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Abstract Background Actinobaculum suis is a bacterium known to cause infections of the urogenital tract of sows. Infection can occur through close contact to boars, who frequently carry the pathogen in their preputial diverticulum but do not become clinically diseased themselves. In the current case, Actinobaculum suis was isolated from pyogranuloma of inflamed epididymis in a boar with poor fertility. Case presentation Increased return to oestrus rate, which worsened after the purchase of a new boar, was reported in an organic farm in Switzerland. During herd examination, azoospermia of the boar was diagnosed, and slaughter, followed by examination of its urogenital tract, was carried out. Pathologically, pyogranuloma formation and epididymitis were diagnosed. Bacteriology of the pyogranulomas showed growth of Actinobaculum suis and mixed flora. After the boar was replaced, the return to oestrus rate improved tremendously. Conclusion A close relative of Actinobaculum suis, namely Actinotignum schaalii, has already been associated with epididymitis in humans. Considering the present case and the parallels in human medicine, Actinobaculum suis should be included in the list of differentials of boars with poor fertility.

Literature support that vitamin-D is important for different systems of the human body including, but not limited to endocrine and immune systems, vasculature and endothelial function of the body. Male erectile function depends on many factors and can be perceived as a health indicator of the body. Epidemiological data have shown that vitamin-D deficiency is also associated with erectile dysfunction. In this review, our aim is to interpret the mechanisms by which vitamin-D might regulate anatomy and physiology of penis. Evidence showed that vitamin-D is needed for an adequate erectile function. Briefly, vitamin-D is crucial for a better healthy body and sexual activity.

Infertility is on a rise, and so is the availability of assisted reproductive technique (ART) centres. The sole aim of these centers is to help these unfortunate couples achieve pregnancy. Hence, the concentration of the treatment is on the female partner, while the male is relegated to just being a source for sperm. In the era of intracytoplasmic sperm injection, when pregnancy is possible even with a single mature sperm, evaluation and management of male factor infertility (MFI) is often neglected. MFI and poor semen parameters are markers of male health. He could be suffering from erectile or ejaculatory issues or with correctable obstructive azoospermia. A simple timely varicocele correction may help resolve the issue. It is important to understand that MFI is not a disease but may be a symptom of major underlying clinical condition like testicular or brain tumors. Infertility treatment could be the only occasion when a male seeks health-care evaluation. India has a large pool of qualified urologists trained in andrological care. In contrast, gynecologists may not be trained in the management of male patients, hence there is an important place for andrological services to be an integral part of ART centers. Andrologists would offer minimal andrological evaluation and condition-specific treatment. This could avoid or reduce the need for invasive and expensive ART. Andrologists could also choose the most appropriate mode of sperm retrieval. Undoubtedly, availability of andrological services would improve the overall quality of care, reduce the costs and complications, and would also be medicolegally safe.

Objective: Penile cancer is a rare malignancy, with a reported incidence of 1.5/100,000 males in the Republic of Ireland in 2015. The aim of this study was to perform the first national review and to evaluate clinicopathological factors affecting survival.Subjects and Methods: All cases of penile cancer in Ireland between 1995 and 2010 were identified through the National Cancer Registry Ireland (NCRI) and analysed to identify factors affecting survival.Results: 360 cases of penile cancer were identified, with a mean age at diagnosis of 65.5 years and 88% (n = 315) of cases occurred in those over 50. 91% (n = 328) of cases were squamous cell carcinomas (SCC). The majority of patients were treated surgically (n = 289), with 57% (n = 206) and 24% (n = 87) undergoing partial penectomy and total penectomy respectively. Only 18% (n = 65) received radiotherapy, and 8% (n = 27) received chemotherapy. Mean overall survival (OS) was 113 months, and five year disease specific survival (DSS) was 70% (95%CI: 59.1-77.8%). Age at diagnosis, nodal status and presence of metastatic disease were independent prognostic markers on multivariate analysis.Conclusion: This study represents the first national review of penile cancer in Ireland. The annual incidence and survival rates are comparable to European figures, though superior DSS has previously been reported from our institution, highlighting the role for centralisation of care in Ireland.Level Of Evidence: 2b. [ABSTRACT FROM AUTHOR]

This document is a comprehensive guidance for human embryology, andrology, and endocrinology laboratories. Universal guidance applicable to all laboratories includes requirements and recommendations for accreditation and staffing in the United States, and specific guidance is included for each laboratory specialty. [ABSTRACT FROM AUTHOR]

Spinal cord injury (SCI) is a relevant medical and social problem. According to the World Health Organization, the commonly estimated worldwide annual incidence of SCI is 40 to 80 cases per million population. After the SCI experience, most men present with sexual dysfunction (erectile dysfunction (ED) and ejaculatory dysfunction), fertility problems (such as impaired spermatogenesis, abnormalities in sperm viability, motility, and morphology), and systemic disorders such as genitourinary infection and endocrine imbalances. The best options available for managing the ejaculatory disorders in patients suffering from SCI are penile vibratory stimulation (PVS) and electroejaculation (EEJ). Furthermore, the treatment of ED in SCI patients consists of medical therapies including phosphodiesterase 5 inhibitors (PDE5i), intracavernosal injections (ICI), vacuum erection devices (VEDs), and surgical as penile prosthesis (PP). This review provides a snapshot of the current evidence for the mechanisms of sexual dysfunction and infertility in SCI patients, discusses the best management strategies for these conditions, and offers our perspective on the direction of future research. [ABSTRACT FROM AUTHOR]

Detailed and direct analysis of semen, including sperm morphology, enables a diagnosis of male fertility. This study aimed to describe an economical and verified protocol for canine spermiograms and compare the effectiveness of Sperm Stain® and Sperm Blue® (Microptic, Spain) in veterinary practice. Sperm assessment was conducted manually, using a standard optical microscope, and via computerized semen analysis using the SCA® CASA (Sperm Class Analyzer® CASA System‐MICROPTIC, Spain). This study showed that Sperm Blue® is a better solution for computerized sperm quality analysis of healthy dogs. At the same time, Sperm Stain® turned out to be more helpful in identifying specific morphological defects of sperm. Automated canine sperm morphology analysis worked better with Sperm Blue stain, but Sperm Stain simplified manual evaluation of various organelles' defects. Standard, manual examination is more error‐prone for an inexperienced andrology technician, but it seems to be still a gold standard technique for canine sperm assessment. [ABSTRACT FROM AUTHOR]

