and negatively with seminal pH), prostate inhomogeneity, macrocalcifications, calcification size and prostate arterial parameters, SV volume before and after ejaculation, deferential and epididymal size. Prostate calcifications and inhomogeneity were frequent, while midline prostatic cysts were rare and small. Ejaculatory duct abnormalities were absent. Periprostatic venous plexus size was positively associated with prostate calcifications, SV volume and arterial peak systolic velocity. Lower and upper limits of SV anterior‐posterior diameter after ejaculation were 6 and 16 mm, defining SV hypotrophy or dilation, respectively. SV total volume before ejaculation and delta SV total volume (DSTV) positively correlated with ejaculate volume, and DSTV correlated positively with sperm progressive motility. SV total volume after ejaculation was associated negatively with SV ejection fraction and positively with distal ampullas size. SV US abnormalities were rare. No association between TRUS and time to pregnancy, number of children or history of miscarriage was observed. Conclusions The present findings will help in better understanding male infertility pathophysiology and the meaning of specific TRUS findings.
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Affiliation(s)
- Francesco Lotti
- Andrology, Female Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Francesca Frizza
- Andrology, Female Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Giancarlo Balercia
- Endocrinology Unit, Ospedali Riuniti Ancona, Polytechnic University of Marche, Ancona, Italy
| | - Arcangelo Barbonetti
- Andrology Unit, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Hermann M Behre
- Center for Reproductive Medicine and Andrology, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Aldo E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Jann-Frederik Cremers
- Department of Clinical and Surgical Andrology, Centre of Reproductive Medicine and Andrology, Münster University Hospital, Münster, Germany
| | - Felice Francavilla
- Andrology Unit, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Andrea M Isidori
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Sabine Kliesch
- Department of Clinical and Surgical Andrology, Centre of Reproductive Medicine and Andrology, Münster University Hospital, Münster, Germany
| | - Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Andrea Lenzi
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Marios Marcou
- Center for Reproductive Medicine and Andrology, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Adrian Pilatz
- Department of Urology, Pediatric Urology and Andrology, Justus Liebig University, Giessen, Germany
| | - Olev Poolamets
- Andrology Unit, Tartu University Hospital, Tartu, Estonia
| | - Margus Punab
- Andrology Unit, Tartu University Hospital, Tartu, Estonia
| | | | - Claudia Quintian
- Andrology Department, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Osvaldo Rajmil
- Andrology Department, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Gianmaria Salvio
- Endocrinology Unit, Ospedali Riuniti Ancona, Polytechnic University of Marche, Ancona, Italy
| | - Osama Shaeer
- Department of Andrology, Kasr El Aini Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Wolfgang Weidner
- Department of Urology, Pediatric Urology and Andrology, Justus Liebig University, Giessen, Germany
| | - Elisa Maseroli
- Andrology, Female Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Sarah Cipriani
- Andrology, Female Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Elisabetta Baldi
- Andrology, Female Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Selene Degl'Innocenti
- Andrology, Female Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Giovanna Danza
- Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | | | | | - Luca Boni
- Clinical Trials Coordinating Center, Toscano Cancer Institute, University Hospital Careggi, Florence, Italy
| | - Csilla Krausz
- Andrology, Female Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Mario Maggi
- Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
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7
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Lotti F, Bertolotto M, Maggi M. Historical trends for the standards in scrotal ultrasonography: What was, what is and what will be normal. Andrology 2021; 9:1331-1355. [PMID: 34089245 DOI: 10.1111/andr.13062] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Ultrasonography is the gold standard imaging method for scrotal investigation. Colour Doppler ultrasonography, contrast-enhanced ultrasonography and sonoelastography allow sonographers to assess size, echotexture, vascular features and stiffness of the scrotal organs and abnormalities. Scrotal ultrasonography has been used to investigate male reproductive health, scrotal pain, masses and trauma. However, ultrasonography thresholds/classifications used to distinguish normal and pathologic features of the scrotal organs have changed over time, and have not yet been fully standardized. OBJECTIVES To evaluate historical trends for the standards in scrotal ultrasonography: what was, what is and what will be normal. METHODS An extensive Medline search was performed identifying the most relevant studies in the English language from inception to date. RESULTS We provide here (i) a brief overview of the history of ultrasonography, (ii) current indications for scrotal ultrasonography and (iii) previous and current normal values, cut-offs and classifications of the main colour-Doppler ultrasonography parameters/characteristics of the scrotal organs, as derived from recent guidelines and evidence-based studies. In addition, we report recommendations and the clinical utility of contrast-enhanced ultrasonography and sonoelastography. Finally, we discuss critical issues needing further evidence and future directions to fill in the current gaps. DISCUSSION Several studies on scrotal ultrasonography are available. However, guidelines/recommendations dealing with specific ultrasonography applications have been published only in recent years. More recently, the European Academy of Andrology published evidence-based scrotal colour-Doppler ultrasonography reference ranges/normative parameters derived from a cohort of healthy, fertile men. In addition, a standardization of the methodology to evaluate qualitative and quantitative colour-Doppler ultrasonography parameters was reported. Other international societies reported indications, methodological standards, clinical utility and limitations of contrast-enhanced ultrasonography and sonoelastography. CONCLUSIONS To date, colour-Doppler ultrasonography normative values for the scrotal organs are available. However, a wide international consensus on assessment and classification of several ultrasonography parameters is still lacking. An alignment of the world societies on these issues is advocated.
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Affiliation(s)
- Francesco Lotti
- Andrology, Female Endocrinology and Gender Incongruence Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy
| | - Michele Bertolotto
- Department of Radiology, Cattinara Hospital, University of Trieste, Trieste, Italy
| | - Mario Maggi
- Endocrinology Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy
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Garolla A, Grande G, Palego P, Canossa A, Caretta N, Di Nisio A, Corona G, Foresta C. Central role of ultrasound in the evaluation of testicular function and genital tract obstruction in infertile males. Andrology 2021; 9:1490-1498. [PMID: 34085393 PMCID: PMC8596694 DOI: 10.1111/andr.13060] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 05/25/2021] [Accepted: 05/27/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Scrotal color Doppler ultrasonography and transrectal ultrasonography provide crucial information about the clinical status of testes and male accessory glands. OBJECTIVE To analyze the impact of ultrasound in the evaluation of infertile males. MATERIALS AND METHODS A total of 1120 records from infertile men were retrospectively evaluated (from January 2016 up to June 2020). Data on physical examination, semen analysis, sperm culture, scrotal color Doppler ultrasonography and transrectal ultrasonography, as well as sex hormones were analyzed. Among them, 238 reports from oligozoospermic/azoospermic infertile patients (P) fulfilling the inclusion criteria were considered for data analysis. Patients were subdivided into two groups according to follicle-stimulating hormone (FSH) values (Pa with FSH < 8 U/L and Pb with FSH ≥ 8 U/L). Sixty-three fertile volunteers (mean ± SD years) were enrolled as controls (C). RESULTS A higher prevalence of ultrasound abnormalities was recorded in P compared to C. Pb group had significantly lower bitesticular volume compared to Pa and C. Pa had a higher prevalence of transrectal ultrasonography abnormalities than Pb (69.9% vs. 38.4%), whereas Pb had a higher prevalence of abnormalities at scrotal color Doppler ultrasonography (60.0% vs. 28.3%, both p < 0.01). Bitesticular volume was inversely proportional to the number of altered seminal parameters and able to predict gonadotropin levels. A bitesticular volume <17 cc was associated with a higher risk of azoospermia (odds ratio = 1.799). Intratesticular vascularization was inversely correlated with gonadotropin levels and directly correlated with sperm count. A higher prevalence of prostate and seminal vesicle alterations was detected in patients and in Pa group, when compared with Pb group. DISCUSSION AND CONCLUSION Ultrasound abnormalities are correlated with seminal parameters and may guide the clinician in the diagnostic workflow of male infertility, suggesting spermatogenesis impairment or genital tract obstructions.
