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1. Priapism in Sickle Cell Anemia: Emerging Mechanistic Understanding and Better Preventative Strategies

Author

Genevieve M. Crane and Nelson E. Bennett

Subjects
Diseases of the blood and blood-forming organs, RC633-647.5
Abstract

Sickle cell anemia is a common and disabling disorder profoundly affecting mortality as well as quality of life. Up to 35% of men with sickle cell disease are affected by painful, prolonged erections termed ischemic priapism. A priapic episode may result in fibrosis and permanent erectile dysfunction. The severity of sickle cell disease manifestations is variable dependent on a number of contributing genetic factors; however, priapism tends to cluster with other severe vascular complications including pulmonary hypertension, leg ulceration, and overall risk of death. The mechanisms underlying priapism in sickle cell disease have begun to be elucidated including hemolysis-mediated dysregulation of the nitric oxide signaling pathway and dysregulation of adenosine-mediated vasodilation. A better understanding of these mechanisms is leading toward novel preventative strategies. This paper will focus on the mechanisms underlying development of ischemic priapism in sickle cell disease, current acute and preventative treatment strategies, and future directions for improved management of this disorder.

Published
2011
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2. The adverse association between stimulant use for attention deficit hyperactivity disorder (ADHD) and semen parameters

Author

James Wren, Matthew T. Hudnall, Gregory Auffenberg, Minh Pham, Joshua A. Halpern, Richard J. Fantus, Jeremy D. Lai, Nelson E. Bennett, Siddhant Ambulkar, Robert E. Brannigan, and David I. Chu

Subjects
Male, medicine.medical_specialty, Urology, medicine.medical_treatment, Semen, Semen analysis, Article, Semen quality, Endocrinology, Internal medicine, Humans, Medicine, Attention deficit hyperactivity disorder, Retrospective Studies, Azoospermia, medicine.diagnostic_test, business.industry, Methylphenidate, Retrospective cohort study, General Medicine, medicine.disease, Stimulant, Attention Deficit Disorder with Hyperactivity, Central Nervous System Stimulants, business, medicine.drug
Abstract

This study examined the relationship between stimulant medications used for the treatment of attention deficit hyperactivity disorder and semen parameters. We performed a retrospective cohort study at a large, academic institution between 2002 and 2020. We included men with a semen analysis without prior spermatotoxic medication use, empiric medical therapy exposure or confounding medical diagnoses (varicocele, Klinefelter’s syndrome, cryptorchidism, cystic fibrosis, diabetes, cancer or cancer-related treatment, and azoospermia). Men were stratified by stimulant exposure (methylphenidate or amphetamines). A multivariable linear regression was fit to assess the association between individual semen parameters, age, stimulant exposure and non-stimulant medication use. Of 8,861 men identified, 106 men had active prescriptions for stimulants within 90 days prior to semen testing. After controlling for age and exposure to non-stimulant medications, stimulant use was associated with decreased total motile sperm count (β: −18.00 mil/ejaculate and standard error: 8.44, p = 0.033) in the setting of decreased semen volume (β: −0.35 ml, and standard error: 0.16, p = 0.035), but not sperm concentration, motility and morphology. These findings suggest a role for reproductive physicians and mental health providers to consider counselling men on the potential negative impact of stimulants prescribed for attention deficit hyperactivity disorder on semen volume during fertility planning.

Published
2021
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3. Effects of nonsteroidal anti‐inflammatory drug (NSAID) use upon male gonadal function: A national, population‐based study

Author

Cecilia Chang, Mary Kate Keeter, Nelson E. Bennett, Brian T. Helfand, Robert E. Brannigan, Joshua A. Halpern, and Richard J. Fantus

Subjects
Adult, Anti-Mullerian Hormone, Male, Drug, medicine.medical_specialty, National Health and Nutrition Examination Survey, medicine.drug_class, Urology, media_common.quotation_subject, Analgesic, Anti-inflammatory, Young Adult, Endocrinology, Internal medicine, medicine, Humans, Testosterone, Aged, media_common, Aged, 80 and over, biology, business.industry, Hypogonadism, Anti-Inflammatory Agents, Non-Steroidal, Anti-Müllerian hormone, Testosterone (patch), General Medicine, Middle Aged, Nutrition Surveys, Cohort, biology.protein, business, Hormone
Abstract

Recent data have suggested that short-term NSAID use induces a state of compensated hypogonadism. Our aim was to investigate the association between chronic, regular NSAID use and compensated hypogonadism in a large, nationally representative cohort, the US National Health and Nutrition Examination Survey (NHANES) database. Men 20-80 years who answered the analgesic use questionnaire and underwent hormonal testing were included. Multivariable regression was utilised to determine the relationship between NSAID use and serum testosterone (T), anti-Mullerian hormone (AMH) and T:AMH ratio. Among 3,749 men, 505 (13.5%) reported regular NSAID use and 3,244 (86.5%) did not. Regular users had lower T (440.7 ± 27.0 vs. 557.0 ± 24.9 ng/dl, p = .005) and albumin (43.8 ± 0.2 vs. 45.1 ± 0.1, p

Published
2020
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