ANDRONET COST ACTION One of the arguably greatest achievements in the history of the EAA - in terms of international cooperation in andrology - was the funding from the European Cooperation in Science and Technology (COST) for the EAA-initiated network ANDRONET.1 We are grateful to B Rafael Oliva b for his hard work coordinating the application. A more detailed report is available on the EAA website: www.andrologyacademy.net/eaa-budapest-school The 23rd EAA Clinical Andrologist examination was held in conjunction with the school. Keywords: European Academy of Andrology EN European Academy of Andrology 619 624 6 04/22/22 20220501 NES 220501 A NOTE FROM THE PRESIDENT GRAPH Dear Colleagues, After a very stressful 2020, we went through the equally difficult 2021. The EAA members are encouraged to use the portal and update their information on the EAA website: https://andrologyacademy.net/portal/. [Extracted from the article]

Background: Previous meta‐analyses concluded that there is a decline in sperm parameters over time. This conclusion might be incorrect due to inherent biases or focusing only on a single parameter – sperm concentration. Objective: To study trends in sperm parameters over the past 20 years using data from the trials that defined the reference ranges of the World Health Organization manual. Materials and methods: Retrospective evaluation of the data used to define the World Health Organization reference ranges. The data from 11 studies, including 3589 participants between 1996 and 2016, were divided into three period groups based on the decade of study. Differences in semen parameters' distribution were presented in boxplot. p‐values were calculated by the Kruskal–Wallis rank‐sum test followed by Dunn post hoc test. Analyses were conducted using the R programming language. Results: A small decrease was noted in mean sperm concentrations (88.1 million/ml, 87.6 million/ml, and 77.2 million/ml for the first, second, and third decades, respectively) (p < 0.01). However, the 5th percentile of sperm concentration for the third decade was higher than the first or second decades (18 million/ml versus 14.9 million/ml and 15 million/ml, respectively). No significant differences were noted in progressive motility over the years (p = 0.32). The percent of morphologically normal sperm decreased between the first (24.2%) and the second (12.6%) periods of the study (p < 0.001) and then increased in the third decade (14.2%) (p < 0.01). Total motile sperm count (TMC) declined between the second and third decades (189 million and 153.9 million, respectively, p < 0.001), at levels unlikely to decrease fertility. However, the 5th percentile of the TMC remained stable at 24.9, 20.8, and 20.6 million, for the first, second, and third decades respectively (p = 0.36). Discussion and conclusion and relevance: Trends in sperm parameters over the last three decades do not seem to be clinically significant. [ABSTRACT FROM AUTHOR]

Copyright of Anatolian Clinic Journal of Medical Sciences is the property of Hayat Saglik ve Sosyal Hizmetler Vakfi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Testicular hydrocele is an abnormal accumulation of fluid in the tunica vaginalis, usually related to injury or inflammation in the scrotum. This study aims to report the use of ultrasound and histopathological exams for the diagnosis of testicular hydrocele in swine. The boar showed increased testicular volume, with edema and stiffening of the testes, without signs of algesia. In the ultrasound examination, there were delimited regions of low echogenicity. In the histopathological examination the findings were compatible with hydrocele. The clinical manifestations and the results of the ultrasound examination in the present study allowed the diagnosis of hydrocele. [ABSTRACT FROM AUTHOR]

Background: Atopic dermatitis (AD) is a common eczematous skin disease that is chronically relapsing. Interleukin - 1-beta (IL-1β) is a pivotal agonist member of the IL-1 family that plays a master role in the induction of an adequate immune response to regulate the sweeping of the diseased cells physiologically. Objective: The aim was to clarify the possible participation of a certain IL (IL-1 beta) in the pathogenesis of atopic dermatitis. Patients and Methods: This case-control study has been conducted in the Dermatology, Venereology and Andrology Department at Zagazig University Hospitals. Our present study included 30 atopic patients and 30 apparently healthy control subjects of matched age and sex. Serum IL-1β level was measured. Results: Gender had no significant effect on serum Il-1β in all groups. Duration of the disease showed a non-significant positive one in atopic patients. The severity of the disease showed a significant positive correlation in atopic patients and similarly, the disease score did. There was a significant difference in serum IL-1β among the three degrees of severity in a topic patients. Conclusion: IL-1β serum level was found in patients with moderate to severe cases of atopic dermatitis, marking the systemic inflammatory nature of these diseases. On the other hand, IL-1β serum level was around normal values in the control group. These mentioned findings were supported by the statistical evaluations on the relationship between serum IL-1β level, severity scores of AD (SCORAD score) and clinical observations. [ABSTRACT FROM AUTHOR]

Abstract Background The potential of COVID-19 severe pandemic necessitates the development of an organized and well-reasoned plan for the management of embryology/andrology laboratories while safeguarding the wellbeing of patients and IVF staff. Main body A COVID-19 pandemic response plan was proposed for embryology and andrology laboratories for pre-pandemic preparedness and pandemic management in anticipation of a possible second coronavirus wave. Preparation involves many plans and logistics before a pandemic risk rises. Many operational changes can be considered during the pandemic. This plan includes logistical arrangements, reducing labor needs, conserving supplies, and protective measures for embryologists and gametes/embryos. Conclusion The unpredictable emergence of the COVID-19 pandemic dictates the need for a preparedness plan for embryology/andrology laboratories, which includes an action-oriented plan to secure the safety of all stakeholders.