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Affiliation(s)
- Andrea Garolla
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
| | - Giuseppe Grande
- Second Division of Medicine, ULSS2 Marca Trevigiana, "Ca' Foncello" Regional Hospital, Treviso, Italy
| | - Pierfrancesco Palego
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
| | - Andrea Canossa
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
| | - Nicola Caretta
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
| | - Andrea Di Nisio
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
| | - Giovanni Corona
- Endocrinology Unit, Medical Department, Azienda-Usl Maggiore-Bellaria Hospital, Bologna, Italy
| | - Carlo Foresta
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
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9
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Can We Clinically Distinguish Anejaculation From Retrograde Ejaculation in Patients on α1A-Blockers Therapy for Lower Urinary Tract Symptoms? Urology 2020; 139:129-133. [PMID: 32032683 DOI: 10.1016/j.urology.2020.01.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 01/20/2020] [Accepted: 01/22/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate the physiopathology of ejaculatory disorders (EjD) and discriminate between retrograde ejaculation (REj) and anejaculation (AEj) induced by α1A-blockers, through the association between the mean postorgasm seminal vesicle volume and the presence of sperm in midstream urine, in patients with moderate-to-severe lower urinary tract symptoms (LUTS) secondary to benign prostatic enlargement. MATERIALS AND METHODS Therapy-naïve male patients with LUTS and without previous EjD were treated with α1A-blockers. Pre- and post-treatment EjD were investigated through question 4 of the 4-item Male Sexual Function questionnaire and the Male Sexual Health Questionnaire for Ejaculatory Dysfunction Short Form (MSHQ-EjD-SF). After 12 weeks, postorgasm urine was collected for sperm count and seminal vesicle volume was calculated through transrectal ultrasound. RESULTS All 42 patients reported with EjD after treatment with α1A-blockers: 4-item Male Sexual Function questionnaire and MSHQ-EjD-SF Q4 scores were significantly higher (P <.001) and MSHQ-EjD-SF Q1-3 score was significantly lower (P <.001) than before. Postorgasm seminal vesicle volume was significantly higher in patients with postorgasm sperm-negative urine (AEj), and lower in patients with postorgasm sperm-positive urine (REj; P <.001). CONCLUSION We clearly demonstrated an association between the presence of sperm in the midstream urine and seminal vesicle volume after orgasm, strongly confirming and differentiating the hypothesis of a dual etiology for EjD (REj vs AEj) secondary to α1A-blockers therapy for LUTS.
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10
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Xue RZ, Tang ZY, Chen Z, Huang L. Clinical outcomes of transperitoneal laparoscopic unroofing and fenestration under seminal vesiculoscopy for seminal vesicle cysts. Asian J Androl 2019; 20:621-625. [PMID: 30136659 PMCID: PMC6219302 DOI: 10.4103/aja.aja_62_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Symptomatic seminal vesicle cysts (SVCs), especially those of a large size, can be removed by surgical treatments. Currently, open surgeries for SVC are rarely performed due to their extensive surgical trauma, and minimally invasive surgical therapies for treating seminal vesicle cysts are still in the early stages. In addition, relevant studies are mostly confined to case reports. In this study, we retrospectively reviewed 53 patients who had received transperitoneal laparoscopic unroofing or fenestration under seminal vesiculoscopy for SVC in our institution. Both surgeries decreased the cyst volume to a significant extent; however, according to the remnant lesion size after rechecking images, seminal vesiculoscopic fenestration tended to have a higher recurrence than laparoscopic unroofing. Regarding complications, two individuals in the laparoscopic unroofing group experienced ureteral injury and rectal injury, while patients in the fenestration group only had temporary hemospermia, which indicates that fenestration surgery tends to have less severe complications than laparoscopic unroofing. There was no solid evidence confirming semen improvement after these surgical therapies in our study. Future studies with a prospective design, larger sample size, and longer follow-up period are required to verify and further explore our findings.
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Affiliation(s)
- Rui-Zhi Xue
- Department of Urology, Xiangya Hospital of Central South University, Changsha 410000, China
| | - Zheng-Yan Tang
- Department of Urology, Xiangya Hospital of Central South University, Changsha 410000, China.,Provincial Laboratory for Diagnosis and Treatment of Genitourinary System Disease, Changsha 410000, China
| | - Zhi Chen
- Department of Urology, Xiangya Hospital of Central South University, Changsha 410000, China
| | - Liang Huang
- Department of Urology, Xiangya Hospital of Central South University, Changsha 410000, China.,Provincial Laboratory for Diagnosis and Treatment of Genitourinary System Disease, Changsha 410000, China
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11
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Samavat J, Cantini G, Lorubbio M, Degl'Innocenti S, Adaikalakoteswari A, Facchiano E, Lucchese M, Maggi M, Saravanan P, Ognibene A, Luconi M. Seminal but not Serum Levels of Holotranscobalamin are Altered in Morbid Obesity and Correlate with Semen Quality: A Pilot Single Centre Study. Nutrients 2019; 11:E1540. [PMID: 31288401 PMCID: PMC6682947 DOI: 10.3390/nu11071540] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 07/02/2019] [Accepted: 07/03/2019] [Indexed: 11/24/2022] Open
Abstract
Vitamin B12 (cobalamin) is an essential cofactor in the one-carbon metabolism. One-carbon metabolism is a set of complex biochemical reactions, through which methyl groups are utilised or generated, and thus plays a vital role to many cellular functions in humans. Low levels of cobalamin have been associated to metabolic/reproductive pathologies. However, cobalamin status has never been investigated in morbid obesity in relation with the reduced semen quality. We analysed the cross-sectional data of 47-morbidly-obese and 21 lean men at Careggi University Hospital and evaluated total cobalamin (CBL) and holotranscobalamin (the active form of B12; holoTC) levels in serum and semen. Both seminal and serum concentrations of holoTC and CBL were lower in morbidly obese compared to lean men, although the difference did not reach any statistical significance for serum holoTC. Seminal CBL and holoTC were significantly higher than serum levels in both groups. Significant positive correlations were observed between seminal holoTC and total sperm motility (r = 0.394, p = 0.012), sperm concentration (r = 0.401, p = 0.009), total sperm number (r = 0.343, p = 0.028), and negative correlation with semen pH (r = -0.535, p = 0.0001). ROC analysis supported seminal holoTC as the best predictor of sperm number (AUC = 0.769 ± 0.08, p = 0.006). Our findings suggest that seminal rather than serum levels of holoTC may represent a good marker of semen quality in morbidly obese subjects.
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Affiliation(s)
- Jinous Samavat
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
| | - Giulia Cantini
- Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio"-University of Florence, 50139 Florence, Italy
| | - Maria Lorubbio
- Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy
| | | | - Antonysunil Adaikalakoteswari
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
- Department of Biosciences, School of Science and Technology, Nottingham Trent University, Clifton, Nottingham NG11 8NS, UK
| | | | | | - Mario Maggi
- Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio"-University of Florence, 50139 Florence, Italy
- Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy
- Istituto Nazionale Biostrutture e Biosistemi (INBB), viale delle Medaglie d'Oro 305, 00136 Rome, Italy
| | - Ponnusamy Saravanan
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK.
- Diabetes and Endocrinology Centre, George Eliot Hospital NHS Trust, College Street, Nuneaton, Warwickshire CV10 7DJ, UK.
| | | | - Michaela Luconi
- Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio"-University of Florence, 50139 Florence, Italy.
- Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy.
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12
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Colpi GM, Francavilla S, Haidl G, Link K, Behre HM, Goulis DG, Krausz C, Giwercman A. European Academy of Andrology guideline Management of oligo-astheno-teratozoospermia. Andrology 2018; 6:513-524. [DOI: 10.1111/andr.12502] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 04/18/2018] [Accepted: 04/18/2018] [Indexed: 12/14/2022]
Affiliation(s)
- G. M. Colpi
- Department of Andrology and IVF; San Carlo Clinic; Paderno-Dugnano/Milano Italy
| | - S. Francavilla
- Department of Life, Health and Environmental Sciences; University of L’ Aquila; L’ Aquila Italy
| | - G. Haidl
- Department of Dermatology/Andrology Unit; University of Bonn; Bonn Germany
| | - K. Link
- Department of Translational Medicine and Reproductive Medicine Centre; Lunds University and Skane University Hospital; Malmö Sweden
| | - H. M. Behre
- Center for Reproductive Medicine and Andrology; University Hospital; Martin Luther University Halle-Wittenberg; Halle Germany
| | - D. G. Goulis
- Unit of Reproductive Endocrinology; 1st Department of Obstetrics and Gynecology; Medical School; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - C. Krausz
- Department of Experimental and Clinical Biomedical Sciences ‘Mario Serio’; Centre of Excellence DeNothe; University of Florence; Florence Italy
| | - A. Giwercman
- Department of Translational Medicine and Reproductive Medicine Centre; Lunds University and Skane University Hospital; Malmö Sweden
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13
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Lotti F, Baldi E, Corona G, Lombardo F, Maseroli E, Degl’Innocenti S, Bartoli L, Maggi M. Epididymal more than testicular abnormalities are associated with the occurrence of antisperm antibodies as evaluated by the MAR test. Hum Reprod 2018; 33:1417-1429. [DOI: 10.1093/humrep/dey235] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 04/10/2018] [Accepted: 06/11/2018] [Indexed: 01/25/2023] Open
Affiliation(s)
- F Lotti
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences ‘Mario Serio’, University of Florence, Viale Pieraccini 6, Florence, Italy
| | - E Baldi
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences ‘Mario Serio’, University of Florence, Viale Pieraccini 6, Florence, Italy
| | - G Corona
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences ‘Mario Serio’, University of Florence, Viale Pieraccini 6, Florence, Italy
| | - F Lombardo
- Laboratory of Seminology-Sperm Bank ‘Loredana Gandini’, Department of Experimental Medicine, University of Rome ‘La Sapienza’, Viale Regina Elena 324, Rome, Italy
| | - E Maseroli
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences ‘Mario Serio’, University of Florence, Viale Pieraccini 6, Florence, Italy
| | - S Degl’Innocenti
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences ‘Mario Serio’, University of Florence, Viale Pieraccini 6, Florence, Italy
| | - L Bartoli
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences ‘Mario Serio’, University of Florence, Viale Pieraccini 6, Florence, Italy
| | - M Maggi
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences ‘Mario Serio’, University of Florence, Viale Pieraccini 6, Florence, Italy
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14
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Hong ZW, Feng YM, Ge YF, Jing J, Hu XC, Shen JM, Peng LP, Yao B, Xin ZC. Relation of size of seminal vesicles on ultrasound to premature ejaculation. Asian J Androl 2018; 19:554-560. [PMID: 27538475 PMCID: PMC5566849 DOI: 10.4103/1008-682x.186187] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Myriad biological factors have been proposed to explain premature ejaculation (PE). However, data correlating PE with seminal vesicles (SVs) are sparse. The study aimed to evaluate the relationship between the size of SV and PE. The cross-sectional study included 44 outpatients with PE and 44 volunteers without PE, and the size of SV was compared. Self-estimated intravaginal ejaculatory latency time, the Premature Ejaculation Diagnostic Tool (PEDT), the International Index of Erectile Function-15, and the National Institutes of Health-Chronic Prostatitis Symptom Index were used for assessment of symptoms. Compared to the control group, the PE group had significantly higher mean anterior-posterior diameter (APD) of SV (P < 0.001). The optimal mean APD of SV cutoff level was 9.25 mm for PE. In the PE group, PEDT was also higher with a mean APD of SV ≥9.25 mm compared with mean APD of SV <9.25 mm. PEDT was significantly correlated with the mean APD of SV (r = 0.326, P = 0.031). The seminal plasma proteins were compared between six PE and six matched control cases by mass spectrometry and it was shown that 102 proteins were at least 1.5-fold up- or down-regulated. Among them, GGT1, LAMC1, and APP were significantly higher in the PE group. These results indicated that men with a larger mean APD of SV might have a higher PEDT score. Transrectal ultrasound of SV should be considered in the evaluation of patients with premature ejaculation. SV might be a potential target for the treatment of patients with PE and ultrasound change in SV.
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Affiliation(s)
- Zhi-Wei Hong
- Center for Reproductive Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, China
| | - Yu-Ming Feng
- Center for Reproductive Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, China
| | - Yi-Feng Ge
- Center for Reproductive Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, China
| | - Jun Jing
- Center for Reproductive Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, China
| | - Xue-Chun Hu
- Center for Reproductive Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, China
| | - Jia-Ming Shen
- Center for Reproductive Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, China
| | - Long-Ping Peng
- Center for Reproductive Medicine, Jinling Hospital, Southern Medical University, Nanjing 210002, China
| | - Bing Yao
- Center for Reproductive Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, China
| | - Zhong-Cheng Xin
- Andrology Center, Peking University First Hospital, Peking University, Beijing 100009, China
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15
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Longping P, Zhiwei H, Jiaming S, Xuechun H, Yong S, Jun J, Jinchun L, Bing Y. Effect of Ningmitai capsule plus sertraline on patients with premature ejaculation and enlarged seminal vesicles: A randomized clinical trial. J TRADIT CHIN MED 2018. [DOI: 10.1016/j.jtcm.2018.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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16
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Lotti F, Tamburrino L, Marchiani S, Maseroli E, Vitale P, Forti G, Muratori M, Maggi M, Baldi E. DNA fragmentation in two cytometric sperm populations: relationship with clinical and ultrasound characteristics of the male genital tract. Asian J Androl 2018; 19:272-279. [PMID: 26924281 PMCID: PMC5427780 DOI: 10.4103/1008-682x.174854] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We investigated whether DNA fragmentation in two cytometric sperm populations (PIdimmer and PIbrighter) with different biological characteristics and clinical relevance is related to clinical and color-Doppler ultrasound (CDUS) parameters of the male genital tract. One hundred and sixty males of infertile couples without genetic abnormalities were evaluated for clinical, scrotal, and transrectal CDUS characteristics, presence of prostatitis-like symptoms (with the National Institutes of Health-Chronic Prostatitis Symptom Index) and sperm DNA fragmentation (sDF) in PIdimmer and PIbrighter populations (using TUNEL/PI method coupled with flow cytometry). Data were adjusted for age (Model 1) along with waistline, testosterone levels, smoking habit, and sexual abstinence (Model 2). According to the statistical Model 2, PIdimmer sDF was associated with testicular abnormalities, including lower clinical and ultrasound volume (r = -0.21 and r = -0.20, respectively; P < 0.05), higher FSH levels (r = 0.34, P < 0.0001) and occurrence of testicular inhomogeneity (P < 0.05) and hypoechogenicity (P < 0.05). PIbrighter sDF was associated with prostate-related symptoms and abnormal signs, including higher NIH-CPSI total and subdomain scores, a higher prevalence of prostatitis-like symptoms and of CDUS alterations such as macro-calcifications, severe echo-texture inhomogeneity, hyperemia (all P < 0.05), and higher arterial peak systolic velocity (r = 0.25, P < 0.05). Our results suggest that DNA fragmentation in PIdimmer sperm, which is related to poor semen quality, mainly originates in the testicles, likely due to apoptosis. Conversely, DNA fragmentation in PIbrighter sperm appears to mainly originate during or after transit through the prostate, increasing with the presence of an inflammatory status of the organ. These results could lead to new perspectives for the identification of therapeutic targets to reduce sDF.