Objective: To evaluate the impact of paternal age on embryology and pregnancy outcomes in the setting of a euploid single-embryo transfer. Design: Retrospective cohort study. Setting: Not applicable. Patient(s): Couples undergoing a first in vitro fertilization cycle with fresh ejaculated sperm who used intracytoplasmic sperm injection for fertilization followed by preimplantation genetic testing for aneuploidy and single-embryo transfer of a euploid embryo between January 2012 and December 2018. Intervention(s): Not applicable. Main Outcome Measure(s): Embryology outcomes assessed were fertilization rate, blastulation rate, and euploid rate. Pregnancy outcomes assessed included positive human chorionic gonadotropin rate, delivery rate, biochemical loss rate, and clinical loss rate. Results: A total of 4,058 patients were assessed. After adjusting for female age, increased paternal age in the setting of fresh ejaculated sperm use was associated with decreased blastulation and decreased euploid rate using 40 years as an age cutoff. Conclusion(s): In this study, advancing paternal age appears to have a detrimental impact on rates of blastocyst formation and euploid status. However, if a euploid embryo is achieved, older paternal age does not appear to affect negatively pregnancy outcomes.

The practice of male infertility has dramatically evolved over the past few decades. This has been achieved after the realization of the important contribution the male counterpart holds in the couple’s infertility. It is also supported by a number of breakthroughs in the diagnosis and treatment of this medical condition. Several tests to investigate sperm quality and function were introduced along with refinements and/or institution of novel surgical techniques that can correct several causes of infertility. This manuscript is aimed at highlighting the current state of male infertility practice in a robust, schematic method addressing a broader audience involved in the treatment of male infertility.

The incidence of testicular cancer is steadily increasing over the past several decades in different developed countries. If on one side better diagnosis and treatment have shone a light on this disease, on the other side, differently from other malignant diseases, few risk factors have been identified. The reasons for the increase in testicular cancer are however unknown while risk factors are still poorly understood. Several studies have suggested that exposure to various factors in adolescence as well as in adulthood could be linked to the development of testicular cancer. Nevertheless, the role of environment, infections, and occupational exposure are undoubtedly associated with an increase or a decrease in this risk. The aim of this narrative review is to summarize the most recent evidence regarding the risk factors associated with testicular cancer, starting from the most commonly evaluated (cryptorchidism, family history, infections) to the newer identified and hypothesized risk factors.

Congenital absence of the vas deferens (CAVD) is a syndrome with a heterogeneous presentation: bilateral (CBAVD) or unilateral (CUAVD), complete or partial and associated or not with other anomalies of the male urogenital system. A turning point came in 1968 when CBAVD was associated with cystic fibrosis and its CFTR gene mutations. Genetic studies then revealed that a minority of CBAVD but a majority of CUAVD are CFTR-independent. In the literature, reference is classically made to two sources from the 18th and 19th century: Hunter and Reverdin. This scarcity prompted us to look for additional observations of CAVD. By a meticulous bibliographical search, we identified a corpus of 10 European observations (8 CUAVD and 2 CBAVD) some of them richly illustrated. They were collected between 1755 and 1876 throughout adult men autopsies. We also provided their primary and unambiguous sources. Analysis of the reported data revealed some interesting facts: both CBAVD cases were unlikely linked to cystic fibrosis and half of CUAVD cases were associated with an ipsilateral kidney absence, suggesting a CFTR-independent pathophysiology. Moreover, the anatomical details of the anomalies raise interesting embryological questions we have tried to address in the light of current data. This work made it possible to identify new historical sources dealing with male genital tract pathologies. It sheds light on the origins of andrology and opens up interesting prospects for research and education in the field., (© 2024 American Society of Andrology and European Academy of Andrology.)

Objective: This study aimed to assess the impact of β-caryophyllene (BC) supplementation in the extender on the post-cryopreservation quality of semen from Dorper rams., Methods: Six Dorper rams were utilized for semen collection over 16 weeks, with BC concentrations determined via the MTT test. Animals were divided into a control group and three treatment groups receiving BC at concentrations of 1.0mM, 2.0mM, and 3.0mM in the Trisegg yolk diluent. Semen was cryopreserved and stored in liquid nitrogen for at least 15 days. After thawing, in vitro assessments including CASA, acrosomal integrity, plasma membrane integrity, mitochondrial membrane potential, and thermo-resistance tests were conducted. Additionally, the TBARS assay was performed to evaluate oxidative stress., Results: While BC supplementation did not significantly affect sperm motility, it notably improved mitochondrial potential and mitigated oxidative stress in cryopreserved ram semen., Conclusions: Incorporating β-caryophyllene into the extender exhibited beneficial effects on the quality of Dorper ram semen post-cryopreservation, enhancing mitochondrial functionality and reducing oxidative stress.

These guidelines update and clarify items relating to diagnostic andrology in the 2012 Association of Biomedical Andrologists Laboratory Andrology Guidelines for Good Practice Version 3. The main change separates diagnostic and therapeutic andrology into individual documents; post-vasectomy semen analysis still references the 2016 guideline. These guidelines seek to incorporate and clarify internationally agreed methodology following the World Health Organization Laboratory Manual for the Examination and Processing of Human Semen 6th edition and publication of ISO 23162:2021. Significant updates include: requiring four-category grading for motility (A, rapidly progressive; B, slowly progressive; C, non-progressive; D, immotile); a four-part morphology assessment (head, midpiece, tail, cytoplasmic droplets) as essential for quality assurance (even if only the percentage of 'normal' is reported); and specifying sperm toxicity testing procedures for diagnostic andrology. These guidelines include a section on haematospermia, an observation requiring rapid onward referral. An Association of Reproductive and Clinical Scientists (ARCS) working group wrote these guidelines, with review by ARCS members. The aim is to guide good practice in laboratories but they are not intended as a tool to judge the practice of centres within the UK or beyond., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Reproductive efficiency is crucial for animal agriculture. This economically important aspect can be influenced by environmental burdens, nutritional imbalance, and gonadal or gametic malformations of genetic origin. Successful implementation of genomic-driven selective breeding in cattle depends on the reproductive performance of artificial insemination (AI) sires with valuable genomic production traits. Reproduction is traditionally viewed as a complex set of polygenic traits that are negatively impacted by using a small number of often closely related sires selected for AI due to their superior genetics. Despite recent progress, it remains difficult to define relationships between sire genome and variation in sperm phenotypes, even though several types of heritable, non-compensable sperm defects have been identified. In this review, we discuss the concept of sperm quality biomarker discovery and genomics of male fertility. We also outline a multidisciplinary genome-to-phenome approach for investigating heritable mutations and their impacts on bull fertility, sperm phenotypes and paternal contributions to early pregnancy. High-precision phenotyping requires novel, state-of-the-art instrumentation for sperm quality evaluation and development of new biomarkers of sperm quality in farm animals, with potential for incorporation into andrology-specific machine learning protocols and translation to human andrology. We conclude that reproduction is a complex phenotype that can be deciphered and explored for more precise male fertility evaluation and higher reproductive efficiency., Competing Interests: Declaration of Competing Interest The authors have declared that no conflict of interest exists., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Despite that the SARS-CoV-2 pandemic has been controlled, it has affected a large proportion of the population, raising some concerns about potential sequelae in men at reproductive age. To contribute to the clarification of this issue, we performed a retrospective study comparing semen parameters values before and after confirmed SARS-CoV-2 infection in a large cohort of infertile men, compared to a control group that did not undergo SARS-CoV-2 infection. Wilcoxon test on paired samples and general linear regression model showed that SARS-CoV-2 infection has a detrimental effect on semen volume values ( p  < 0.005). However, semen volume seems to be significantly lower only during the first spermatogenic cycle after SARS-COV-2 infection ( p  < 0.005) and mainly in unvaccinated patients ( p  < 0.05). In addition, we detected alterations in progressive motility in patients infected with the alpha SARS-COV-2 strain ( p  < 0.05). In conclusion, our results show that although SARS-CoV-2 has a small effect on semen volume and sperm motility in infertile men, depending on the infectious strain or vaccination status, pre-infection values of semen parameters appear to be restored over one spermatogenic cycle after infection.

Abstract: Artificial intelligence (AI) is revolutionizing the current approach to medicine. AI uses machine learning algorithms to predict the success of therapeutic procedures or assist the clinician in the decision-making process. To date, machine learning studies in the andrological field have mainly focused on prostate cancer imaging and management. However, an increasing number of studies are documenting the use of AI to assist clinicians in decision-making and patient management in andrological diseases such as varicocele or sexual dysfunction. Additionally, machine learning applications are being employed to enhance success rates in assisted reproductive techniques (ARTs). This article offers the clinicians as well as the researchers with a brief overview of the current use of AI in andrology, highlighting the current state-of-the-art scientific evidence, the direction in which the research is going, and the strengths and limitations of this approach., (Copyright © 2024 Copyright: ©The Author(s)(2024).)

Background and Objective: Premature ejaculation (PE) and erectile dysfunction (ED) are two common sexual symptoms of male sexual dysfunction that can strongly affect men's mental health and quality of life, and they often coexist. This aim of this study was to explore the causes and relationships between PE and ED, with a focus on the progression of PE accompanied by high-frequency ED. A deeper understanding of the causes and treatments for PE combined with ED will help improve clinical diagnosis and treatment., Methods: We conducted a literature review of the most relevant articles related to the outlined topic in the PubMed, Google Scholar, and Web of Science databases. We did not limit language, covering both English and non-English publications, and include Chinese and English papers published between January 1996 and March 2024., Key Content and Findings: The incidence of PE and ED increases with age. Approximately one-third of patients who complain of ED suffer from PE. Similarly, in a large-scale survey in the Asia-Pacific region, more than 30% of patients with PE reported concurrent ED. Various research findings indicate a strong correlation between PE and ED. Some scholars speculate that there is a vicious cycle between PE and ED. Men who attempt to control ejaculation can reduce the level of arousal, leading to ED, whereas men who try to achieve an erection will attempt to increase the level of arousal, which can lead to PE. This cycle of mutual influence may lead to reciprocal aggravation and persistence of sexual dysfunction in both parties. Although some studies have explored the relationship between PE and ED, the specific determinants and underlying factors have not yet been clarified., Conclusions: There is a close interrelationship between PE and ED, and a vicious cycle may exist between the two. This cycle of mutual influence may lead to the mutual aggravation and persistence of both sexual dysfunctions. However, the specific determining factors and potential factors underlying the correlation between the two have not been clearly identified and require further exploration., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tau.amegroups.com/article/view/10.21037/tau-24-204/coif). The authors have no conflicts of interest to declare., (2024 AME Publishing Company. All rights reserved.)

Backgrounds: Despite a wide spectrum of contraceptive methods for women, the unintended pregnancy rate remains high (45% in the US), with 50% resulting in abortion. Currently, 20% of global contraceptive use is male-directed, with a wide variation among countries due to limited availability and lack of efficacy. Worldwide studies indicate that >50% of men would opt to use a reversible method, and 90% of women would rely on their partner to use a contraceptive. Additional reasons for novel male contraceptive methods to be available include the increased life expectancy, sharing the reproductive risks among partners, social issues, the lack of pharma industry involvement and the lack of opinion makers advocating for male contraception., Aim: The present guidelines aim to review the status regarding male contraception, the current state of the art to support the clinical practice, recommend minimal requirements for new male contraceptive development and provide and grade updated, evidence-based recommendations from the European Society of Andrology (EAA) and the American Society of Andrology (ASA)., Methods: An expert panel of academicians appointed by the EAA and the ASA generated a consensus guideline according to the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) system., Results: Sixty evidence-based and graded recommendations were produced on couple-centered communication, behaviors, barrier methods, semen analysis and contraceptive efficacy, physical agents, surgical methods, actions before initiating male contraception, hormonal methods, non-hormonal methods, vaccines, and social and ethical considerations., Conclusion: As gender roles transform and gender equity is established in relationships, the male contribution to family planning must be facilitated. Efficient and safe male-directed methods must be evaluated and introduced into clinical practice, preferably reversible, either hormonal or non-hormonal. From a future perspective, identifying new hormonal combinations, suitable testicular targets, and emerging vas occlusion methods will produce novel molecules and products for male contraception., (© 2023 American Society of Andrology and European Academy of Andrology.)