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Affiliation(s)
- Francesco Lotti
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, Center of Excellence DeNothe, University of Florence, Viale Pieraccini 6, I-50036, Florence, Italy
| | - Lara Tamburrino
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, Center of Excellence DeNothe, University of Florence, Viale Pieraccini 6, I-50036, Florence, Italy
| | - Sara Marchiani
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, Center of Excellence DeNothe, University of Florence, Viale Pieraccini 6, I-50036, Florence, Italy
| | - Elisa Maseroli
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, Center of Excellence DeNothe, University of Florence, Viale Pieraccini 6, I-50036, Florence, Italy
| | - Pasquale Vitale
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, Center of Excellence DeNothe, University of Florence, Viale Pieraccini 6, I-50036, Florence, Italy
| | - Gianni Forti
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, Center of Excellence DeNothe, University of Florence, Viale Pieraccini 6, I-50036, Florence, Italy
| | - Monica Muratori
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, Center of Excellence DeNothe, University of Florence, Viale Pieraccini 6, I-50036, Florence, Italy
| | - Mario Maggi
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, Center of Excellence DeNothe, University of Florence, Viale Pieraccini 6, I-50036, Florence, Italy
| | - Elisabetta Baldi
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, Center of Excellence DeNothe, University of Florence, Viale Pieraccini 6, I-50036, Florence, Italy
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17
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Barrett T, Tanner J, Gill AB, Slough RA, Wason J, Gallagher FA. The longitudinal effect of ejaculation on seminal vesicle fluid volume and whole-prostate ADC as measured on prostate MRI. Eur Radiol 2017; 27:5236-5243. [PMID: 28677052 PMCID: PMC5674119 DOI: 10.1007/s00330-017-4905-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 05/18/2017] [Accepted: 05/18/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To prospectively investigate the longitudinal effect of ejaculatory abstinence on MRI-measured seminal vesicle (SV) volume and whole-prostate ADC over consecutive days. METHODS 15 healthy male volunteers (mean 35.9 years, range 27-53) underwent 3-T MRI at baseline and 1, 2 and 3 days post-ejaculation. Prostate and SV volumes were derived by volume segmentation and whole-gland apparent diffusion coefficient (ADC) values calculated. A mixed-effects linear regression compared ADC values and prostate/seminal vesicle volumes in each volunteer between studies in a pairwise manner. RESULTS All subjects completed the four MRIs. Mean prostate volume was 22.45 cm3 (range 13.04-31.21 cm3), with no change between the four studies (p = 0.89-0.99). 13/15 subjects showed SV volume reduction from baseline to day 1, with group-mean decreasing from 6.45 to 4.80 cm3 (-25.6%, p < 0.001), and a significant reduction from baseline to day 2 (-18.1%, p = 0.002). There was a significant volume increase from both day 1 (+21.3%, p = 0.006) and day 2 (+10.2%, p = 0.022) to day 3 post-ejaculation. There was a significant reduction in ADC from 1.105 at baseline to 1.056 × 10-3 mm2/s at day 1 (mean -4.3%, p = 0.009). CONCLUSION The longitudinal effect of ejaculation on SV volume was demonstrated. Significant reductions in SV volume and whole-gland ADC were observed post-ejaculation, supporting a 3-day period of abstinence before prostate MRI. KEY POINTS • Seminal vesicle volume significantly reduced 24 h post-ejaculation remaining reduced at day 2 • Seminal vesicle fluid volume significantly increased from day 1 to day 3 post-ejaculation • There was a significant reduction in whole-gland prostate ADC values day 1 post-ejaculation • 3-day abstinence from ejaculation is required to ensure maximal seminal vesicle distension.
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Affiliation(s)
- Tristan Barrett
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, CB2 0QQ, UK.
- CamPARI Clinic, Addenbrooke's Hospital and University of Cambridge, Cambridge, CB2 0QQ, UK.
| | - James Tanner
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Andrew B Gill
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Rhys A Slough
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, CB2 0QQ, UK
| | - James Wason
- MRC Biostatistics Unit, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Ferdia A Gallagher
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, CB2 0QQ, UK
- CamPARI Clinic, Addenbrooke's Hospital and University of Cambridge, Cambridge, CB2 0QQ, UK
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18
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Williams SA, Christodoulidou M, Nigam R. Large bilateral seminal vesicle calculi presenting with spermolithiasis. BMJ Case Rep 2017; 2017:bcr-2017-219630. [PMID: 28576910 DOI: 10.1136/bcr-2017-219630] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 34-year-old male presented with an 8-month history of passing increasingly painful 'grit' in his ejaculate. Semen analysis was normal as were urinary and blood tests. T1-weighted MRI revealed several bilateral high-signal areas measuring up to 1 cm in diameter, located in the seminal vesicles. These were confirmed as calculi on T2-weighted imaging and a seminal vesiculogram, with no drainage from the left ejaculatory duct and only minimal from the right duct. He is currently awaiting a robot-assisted laparoscopic vesiculotomy after completion of family.
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Affiliation(s)
| | | | - Raj Nigam
- Urology, The Royal Surrey County Hospital, Surrey, UK
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19
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Dell'Atti L, Galosi AB. Ultrasound analysis of seminal vesicles in prostate cancer invasion: monocentric experience of an extended prostate biopsy scheme. Abdom Radiol (NY) 2017; 42:1250-1254. [PMID: 27838771 DOI: 10.1007/s00261-016-0968-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE At present, uniformity does not exist with regard to the indication criteria of seminal vesicle (SV) biopsies. The aim of this study was to define the ultrasonographic (US) patterns observed in SV invaded by prostate cancer (PCa), and propose an extended prostate biopsy protocol when SV invasion (SVI) is suspected. METHODS We reviewed 1.252 patients who underwent an initial transrectal ultrasound-guided prostate biopsy for suspicious PCa. We performed a 14-core biopsy scheme, as first intention, including 1 SV sample on each side when SVI is suspected: a nodule at the base of prostate (determined by digital rectal examination or US) and/or an US pattern that suggests a SVI. US patterns of SVs were classified as abnormal by a variation of the body anterior-posterior diameter, asymmetry of the volume, parietal thickness, distance between the SVs and the rectal surface, and altered echogenicity of SVs and the base of the prostate. RESULTS Of the 137 biopsies performed in SVs, the SVI by PCa was diagnosed in 66.5% of candidate patients. The overall prevalence of SVI was 28.5%. No significant difference was noted between the patients with SVI and without SVI, when comparing age, prostate volume, and total core length, except for preoperative PSA serum levels. The sensitivity of any abnormal finding on transrectal ultrasound for the presence of SVI by PCa is 90.8%, whereas the specificity is 96%. CONCLUSIONS We believe that an extended prostate biopsy protocol to provide the possibility of taking one biopsy core of each SV when SVI is suspected should be considered a complementary procedure for PCa staging.
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Affiliation(s)
- Lucio Dell'Atti
- Department of Urology, University Hospital "St.Anna", 8 A. Moro Street, 44124, Ferrara, Cona, Italy.
| | - Andrea B Galosi
- Department of Urology, Marche Polytechnic University, Ancona, Italy
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Mieusset R, Walschaerts M, Isus F, Almont T, Daudin M, Hamdi SM. Diagnosis of Partial Retrograde Ejaculation in Non-Azoospermic Infertile Men with Low Semen Volume. PLoS One 2017; 12:e0168742. [PMID: 28060836 PMCID: PMC5218555 DOI: 10.1371/journal.pone.0168742] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 12/06/2016] [Indexed: 01/23/2023] Open
Abstract
In non-azoospermic patients with low semen volume (LSV), looking for partial retrograde ejaculation (PRE) by searching sperm in the postejaculatory urine (PEU) is required. The use of a retro-ejaculatory index (R-ratio) was suggested to define PRE, but none of the studies indicated a specific threshold above which PRE must be considered. Our objective was to propose a threshold value for the R-ratio as indicative of PRE in patients with LSV selected to be devoid of any known causes or risk factors for retrograde ejaculation or LSV. Among our data base (2000–2009) including 632 patients with PEU, 245 male patients from infertile couples who had had a first semen analysis with LSV (< 2mL) and a second semen analysis associated with PEU, were selected on the previous criteria. A prospective control group was randomly constituted (2007–2008) of 162 first consulting male patients from infertile couples, with a normal semen volume (≥ 2mL) on a first semen analysis and who accepted to collect PEU with their usual second semen analysis, selected on the previous criteria. To define an R-ratio threshold indicative of PRE, we used a ROC curve analysis and a regression tree based on a classification and regression tree (CART) algorithm. Of the 245 LSV patients, 146 still presented low semen volume (< 2 mL) on the second semen analysis. From the use of the CART algorithm, two low (1.5% and 2.8%) and two high R-values (7.1% and 8.3%) were defined, according to the lower reference limit for semen volume of 2.0 mL (WHO 1999) or 1.5 mL (WHO 2010) respectively. As only one or no patient with normal semen volume was observed above the two high R-values, we suggest an R-value higher than the range of [7.1–8.3]% as indicative of PRE until confirmation by a prospective multicenter study.