Objective: New indices of dyslipidemia, such as the Atherogenic Index of Plasma (AIP) or Castelli Risk Index I and II (CR-I/II), have been tested to predict erectile dysfunction (ED). The aim of this study was to assess the role of these lipidic scores in predicting severe ED and erectile function (EF) worsening in patients who underwent robot-assisted radical prostatectomy (RARP)., Methods: Data from 1249 prostate cancer patients who underwent RARP at our single tertiary academic referral center from September 2021 to April 2023 were reviewed. RARP patients with a complete lipid panel were included in the final analysis. Two independent multivariable logistic regression models (LRMs) were fitted to identify predictors of ED severity and worsening in RARP patients., Results: Among the 357 RARP patients, the median age was 70 (interquartile range [IQR]: 65-74), and the median BMI was 28.4 (IQR: 26-30.4). According to the preoperative IIEF5, 115 (32.2%), 86 (24.5%), 26 (7.3%), and 40 (11.2%) were mild, mild-moderate, moderate, and severe ED patients, respectively. After multivariable LRMs predicting severe ED, only the nerve-sparing (NS) approach (odds ratio [OR]: 0.09) as well as the preoperative IIEF5 score (OR: 0.32) were independent predictors (p < 0.001). After LRMs predicting EF worsening, only preoperative IIEF5 was an independent predictor (OR: 1.42, p < 0.001)., Conclusion: The power of novel lipidic scores in predicting severe ED and EF worsening in RARP patients was low, and they should not be routinely applied as a screening method in this patient subgroup. Only preoperative IIEF5 and nerve-sparing approaches are relevant in EF prediction after RARP., (© 2024 The Japanese Urological Association.)

Objective: This systematic review aimed to analyze animal and human trial data to better understand the efficacy of stem cell therapy (SCT) for erectile dysfunction (ED) and the obstacles that may hinder its application in this field., Methods: We searched electronic databases, including PubMed and Scopus, for published studies with the Medical Subject Heading terms of "erectile dysfunction" (AND) "stem cell therapy" (OR) "erectile dysfunction" (AND) "clinical trial of stem cell therapy" (OR) "stem cell therapy" (AND) "sexual dysfunction". The search was limited to English-language journals and full papers only. The initial search resulted in 450 articles, of which 90 relevant to our aims were included in the analysis., Results: ED is a multifactorial disease. Current treatment options rely on pharmacotherapy as well as surgical options. Patients may have side effects or unsatisfactory results following the use of these treatment options. SCT may restore pathophysiological changes leading to ED rather than treating the symptoms. It has been evaluated in animal models and shown promising results in humans. Results confirm that SCT does improve erectile function in animals with different types of SC use. In humans, evidence showed promising results, but the trials were heterogeneous and limited mainly by a lack of randomization and the small sample size. Many challenges could limit future research in this field, including ethical dilemmas, regulation, patient recruitment, the cost of therapy, and the lack of a standardized SCT regimen. Repairing and possibly replacing diseased cells, tissue, or organs and eventually retrieving normal function should always be the goals of any therapy, and this can only be guaranteed by SCT., Conclusion: SCT is a potential and successful treatment for ED, particularly in patients who are resistant to the classic therapy. SCT may promote nerve regeneration and vascular cell regeneration, not only symptomatic treatment., Competing Interests: The authors declare no conflict of interest., (© 2024 Editorial Office of Asian Journal of Urology. Production and hosting by Elsevier B.V.)

Copyright of Revista Chilena de Urologia is the property of Sociedad Chilena de Urologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Within modern biotechnology, different tools and methodologies have been developed to maximize canine semen conservation protocol to optimize reproductive results. In the last decades, the survival of chilled semen has been prolonged from 2 to 3 days with the first basic diluents, to 10–14 days with the modern extenders. However, their main limitation is that sperm quality decreases during cold storage. Sperm activators (SA) have been produced to provide the molecules necessary to maximize the sperm survival and quality with the aim to enhance fertility and prolificacy. In this study, the effect of commercial extender SA (Theriosolution® Canine AI extender -Chile-) was recorded by daily evaluation of chilled semen for 14 days. In this experiment, sperm-rich ejaculate fraction was collected from six adult healthy Neapolitan Mastiff dogs. The semen evaluation started immediately after collection (d0), and after that a next generation extender was added (d0) for every 24 h from d1 (with and without SA) to d14, to determine spermatozoa progressive motility, velocity of forward progression (VFP), morphology, and integrity of the spermatic membrane. The initial sperm concentration of extended semen was 417.3 ± 170.4 x 106/mL (mean ± SEM) with 85.89 ± 4.76% of MNS (morphologically normal sperm), 84.47 ± 5.22 % live sperm, and pH of 6.2 ± 2.8. The initial VFP was 3.83 ± 0.48, but after 1 min with SA, it rises to 4.45 ± 0.45 (P < 0.001). The sperm progressive motility parameter increases significantly (P < 0.05) in experimental trial, respect to control, starting to d2 at finish (except for d7). The VFP analysis significantly increases in experimental trial (P < 0.05) during most days of the study with the exclusion of d3 and d14. To evaluate the seminal characteristics over time, the experiment was divided into T1 (d0–d5), T2 (d6–d10), and T3 (d11–d14) (P < 0.001) in evaluation of morphology and membrane functionality. The MNS reached 70% at d10 and finally 65% at d14, being considered normal and possibly fertile. With Host-s, 65% of MNS were also achieved at d14. The presence of glucose and fructose in the diluents used for refrigeration can exert very important effects given the fact that metabolic routes have been found in both sugars, providing both different and complementing effects. It can be concluded that the use of SA prior to artificial insemination improves the quality of chilled semen significantly, although it does not reverse the effects of deterioration due to cellular metabolism over time.