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Affiliation(s)
- Roger Mieusset
- Université Toulouse III—Paul Sabatier, Groupe de Recherche en Fertilité Humaine (Human Fertility Research Group), Toulouse, France
- Andrologie—Médecine de la Reproduction, Hôpital Paule de Viguier, CHU de Toulouse, Toulouse, France
| | - Marie Walschaerts
- Université Toulouse III—Paul Sabatier, Groupe de Recherche en Fertilité Humaine (Human Fertility Research Group), Toulouse, France
| | - François Isus
- Université Toulouse III—Paul Sabatier, Groupe de Recherche en Fertilité Humaine (Human Fertility Research Group), Toulouse, France
- Andrologie—Médecine de la Reproduction, Hôpital Paule de Viguier, CHU de Toulouse, Toulouse, France
| | - Thierry Almont
- Université Toulouse III—Paul Sabatier, Groupe de Recherche en Fertilité Humaine (Human Fertility Research Group), Toulouse, France
| | - Myriam Daudin
- Université Toulouse III—Paul Sabatier, Groupe de Recherche en Fertilité Humaine (Human Fertility Research Group), Toulouse, France
- Explorations biologiques—Médecine de la Reproduction, Hôpital Paule de Viguier, CHU de Toulouse, Toulouse, France
| | - Safouane M. Hamdi
- Université Toulouse III—Paul Sabatier, Groupe de Recherche en Fertilité Humaine (Human Fertility Research Group), Toulouse, France
- * E-mail:
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Furuya S, Masumori N, Takayanagi A. Natural history of hematospermia in 189 Japanese men. Int J Urol 2016; 23:934-940. [PMID: 27520544 DOI: 10.1111/iju.13176] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 07/04/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To prospectively investigate the natural history of hematospermia. METHODS This study included 189 patients with hematospermia. All the patients underwent watchful waiting without any empirical treatment. RESULTS The median observation period was 52 months. Hematospermia resolved spontaneously in 168 (88.9%) of the 189 patients, and the median disease duration was 1.5 months. Kaplan-Meier analysis showed that the persistence rates of hematospermia were 57.7% at 1 month, 34.2% at 3 months, 23.3% at 6 months, 12.5% at 1 year and 7.6% at 2 years. Hematospermia reoccurred in 20 (13.5%) of the 148 patients who had adequate follow up. The recurrence-free rates were 96.6% at 3 months, 89.0% at 1 year, 84.8% at 5 years and 78.2% at 10 years. Multivariate analysis showed that seminal vesicle hemorrhage and a midline cyst of the prostate were significant factors to predict the duration of hematospermia until spontaneous resolution. The nine patients with persisting hematospermia for more than 1 year were treated with transurethral endoscopic surgery (unroofing of the midline cyst in six, and transurethral resection of the ejaculatory duct in three), and hematospermia resolved postoperatively in all these patients. CONCLUSIONS In patients with hematospermia without inflammation, infection or malignancy, it is important to provide information on the possibility that symptoms will resolve spontaneously and to implement measures to relieve their anxiety. Detection of seminal vesicle hemorrhage and a midline cyst of the prostate is important for prediction of the duration of hematospermia.
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Affiliation(s)
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan.
| | - Akio Takayanagi
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
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Yuruk E, Pastuszak AW, Suggs JM, Colakerol A, Serefoglu EC. The association between seminal vesicle size and duration of abstinence from ejaculation. Andrologia 2016; 49. [PMID: 27660049 DOI: 10.1111/and.12707] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2016] [Indexed: 01/14/2023] Open
Abstract
There are few data describing the relationship between seminal vesicle (SV) size and duration of abstinence between ejaculations. This study evaluates the association between SV size and duration of abstinence from ejaculation using pelvic magnetic resonance imaging (MRI). Sexually active men 18-68 years old who underwent pelvic MRI for various medical indications were included. The date of last ejaculation was recorded, and the cross-sectional areas of the right and left seminal vesicles were calculated separately using mediolateral and anteroposterior measurements on T2-weighted MRI images. The association between SV area and duration of abstinence between ejaculations was determined via linear regression analysis. The study cohort consisted of 104 men with a mean age of 46.45 ± 11.4 (range 18-68) years old. Mean right and left SV cross-sectional areas were 744.1 ± 351.1 (range: 149.9-1794.7) mm2 and 727.6 ± 359.2 (range 171.4-2248.4) mm2 respectively. The mean duration of abstinence between ejaculations in the cohort was 3.6 ± 2.6 (range 1-15) days. Although no correlation between age and SV area was observed (r = .007, p = .947), linear regression analysis demonstrated a positive correlation between SV area and the duration of abstinence from ejaculation (r = .372, p = .0001). SV cross-sectional area increases with duration of abstinence from ejaculation and can be assessed using MRI. The use of SV size estimation may be applicable in diagnosis, risk stratification and treatment of urological diseases.
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Affiliation(s)
- E Yuruk
- Bagcilar Research and Training Hospital, Istanbul, Turkey
| | - A W Pastuszak
- Center for Reproductive Medicine, Baylor College of Medicine, Houston, TX, USA.,Division of Male Reproductive Medicine, Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA
| | - J M Suggs
- Baylor College of Medicine, Houston, TX, USA
| | - A Colakerol
- Bagcilar Research and Training Hospital, Istanbul, Turkey
| | - E C Serefoglu
- Bagcilar Research and Training Hospital, Istanbul, Turkey
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Akmal M, Siregar TN, Wahyuni S, Hamny, Nasution MK, Indriati W, Panjaitan B, Aliza D. The expression of cyclic adenosine monophosphate responsive element modulator in rat sertoli cells following seminal extract administration. Vet World 2016; 9:1001-1005. [PMID: 27733803 PMCID: PMC5057020 DOI: 10.14202/vetworld.2016.1001-1005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 08/10/2016] [Indexed: 01/15/2023] Open
Abstract
Aim: This study aims to determine the effect of seminal vesicle extract on cyclic adenosine monophosphate responsive element modulator (CREM) expression in rat Sertoli cells. Materials and Methods: This study examined the expression of CREM on 20 male rats (Rattus norvegicus) at 4 months of age, weighing 250-300 g. The rats were divided into four groups: K0, KP1, KP2, and KP3. K0 group was injected with 0.2 ml normal saline; KP1 was injected with 25 mg cloprostenol (Prostavet C, Virbac S. A); KP2 and KP3 were injected with 0.2 and 0.4 ml seminal vesicle extract, respectively. The treatments were conducted 5 times within 12-day interval. At the end of the study, the rats were euthanized by cervical dislocation; then, the testicles were necropsied and processed for histology observation using immunohistochemistry staining. Results: CREM expression in rat Sertoli cells was not altered by the administration of either 0.2 or 0.4 ml seminal vesicle extract. Conclusion: The administration of seminal vesicle extract is unable to increase CREM expression in rat Sertoli cells.
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Affiliation(s)
- Muslim Akmal
- Laboratory of Histology, Faculty of Veterinary Medicine, Syiah Kuala University, Banda Aceh, Aceh, Indonesia
| | - Tongku Nizwan Siregar
- Laboratory of Reproduction, Faculty of Veterinary Medicine, Syiah Kuala University, Banda Aceh, Aceh, Indonesia
| | - Sri Wahyuni
- Laboratory of Research, Faculty of Veterinary Medicine, Syiah Kuala University, Banda Aceh, Aceh, Indonesia; Laboratory of Anatomy, Faculty of Veterinary Medicine, Syiah Kuala University, Banda Aceh, Aceh, Indonesia
| | - Hamny
- Laboratory of Anatomy, Faculty of Veterinary Medicine, Syiah Kuala University, Banda Aceh, Aceh, Indonesia
| | - Mustafa Kamal Nasution
- Department of PGMI, Faculty of Tarbiyah, STAIN Gajah Putih Takengon, Aceh Tengah, Aceh, Indonesia
| | - Wiwik Indriati
- Student at Veterinary Public Health Graduate Program, Syiah Kuala University, Banda Aceh, Aceh, Indonesia
| | - Budianto Panjaitan
- Laboratory of Clinic, Faculty of Veterinary Medicine, Syiah Kuala University, Banda Aceh, Aceh, Indonesia
| | - Dwinna Aliza
- Laboratory of Pathology, Faculty of Veterinary Medicine, Syiah Kuala University, Banda Aceh, Aceh, Indonesia
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Lotti F, Maseroli E, Fralassi N, Degl'Innocenti S, Boni L, Baldi E, Maggi M. Is thyroid hormones evaluation of clinical value in the work-up of males of infertile couples? Hum Reprod 2016; 31:518-29. [PMID: 26759137 DOI: 10.1093/humrep/dev338] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2015] [Accepted: 12/14/2015] [Indexed: 01/23/2023] Open
Abstract
STUDY QUESTION Is thyroid hormones (TH) evaluation of clinical value in the work-up of males of infertile couples? STUDY ANSWER Our results suggest that TH evaluation is not mandatory in the work-up of male infertility. WHAT IS KNOWN ALREADY A few previous studies performed on a limited series of subjects reported a negative impact of hyper- and hypo-thyroidism on semen volume, sperm concentration, progressive motility and normal morphology. No previous study has systematically evaluated associations between TH variation, semen parameters and ultrasound characteristics of the male genital tract. STUDY DESIGN, SIZE AND DURATION Cross-sectional analysis of a consecutive series of 172 subjects seeking medical care for couple infertility from September 2010 to November 2014. PARTICIPANTS/MATERIALS, SETTING, METHODS Of the entire cohort, 163 men (age 38.9 ± 8.0 years) free of genetic abnormalities were studied. All subjects underwent a complete andrological and physical examination, biochemical and hormonal assessment, scrotal and transrectal colour-Doppler ultrasound (CDUS) and semen analysis (including seminal interleukin 8 levels, sIL-8) evaluation within the same day. MAIN RESULTS AND THE ROLE OF CHANCE Among the patients studied, 145 (88.9%) showed euthyroidism, 6 (3.7%) subclinical hyper- and 12 (7.4%) subclinical hypo-thyroidism. No subjects showed overt hyper- or hypo-thyroidism. At univariate analysis, no associations among thyroid-stimulating hormone (TSH) or TH levels and sperm parameters were observed. Conversely, we observed positive associations among free triiodothyronine (fT3) and free thyroxine (fT4) levels, ejaculate volume and seminal fructose levels. In a multivariate model, after adjusting for confounders such as age, body mass index, smoking habit, sexual abstinence, calculated free testosterone, prolactin and sIL-8 levels, only the associations found for fT3 levels were confirmed. When CDUS features were investigated, using the same multivariate model, we found positive associations between fT3 levels and seminal vesicles (SV) volume, both before and after ejaculation (adj. r = 0.354 and adj. r = 0.318, both P < 0.0001), as well as with SV emptying (ΔSV volume; adj. r = 0.346, P < 0.0001) and echo-texture inhomogeneity. In addition, after adjusting for confounders, negative associations between fT4 levels and epididymal body and tail diameters were found. No significant associations between TSH or TH levels and CDUS features of other organs of the male genital tract, including testis and prostate, were found. Finally, when the features of subjects with euthyroidism, subclinical hypo- and hyper-thyroidism were compared, no significant differences in seminal or hormonal parameters were found. Conversely, evaluating CDUS parameters, subjects with subclinical hyperthyroidism showed a higher difference between the SV longitudinal diameters measured before and after ejaculation when compared with that of subclinical hypothyroid men, even after adjusting for confounders (P < 0.007). All the other male genital tract CDUS characteristics did not differ among groups. LIMITATIONS, REASONS FOR CAUTION First, the number of patients investigated is relatively small and those with (subclinical) thyroid dysfunctions are an even smaller number; hence, it is therefore difficult to draw firm conclusions. Moreover, the present results are derived from patients consulting an Italian Andrology Clinic for couple infertility, and could have different characteristics from the male general population or from those males consulting general practitioners for reasons other than couple infertility. Finally, due to the cross-sectional nature of the study, neither a causality hypothesis nor mechanistic models can be inferred. WIDER IMPLICATIONS OF THE FINDINGS Although no associations between TH and sperm parameters were observed, present data support a positive effect of TH on SV size and a permissive role on the ejaculatory machinery, likely through an action on SV and epididymal contractility. This is the first study reporting such evidence. However, in contrast with the view that TH assessment is important for female fertility, our results do not support a systematic evaluation of thyroid function in males of infertile couples. How TH abnormalities impact male fertility needs to be addressed by further studies. STUDY FUNDING/COMPETING INTERESTS No funding was received for the study. None of the authors have any conflict of interest to declare.
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Affiliation(s)
- F Lotti
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy
| | - E Maseroli
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy
| | - N Fralassi
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy
| | - S Degl'Innocenti
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy
| | - L Boni
- Department of Oncology, Istituto Toscano Tumori/AOU Careggi, Florence, Italy
| | - E Baldi
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy
| | - M Maggi
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy
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Wang Z, Yang Z, Lei YY, Zhang YD, Chen LD, Xie XY, Lu MD, Wang W. Who Is Doing the Dance in Epididymis: The Principle of Moblile Echogenicities Without Filarial Infection: Case Report. Medicine (Baltimore) 2015; 94:e1418. [PMID: 26313791 PMCID: PMC4602904 DOI: 10.1097/md.0000000000001418] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The aim of this study was to explore the principle of moblile echogenicities in epididymis in patients with a history of postvasectomy or infertility, which were reported as the characteristic sonographic sign of filarial infection.We reported a 38-year-old man presented with a 3-year history of infertility after marriage. Ultrasound imaging revealed an enlarged body in the inner left epididymis along with innumerable punctate mobile echogenicities, which showed random to-and-fro movements in the left epididymis. This had previously been recognized as the sonographic filarial dance sign of live filarial worms or microfilaria. The patient subsequently underwent needle aspiration of the left epididymis.Histopathological examination confirmed that the mobile echogenicities were a large number of macrophages with phagocytized sperm or clumps of agglutinated sperm. Our report includes a video clip that will help familiarize readers with this phenomenon.Our case highlighted that moblile echogenicities should be an important sign for epididymal obstruction to initiate corresponding treatment.
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Affiliation(s)
- Zhu Wang
- From the Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen University, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University (ZW, Y-YL, L-DC, X-YX, WW); Department of Pathology (ZY); Department of Urology, The First Affiliated Hospital of Sun Yat-Sen University (Y-DZ); and Department of Pathology, Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen University, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, Guangzhou, China (M-DL)
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Tian JC, Xia JY, Jiang J, Jiang R, He YZ, Lin H. Effect of androgen deprivation on the expression of aquaporins in rat prostate and seminal vesicles. Andrologia 2015; 48:268-76. [PMID: 26011465 DOI: 10.1111/and.12442] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2015] [Indexed: 11/30/2022] Open
Affiliation(s)
- J. C. Tian
- Affiliated Hospital; Luzhou Medical College; Luzhou Sichuan China
| | - J. Y. Xia
- Affiliated Hospital; Luzhou Medical College; Luzhou Sichuan China
| | - J. Jiang
- Affiliated Hospital; Luzhou Medical College; Luzhou Sichuan China
| | - R. Jiang
- Affiliated Hospital; Luzhou Medical College; Luzhou Sichuan China
| | - Y. Z. He
- Affiliated Hospital; Luzhou Medical College; Luzhou Sichuan China
| | - H. Lin
- Department of Surgery; University of Texas Health Science Center at Houston; Houston TX USA
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Bozkurt O, Demir O, Sen V, Esen A. Silodosin Causes Impaired Ejaculation and Enlargement of Seminal Vesicles in Sexually Active Men Treated for Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia. Urology 2015; 85:1085-1089. [DOI: 10.1016/j.urology.2015.01.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 01/07/2015] [Accepted: 01/09/2015] [Indexed: 10/23/2022]
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Lotti F, Corona G, Vitale P, Maseroli E, Rossi M, Fino MG, Maggi M. Current smoking is associated with lower seminal vesicles and ejaculate volume, despite higher testosterone levels, in male subjects of infertile couples. Hum Reprod 2015; 30:590-602. [PMID: 25567620 DOI: 10.1093/humrep/deu347] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