Cycle use has grown rapidly over the last few years in the UK. British Cycling membership has increased threefold since the 2012 Olympic and Paralympic Games, and this is likely to rise in the wake of the Coronavirus pandemic. As urologists, day-to-day encounters with cyclists are commonplace, who may present with acute traumatic injuries or chronic overuse injuries. The aim of this literature review was to evaluate the effect of cycling on conditions presenting to the urology clinic, in particular those of raised prostate-specific antigen (PSA), haematuria and soft-tissue lesions ('cyclist nodules'). Furthermore, the review aimed to summarize the relationship between cycling and pudendal nerve entrapment (PNE) syndromes. A PubMed search of the literature on cycling and genitourinary disorders was performed. The literature suggests no significant change in PSA levels after a bout of cycling. Age appears to have no effect on the change in PSA experienced following a bout of cycling, in particular when comparing those <50 years of age to those >50 years of age. Haematuria appears to be rare with cycling but has been described, even with stationary bike riding. It is imperative to exclude coexisting urinary-tract pathological conditions, and cycling-induced haematuria should always be considered a diagnosis of exclusion. Perineal nodular induration ('cyclist nodules') is a rare condition, related to pressure and repetitive micro-trauma between the perineum and saddle. Pudendal Nerve Entrapment (PNE) represents the most common bicycling-associated urogenital complaint. Numbness in the perineum, penis, scrotum or buttocks—'genital numbness'—is the most common and most recognized symptom of pudendal compression. Despite several studies demonstrating a link between elite cyclists and erectile dysfunction, for the average cyclist riding may actually have a protective effect on sexual function. [ABSTRACT FROM AUTHOR]

Context: The use of buserelin, a gonadotropin-releasing hormone (GnRH) agonist, can improve semen quality. Nevertheless, the appropriate dosage, and frequency and time of application, remain to be established owing to the subsequent negative feedback on endogenous production of testosterone described so far. Aims: This study aimed to propose a new buserelin application protocol for sperm improvement in Santa Inês rams. Methods: Fifteen Santa Inês rams were divided into two experimental groups: the first group (n = 8) received 2.5 μg buserelin acetate; and the second group (n = 7) received saline solution. Treatments were applied for 21 days at intervals of 6 h, totalling four hormonal or saline applications per day. In all animals, macroscopic and microscopic seminal characteristics and freezability, plasma testosterone, pixels of testicular parenchyma, and biometric analysis of testicular and accessory sex glands by ultrasound were evaluated throughout the period of hormonal application and for a further 7 days. Key results: Rams receiving buserelin showed a peak of testosterone after the first week (Day 7) of application, with a drop in values at Day 14, followed by negative feedback at Day 21 and return to basal concentrations at Day 28. They also showed improvement of kinetics parameters such as straight line velocity (μm/s: +buserelin 51.5 ± 1.5 > control 46.6 ± 1.6) and linearity coefficient (%: +buserelin 53.5 ± 1.8 > control 47.5 ± 1.9). Ultrasound parameters, pixels of testicular parenchyma, and freezability were not affected by treatment. Conclusions: The administration of buserelin was able to improve some sperm kinetics parameters of Santa Inês rams. Implications: Low doses of this GnRH analogue can be used; however, further adjustments to the hormonal protocol are needed to obtain an effective improvement in sperm quality. The use of buserelin (GnRH agonist) can improve semen quality; nevertheless, the dosage, and frequency and time of application, are unresolved owing to the reported subsequent negative feedback on endogenous production of testosterone. In this study, the administration of buserelin improved some sperm kinetics parameters of Santa Inês rams. Therefore, low doses of buserelin can be used, although further adjustments to the hormonal protocol are needed to obtain an effective improvement in sperm quality. [ABSTRACT FROM AUTHOR]

Male reproduction is a complex biological process, and male factor infertility is increasingly recognized as a biomarker for overall male health. Emerging data suggest associations between male reproduction and medical disease (genetic, infectious, chronic comorbid conditions), psychological disease, environmental exposures, dietary habits, medications and substances of abuse, and even socioeconomic factors. There is also evidence that a diagnosis of male fertility is associated with future disease risk including cancer, metabolic disease and mortality. As such, there is a growing view that the male fertility evaluation is an opportunity to improve a man's health beyond his immediate reproductive goals, and also highlights the necessity of a multidisciplinary approach. [ABSTRACT FROM AUTHOR]

Background: Hyaluronic acid is a glycosaminoglycan widely used in the fields of orthopedics, ophthalmology, and aesthetic medicine due to its significant ability to reduce the synthesis of pro‐inflammatory proteins and its activity against oxidative stress, a feature of many degenerative illnesses. Objectives: The objective of the present review is to provide a comprehensive narrative review of the most recent literature on the use of hyaluronic acid in andrology in order to facilitate the use of this therapeutic device in the common clinical practice of many physicians. Specific conditions covered in the review are Peyronie's disease, premature ejaculation, and penile enlargement. Materials and methods: A broad and comprehensive literature search included Medline, EMBASE, and the Cochrane Libraries, with no time restriction up to December 2020 and restricted to English language publications. Unpublished studies were not included. The study was registered as "The role of hyaluronic acid in andrology: A systematic review and meta‐analysis" in PROSPERO with the ID CRD42021223416. Discussion and conclusion: Hyaluronic acid is a valid choice for the treatment of Peyronie's disease in terms of the resolution of the acute phase of the disease and of contributing to stabilizing the disease as a bridge to potential surgery. Data, furthermore, suggest that hyaluronic acid is frequently associated with an overall clinical improvement, allowing the patient to resume normal sexual activity. With regard to premature ejaculation, data suggests hyaluronic acid‐based treatments were effective in prolonging intra‐vaginal ejaculation time. Furthermore, hyaluronic acid was found to be safe and well‐tolerated, with main adverse events limited to local discomfort, ecchymosis, papule formation, and glans numbness, all of which were reported to resolve spontaneously. Last, with regard to penile enlargement, the overall perception of experts is that hyaluronic acid may be an extremely well‐tolerated compound with potential for application in specific areas of male sexual health that are often neglected as compared to more common, and relatively simpler to treat, conditions. [ABSTRACT FROM AUTHOR]