STUDY QUESTION What is the impact of smoking behaviour on seminal, hormonal and male genital tract ultrasound parameters in subjects seeking medical care for couple infertility? STUDY ANSWER In males of infertile couples, current smokers (CS), when compared with non-smokers, show lower ejaculate and ultrasound-derived seminal vesicles (SV) volume, despite higher testosterone levels. WHAT IS KNOWN ALREADY Data on the effects of smoking on male fertility are conflicting. A correlation between smoking and reduced semen parameters has been reported, however, with a high heterogeneity among studies. An association between smoking behaviour and higher testosterone levels in men has been described in several, but not all, the previous studies. No study has systematically evaluated the impact of smoking on the male genital tract ultrasound characteristics. STUDY DESIGN, SIZE AND DURATION Retrospective cross-sectional analysis of a consecutive series of 426 subjects seeking medical care for couple infertility from January 2010 to July 2013. PARTICIPANTS/MATERIALS, SETTING, METHODS From the entire cohort, 394 men (age 36.0 ± 8.0 years) free of genetic abnormalities were selected. All subjects underwent a complete andrological and physical examination, biochemical and hormonal assessment, scrotal and transrectal colour-Doppler ultrasound and semen analysis (including seminal interleukin-8 levels, sIL-8) within the same day. MAIN RESULTS AND THE ROLE OF CHANCE Among the patients evaluated, 229 were never smokers (NS), 56 past smokers (PS) and 109 CS. When CS were compared with the rest of the sample (non-smokers, NS + PS), in a multivariate model (analysis of covariance, ANCOVA) adjusted for age, lifestyle (including alcohol, cannabis and physical activity), BMI and sex hormone-binding globulin, significantly higher androgen (total testosterone, P = 0.001; calculated free testosterone, P < 0.005) and lower FSH (P < 0.05) levels were observed in CS. However, when total testosterone was also included in the multivariate model as a further covariate, the difference in FSH levels was not confirmed. In a similar model, a lower ejaculate volume (P < 0.01) and a higher prevalence of normal sperm morphology (P < 0.02) were also detected in CS in comparison with the rest of the sample. However, when total testosterone was also included in the multivariate model as a further covariate, only the difference in ejaculate volume between CS and non-smokers was confirmed (-0.61 ± 0.23 ml, P < 0.01). Finally, CS showed lower total SV volume, before and after ejaculation, even after adjusting for confounders (P = 0.02 and <0.01, respectively). Similar results were observed when the reported number of cigarettes smoked or the number of pack-years was considered separately. LIMITATIONS, REASONS FOR CAUTION The present results are derived from patients consulting an Andrology Clinic for couple infertility, who could have different characteristics from the general male population or males consulting general practitioners for reasons other than couple infertility. In addition, we did not have a true control group composed of age-matched, apparently healthy, fertile men, and therefore true normative data of sonographic parameters cannot be inferred. Due to the cross-sectional nature of our study, neither a causality hypothesis nor mechanistic models can be drawn. Finally, this is a retrospective study, and further prospective studies are required. WIDER IMPLICATIONS OF THE FINDINGS We report an apparent paradox in CS: lower SV volume despite higher testosterone levels. Our data suggest that smoking may negatively affect SV volume in an independent manner, as the difference between CS and non-smokers retained significance after adjusting for confounders including testosterone. This is the first study reporting such ultrasound evidence. How this new smoking-related alteration, along with low semen volume, impacts male fertility needs to be addressed by further studies. STUDY FUNDING/COMPETING INTERESTS No funding was received for the study. None of the authors have any conflict of interest to declare.
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Affiliation(s)
- F Lotti
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy
| | - G Corona
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy Endocrinology Unit, Maggiore-Bellaria Hospital, Bologna, Italy
| | - P Vitale
- Endocrinology Unit, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - E Maseroli
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy
| | - M Rossi
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy
| | - M G Fino
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy
| | - M Maggi
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy
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Mazzola CR, Katz DJ, Loghmanieh N, Nelson CJ, Mulhall JP. Predicting Biochemical Response to Clomiphene Citrate in Men with Hypogonadism. J Sex Med 2014; 11:2302-7. [DOI: 10.1111/jsm.12592] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Lotti F, Maggi M. Ultrasound of the male genital tract in relation to male reproductive health. Hum Reprod Update 2014; 21:56-83. [DOI: 10.1093/humupd/dmu042] [Citation(s) in RCA: 189] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Pezzella A, Barbonetti A, D'Andrea S, Necozione S, Micillo A, Di Gregorio A, Francavilla F, Francavilla S. Ultrasonographic caput epididymis diameter is reduced in non-obstructive azoospermia compared with normozoospermia but is not predictive for successful sperm retrieval after TESE. Hum Reprod 2014; 29:1368-74. [DOI: 10.1093/humrep/deu092] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Lotti F, Corona G, Vignozzi L, Rossi M, Maseroli E, Cipriani S, Gacci M, Forti G, Maggi M. Metabolic syndrome and prostate abnormalities in male subjects of infertile couples. Asian J Androl 2014; 16:295-304. [PMID: 24435050 PMCID: PMC3955344 DOI: 10.4103/1008-682x.122341] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Revised: 07/05/2013] [Accepted: 07/19/2013] [Indexed: 12/12/2022] Open
Abstract
No previous study has evaluated systematically the relationship between metabolic syndrome (MetS) and prostate-related symptoms and signs in young infertile men. We studied 171 (36.5 ± 8.3-years-old) males of infertile couples. MetS was defined based on the National Cholesterol Education Program Third Adult Treatment Panel. All men underwent hormonal (including total testosterone (TT) and insulin), seminal (including interleukin-8 (IL-8), seminal plasma IL-8 (sIL-8)), scrotal and transrectal ultrasound evaluations. Because we have previously assessed correlations between MetS and scrotal parameters in a larger cohort of infertile men, here, we focused on transrectal features. Prostate-related symptoms were assessed using the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and the International Prostate Symptom Score (IPSS). Twenty-two subjects fulfilled MetS criteria. In an age-adjusted logistic ordinal model, insulin levels increased as a function of MetS components (Wald = 29.5, P < 0.0001) and showed an inverse correlation with TT (adjusted r = -0.359, P< 0.0001). No association between MetS and NIH-CPSI or IPSS scores was observed. In an age-, TT-, insulin-adjusted logistic ordinal model, an increase in number of MetS components correlated negatively with normal sperm morphology (Wald = 5.59, P< 0.02) and positively with sIL-8 levels (Wald = 4.32, P < 0.05), which is a marker of prostate inflammation, with prostate total and transitional zone volume assessed using ultrasound (Wald = 17.6 and 12.5, both P < 0.0001), with arterial peak systolic velocity (Wald = 9.57, P = 0.002), with texture nonhomogeneity (hazard ratio (HR) = 1.87 (1.05-3.33), P < 0.05), with calcification size (Wald = 3.11, P< 0.05), but not with parameters of seminal vesicle size or function. In conclusion, in males of infertile couples, MetS is positively associated with prostate enlargement, biochemical (sIL8) and ultrasound-derived signs of prostate inflammation but not with prostate-related symptoms, which suggests that MetS is a trigger for a subclinical, early-onset form of benign prostatic hyperplasia.
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Affiliation(s)
- Francesco Lotti
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Giovanni Corona
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
- Endocrinology Unit, Maggiore-Bellaria Hospital, Bologna, Italy
| | - Linda Vignozzi
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Matteo Rossi
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Elisa Maseroli
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Sarah Cipriani
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Mauro Gacci
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Gianni Forti
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Mario Maggi
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
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Medved M, Sammet S, Yousuf A, Oto A. MR imaging of the prostate and adjacent anatomic structures before, during, and after ejaculation: qualitative and quantitative evaluation. Radiology 2014; 271:452-60. [PMID: 24495265 DOI: 10.1148/radiol.14131374] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE To determine the possibility of obtaining high-quality magnetic resonance (MR) images before, during, and immediately after ejaculation and detecting measurable changes in quantitative MR imaging parameters after ejaculation. MATERIALS AND METHODS In this prospective, institutional review board-approved, HIPAA-compliant study, eight young healthy volunteers (median age, 22.5 years), after providing informed consent, underwent MR imaging while masturbating to the point of ejaculation. A 1.5-T MR imaging unit was used, with an eight-channel surface coil and a dynamic single-shot fast spin-echo sequence. In addition, a quantitative MR imaging protocol that allowed calculation of T1, T2, and apparent diffusion coefficient (ADC) values was applied before and after ejaculation. Volumes of the prostate and seminal vesicles (SV) were calculated by using whole-volume segmentation on T2-weighted images, both before and after ejaculation. Pre- and postejaculation changes in quantitative MR parameters and measured volumes were evaluated by using the Wilcoxon signed rank test with Bonferroni adjustment. RESULTS There was no significant change in prostate volumes on pre- and postejaculation images, while the SV contracted by 41% on average (median, 44.5%; P = .004). No changes before and after ejaculation were observed in T1 values or in T2 and ADC values in the central gland, while T2 and ADC values were significantly reduced in the peripheral zone by 12% and 14%, respectively (median, 13% and 14.5%, respectively; P = .004). CONCLUSION Successful dynamic MR imaging of ejaculation events and the ability to visualize internal sphincter closure, passage of ejaculate, and significant changes in SV volumes were demonstrated. Significant changes in peripheral zone T2 and ADC values were observed.