Introduction: seminal fluid is the combination of fluid from the prostate and other sex glands that allows the transport of sperm during ejaculation. It contains sugar as the main source of energy. Its composition is relevant because it can give indications of health problems or infertility, so its study in the clinical or andrology laboratory must guarantee a reliable result through the use of standardized methods. Objective: to evaluate the quality of sperm concentration determination in the direct spermatobioscopy test in clinical laboratories according to the World Health Organization Manual for the analysis and processing of human semen. Methods: an observational, descriptive, longitudinal and prospective research was conducted in 23 clinical laboratories between September 2017 and May 2018 with minimal risk, level II and in accordance with the Regulations of the General Health Law on Health Research. Results: several conditions highlight the deficiency in sperm concentration analysis: lack of capacitation (65.2%), lack of instructions (60.9%), lack of procedures (69.6%), lack of calibration of measuring and support equipment, such as automatic pipettes (69.6%). Spearman (rs=0.753402; NC:95%; rs<0.05) and Kendal Tau (t=0.707696; NC:95%; t<0.05) tests were not significant for clinical laboratory operating time, and Mann-Whitney and Kruskal-Wallis tests showed significant differences (U: p=0.037887; NC=95%; p<0.05/KW: p=0.000000; NC=95%; p<0.05) with respect to sperm concentration readings. Conclusions: more than 60% of the laboratories lack an adequate process for seminal fluid analysis. [ABSTRACT FROM AUTHOR]

Aim: To assess the correlation between semen parameters and sperm DNA fragmentation (SDF) and to examine whether SDF can be recommended as a routine test along with semen analysis. Materials and methods: Retrospective analysis was conducted for 118 male infertile patients attending a fertility clinic obtained from the records between 2017 and 2019. Semen analysis and SDF were assessed according to World Health Organization - 2010 guidelines and sperm chromatin dispersion test, respectively. Patients were grouped based on their SDF scores as "low DNA fragmentation group (LDF)" if SDF ≤ 18% and as "high DNA fragmentation group (HDF)" if SDF > 18%. Mann-Whitney and Kruskal-Wallis tests were used to find the difference in the mean of semen parameters between SDF groups. Statistical analysis was carried out using STATA Version-14. Results: The mean value of sperm concentration, motility, and normal morphology was higher in LDF compared to HDF. Correlation analysis showed patients' age to be positively associated with SDF (r=0.125; P=0.102). Sperm concentration, progressive motility, and normal morphology had a weak negative correlation with SDF. Around 63% and 69% of patients with normal morphology and normal motility respectively had high SDF. In the HDF category, nearly 42% had normal morphology, whereas a 66% demonstrated normal motility. The results of Kruskal-Wallis test for patients who had a treatment outcome (conception) showed that patients in LDF group had 1.5 times higher chance of "conception and live birth." Conclusion: Men with normal semen parameters can still have a high level of SDF. SDF along with semen analysis can help assess the reproductive potential of a male better. [ABSTRACT FROM AUTHOR]

Infertility is diagnosed clinically in heterosexual couples who cannot achieve pregnancy after a year of having intercourse without using birth control. Statistically, every sixth couple in Croatia is infertile and 50% of infertility cases are male-originated.

Purpose: What is the trend in sperm parameters in a group of men attending a single reproductive center, over a 10-year period? Methods: A retrospective study was conducted on 12,188 semen samples obtained from unique individuals who attended a university reproductive clinic from 2009 to 2018, inclusively. Semen analysis was done using computer-assisted sperm analysis and verified by an andrologist. Analysis was done after dividing the dataset into two groups: above WHO 2010 lower reference limits (ARL) (N = 6325) and below the reference limits (BRL) (N = 5521). Results: Volume increased slightly (ARL, p = 0.049) before returning to baseline or was stable (BRL, p = 0.59). Sperm concentration and total count of the BRL and ARL group declined initially and then recovered slightly (p < 0.0001, in all cases). Although these changes were statistically significant, this was due to the large study population; clinically, these changes were quite mild and would not have been significant for fertility. Sperm total motility and progressive motility of both the BRL group and the ARL group increased slightly from 2009 until 2015 and then decreased back to baseline (p < 0.0001). This change offset the decrease in count seen in those years. A spurious change was observed with sperm morphology that declined after the first 2 years and remained stable thereafter (p < 0.0001, in both groups). However, this change was attributed to a contemporaneous change in the method of analyzing strict morphology which happened when the change occurred. Conclusion: While statistically significant changes were found, clinically, these changes were quite mild and would not have been significant for fertility. [ABSTRACT FROM AUTHOR]

Objective: To demonstrate the distribution and impact of fellowship-trained andrology and/or sexual medicine urological specialists (FTAUS) on resident in-service examination (ISE) performance.Methods: Residency program websites were accessed to create a database of FTAUS in the United States between 2007 and 2017. This database was reviewed by three separate FTAUS and cross referenced with membership lists to the Sexual Medicine of North America Society and the Society for the Study of Male Reproduction. De-identified ISE scores were obtained from the American Urological Association from 2007-2017 and scores from trainees at programs with a FTAUS were identified for comparison. Resident performance was analyzed using a linear model of the effect of a resident being at a program with an FTAUS, adjusting for post-graduate year.Results: ISE data from 13,757 residents were obtained for the years 2007-2017. The number of FTAUS in the United States increased from 40-102 during this study period. Mean raw scores on the "Sexual Dysfunction, Endocrinopathy, Fertility Problems" (SDEFP) section of the ISE ranged from 52.1% ± 17.7% to 65.7% ± 16% (mean ± SD). Throughout the study period, there was no difference in performance within the SDEFP section (P < .01). Residents at a program with a FTAUS answered 0.95% more questions correctly in the SDEFP than those without a FTAUS (P < .001). For these residents, there was an improvement of approximately 0.66% on the percentage of questions answered correctly on the ISE overall (P < .001). Performance improved significantly as residents progressed from PGY-2-PGY-5.Conclusion: There is a small but statistically significant improvement in overall ISE and SDEFP sub-section performance. [ABSTRACT FROM AUTHOR]