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Affiliation(s)
- Milica Medved
- From the Department of Radiology, University of Chicago, 5841 S Maryland Ave, MC 2026, Chicago, IL 60637
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Lotti F, Corona G, Mondaini N, Maseroli E, Rossi M, Filimberti E, Noci I, Forti G, Maggi M. Seminal, clinical and colour-Doppler ultrasound correlations of prostatitis-like symptoms in males of infertile couples. Andrology 2013; 2:30-41. [DOI: 10.1111/j.2047-2927.2013.00156.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 10/10/2013] [Accepted: 10/11/2013] [Indexed: 11/29/2022]
Affiliation(s)
- F. Lotti
- Sexual Medicine and Andrology Unit; Department of Experimental and Clinical Biomedical Sciences; University of Florence; Florence Italy
| | - G. Corona
- Sexual Medicine and Andrology Unit; Department of Experimental and Clinical Biomedical Sciences; University of Florence; Florence Italy
- Endocrinology Unit; Maggiore-Bellaria Hospital; Bologna Italy
| | - N. Mondaini
- Santa Maria Annunziata Hospital; Florence Italy
| | - E. Maseroli
- Sexual Medicine and Andrology Unit; Department of Experimental and Clinical Biomedical Sciences; University of Florence; Florence Italy
| | - M. Rossi
- Sexual Medicine and Andrology Unit; Department of Experimental and Clinical Biomedical Sciences; University of Florence; Florence Italy
| | - E. Filimberti
- Sexual Medicine and Andrology Unit; Department of Experimental and Clinical Biomedical Sciences; University of Florence; Florence Italy
| | - I. Noci
- Department of Obstetrics and Gynecology; University of Florence; Florence Italy
| | - G. Forti
- Sexual Medicine and Andrology Unit; Department of Experimental and Clinical Biomedical Sciences; University of Florence; Florence Italy
| | - M. Maggi
- Sexual Medicine and Andrology Unit; Department of Experimental and Clinical Biomedical Sciences; University of Florence; Florence Italy
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Lotti F, Maggi M. Interleukin 8 and the male genital tract. J Reprod Immunol 2013; 100:54-65. [PMID: 23611586 DOI: 10.1016/j.jri.2013.02.004] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Revised: 01/17/2013] [Accepted: 02/13/2013] [Indexed: 11/20/2022]
Affiliation(s)
- Francesco Lotti
- Sexual Medicine and Andrology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy.
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Lotti F, Corona G, Maseroli E, Rossi M, Silverii A, Degl'Innocenti S, Rastrelli G, Forti G, Maggi M. Clinical implications of measuring prolactin levels in males of infertile couples. Andrology 2013; 1:764-71. [DOI: 10.1111/j.2047-2927.2013.00114.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Revised: 06/11/2013] [Accepted: 06/21/2013] [Indexed: 01/05/2023]
Affiliation(s)
- F. Lotti
- Sexual Medicine and Andrology Unit; Department of Clinical Physiopathology; University of Florence; Florence; Italy
| | | | - E. Maseroli
- Sexual Medicine and Andrology Unit; Department of Clinical Physiopathology; University of Florence; Florence; Italy
| | - M. Rossi
- Sexual Medicine and Andrology Unit; Department of Clinical Physiopathology; University of Florence; Florence; Italy
| | - A. Silverii
- Sexual Medicine and Andrology Unit; Department of Clinical Physiopathology; University of Florence; Florence; Italy
| | - S. Degl'Innocenti
- Sexual Medicine and Andrology Unit; Department of Clinical Physiopathology; University of Florence; Florence; Italy
| | - G. Rastrelli
- Sexual Medicine and Andrology Unit; Department of Clinical Physiopathology; University of Florence; Florence; Italy
| | - G. Forti
- Sexual Medicine and Andrology Unit; Department of Clinical Physiopathology; University of Florence; Florence; Italy
| | - M. Maggi
- Sexual Medicine and Andrology Unit; Department of Clinical Physiopathology; University of Florence; Florence; Italy
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La Vignera S, Condorelli RA, Vicari E, Lotti F, Favilla V, Morgia G, Maggi M, Calogero AE. Seminal vesicles and diabetic neuropathy: ultrasound evaluation after prolonged treatment with a selective phosphodiesterase-5 inhibitor. Andrology 2012; 1:245-50. [PMID: 23413137 DOI: 10.1111/j.2047-2927.2012.00025.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2012] [Revised: 09/09/2012] [Accepted: 09/10/2012] [Indexed: 12/20/2022]
Abstract
We have previously reported that infertile patients with diabetes mellitus (DM) have a particular ultrasound features of the seminal vesicles (SV) characterized by higher fundus-to-body ratio and lower pre- and post-ejaculatory difference in body antero-posterior diameter (APD). Based on these premises the aim of the present study was to investigate possible ultrasound SV changes in infertile patients with DM and diabetic neuropathy (DN), after prolonged administration of tadalafil (TAD) (a specific phosphodiesterase-5 inhibitor). To accomplish this, 20 infertile patients with symptomatic DN and erectile dysfunction were selected and arbitrarily divided into two groups which were assigned to: daily administration of 5 mg TAD for 3 months (Group A) (n = 10) and administration of placebo (Group B) (n = 10). All patients underwent to scrotal and prostate-vesicular transrectal ultrasound evaluation and semen analysis (Laboratory Manual for the Examination and Processing of Human Semen, WHO, 2010) before and after treatment. The following SV US parameters were recorded: (i) body APD; (ii) fundus APD; (iii) parietal thickness of the right and left SVs; and (iv) number of polycyclic areas within both SVs. We then calculated the following parameters: (i) fundus/body (F/B) ratio; (ii) difference of the parietal thickness between the right and the left SV and (iii) pre- and post-ejaculatory APD difference. In addition, we also evaluated the SV ejection fraction. Group A patients showed a significant reduction in F/B ratio and higher pre- and post-ejaculatory body SV APD difference compared with baseline or Group B after 3 months. These patients showed also a significant increase in SV ejection fraction and a significant improvement of the total sperm count, progressive motility, seminal levels of fructose, leucocytes and ejaculate volume. In conclusion, these results suggest that infertile DM patients with DN and erectile dysfunction had an improvement of ultrasound features suggestive of diabetic neuropathy after daily treatment with low doses of TAD.
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Affiliation(s)
- S La Vignera
- Section of Endocrinology, Andrology and Internal Medicine, Department of Medical and Pediatric Sciences, University of Catania, Catania, Italy.
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La Vignera S. Seminal vesicles of infertile patients with male accessory gland infection: ultrasound evaluation after prolonged treatment with tadalafil, a selective phosphodiesterase-5 inhibitor. Andrologia 2012; 45:386-91. [DOI: 10.1111/and.12027] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2012] [Indexed: 12/19/2022] Open
Affiliation(s)
- S. La Vignera
- Section of Endocrinology, Andrology and Internal Medicine; Department of Medical and Pediatric Sciences; University of Catania; Catania Italy
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Lotti F, Corona G, Rastrelli G, Forti G, Jannini EA, Maggi M. Clinical Correlates of Erectile Dysfunction and Premature Ejaculation in Men with Couple Infertility. J Sex Med 2012; 9:2698-707. [DOI: 10.1111/j.1743-6109.2012.02872.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Lotti F, Tamburrino L, Marchiani S, Muratori M, Corona G, Fino M, Degl'Innocenti S, Forti G, Maggi M, Baldi E. Semen apoptotic M540 body levels correlate with testis abnormalities: a study in a cohort of infertile subjects. Hum Reprod 2012; 27:3393-402. [DOI: 10.1093/humrep/des348] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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