Purpose: Andrology research has evolved notoriously in the latest years, particularly since male factor contribution to couple infertility has been undoubtedly demonstrated. However, sperm function investigations results are sometimes contradictory, probably as a result of the use of different sperm processing techniques. In this work, we underwent a systematic functional comparison of human sperm samples simultaneously processed by swim-up and density gradient centrifugation, which are the preferred sperm processing methods used in basic and clinical laboratories. Materials and Methods: To compare functional characteristics of sperm isolated by swim-up and density gradient centrifugation followed by incubation at different times under capacitating conditions. Results: Semen samples processed in parallel by these two procedures resulted in sperm preparations with significant differences in redox state, spontaneous intracellular calcium oscillations, hyperactivation, protein tyrosine phosphorylation, and acrosome reaction responsivity to calcium ionophore. Such differences showed time-dependent specific patterns for spontaneous intracellular calcium oscillations, hyperactivation and protein tyrosine phosphorylation. Sperm retrieved by density gradient centrifugation showed more hyperactivation and tyrosine phosphorylation than swim-up sperm, suggesting a higher degree of capacitation. Conclusions: Our results account for functional differences observed in spermatozoa processed with these two methods and therefore may contribute to a better interpretation of outcomes obtained in different laboratories as well as to improve experimental designs aimed to study sperm physiology and fertility potential. [ABSTRACT FROM AUTHOR]

The statement "middle deficiency causes seminal changes" is an analogy of the statement "urine and stool change due to middle deficiency" from Neijing. The "middle deficiency" is mainly the deficiency of spleen and stomach, and the "seminal changes" included the changes of sperm and seminal plasma. The statement is made to describe the relation between male semen diseases and spleen and stomach, and strategies of treating semen diseases from spleen. Firstly, the connection between the spleen and stomach meridian sinew and the reprodutive organs is the basis for the male semen to be under the effects of the spleen and stomach, including the spleen and stomach transforming blood, essence and blood mutual transformation, and sufficient blood with essence for fertility; Spleen and stomach transform qi, control the passage, storage and discharge of semen. The spleen and stomach regulate qi movement and ensure the smooth discharge of the semen without blockage. The spleen and stomach transport water, moisten the semen chamber, adjust the Yin and Yang of the semen chamber to ensure the proper production, storage and discharge. Secondly, the causes of spleen and stomach deficiency in the middle energizer are complicated, including irregular diet, emotional disorder, congenital deficiency, medication and surgical injury, stress, prolonged illness and dampness, etc., which can induce deficiency and cause semen diseases. Thirdly, deficiency, including abnormal sperm count and vitality, abnormal semen volume, color and quality, and abnormal semen excretion can cover all aspects of semen diseases. Finally, treatment principles are summarized including tonifying the deficient spleen and kidney, eliminating pathogens and protecting spleen, differentiation of severity and identification of key pathogenesis, and general tonification for indiscernible pattern with balanced prescription. Animal laboratory experiments and clinical studies are used to validate the statement and show that the theory of "middle deficiency causes seminal changes" can be applied as reference to clinical practice. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the potentiality of biomodels to be produced as alternative tools to slaughterhouse materials in andrology education. For this purpose, testis biomodels were produced with reference to bull testes. The biomodel production was carried out by the following steps: the preparation of the reference organs, 3D modelling, and processing of data sets and stages. The biomodels and reference testes were compared in terms of morphological parameters and tonicity. As a result of quantitative measurements, the average length in the reference testicles was 145.56 ± 21.3 mm, while the thickness was 61.94 ± 17.2 mm. The average length, thickness, volume and tonicity values of the biomodels showed similarity to the values of the reference testicles (p >.05). However, it was recorded that the average weight of the reference testicles was determined as 368.07 ± 40.3 g, while the average weight of the biomodels was 69.02 ± 3.18 g (p <.01). As a result, it has been shown that testis biomodels can be successfully produced using three‐dimensional technologies. These biomodels are the first examples in the field. We think that the biomodels produced by using innovative technologies should be considered as serious alternatives, which could contribute to the learning processes of students, especially in andrology education. [ABSTRACT FROM AUTHOR]

Purpose: In response to the COVID-19 pandemic, the American Center for Reproductive Medicine (ACRM) transitioned its annual training in assisted reproductive technology (ART) from a hands-on, laboratory-based training course to a fully online training endorsed by the American College of Embryology. Here we describe our experience and assess the quality of an online training format based on participant outcomes for the first three modules of a planned series of online ART training. Materials and Methods: These modules included manual semen analysis, sperm morphology and ancillary semen tests (testing for leukocytospermia, sperm vitality, and anti-sperm antibody screening). The virtual format consisted of lecture presentations featuring laboratory protocols with corresponding video demonstrations of routine techniques and best practices. Practical scenarios, troubleshooting, and clinical interpretation of laboratory results were also discussed. At the end of each module, an optional multiple choice question test was held as a prerequisite to obtain certification on the topics presented. Course quality was assessed using participant responses collected via online surveys. Results: The digital delivery methods used were found to have largely or completely met the participants’ expectations for all questions (>85%). The majority (>87%) of the participants either strongly agreed or agreed that the course content was well-structured with appropriate depth, and that their overall expectations of the course had been met. Conclusions: This training format appears to be a realistic teaching option to freely share highly specialized expertise and technical knowledge with participants from anywhere in the world with varying levels of competency or experience. [ABSTRACT FROM AUTHOR]