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4. Quality of Life and Sexual Function Benefits of Long-Term Testosterone Treatment: Longitudinal Results From the Registry of Hypogonadism in Men (RHYME)

Author

Maggi, M., Behre, H.M., Meuleman, E., Dohle, G., Arver, S., Wu, F., Porst, H., Jones, T.H., Quinton, R., Lenzi, A., Bouloux, P.-M., Morales, A.M., Hackett, G., Stroberg, P., Maggio, M., Cruz, N., Balercia, G., Yassin, A., Reisman, C., Bassas, L., Pescatori, E., Salamanca, J.I. Martinez, Otero, J. Romero, Jockenhoevel, F., Debruyne, F., Rosen, Raymond C., Wu, Frederick, Behre, Hermann M., Porst, Hartmut, Meuleman, Eric J.H., Maggi, Mario, Romero-Otero, Javier, Martinez-Salamanca, Juan I., Jones, Thomas Hugh, Debruyne, Frans M.J., Kurth, Karl-Heinz, Hackett, Geoff I., Quinton, Richard, Stroberg, Peter, Reisman, Yacov, Pescatori, Edoardo S., Morales, Antonio, Bassas, Lluis, Cruz, Natalio, Cunningham, Glenn R., and Wheaton, Olivia A.

Published
2017
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5. Controversy and Consensus on Indications for Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations

Author

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

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

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

Published
2023

7. Klinefelter syndrome (KS): genetics, clinical phenotype and hypogonadism

Author

Bonomi, M., Rochira, V., Pasquali, D., Balercia, G., Jannini, E. A., Ferlin, A., Balercia, Giancarlo, Bonomi, Marco, Calogero, Aldo, Corona, Giovanni, Fabbri, Andrea, Ferlin, Alberto, Francavilla, Felice, Giagulli, Vito, Lanfranco, Fabio, Maggi, Mario, Pasquali, Daniela, Pivonello, Rosario, Pizzocaro, Alessandro, Pivonello, Rosario, Radicioni, Antonio, Rochira, Vincenzo, Accardo, Linda, Cangiano, Biagio, Condorelli, Rosita A., Cordeschi, Giuliana, D’Andrea, Settimio, Mambro, Antonella Di, Esposito, Daniela, Foresta, Carlo, Francavilla, Sandro, Galdiero, Mariano, Garolla, Andrea, Giovannini, Lara, Balercia, Antonio R. M., La Vignera, Sandro, Motta, Giovanna, Luciano, Luciano, Pelliccione, Fiore, Persani, Luca, Santi, Daniele, Selice, Riccardo, Simoni, Manuela, Tatone, Carla, Tirabassi, Giacomo, Tresoldi, Alberto Stefano, Vicari, Enzo, and On behalf of the Klinefelter ItaliaN Group (KING)

Published
2017
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8. Testosterone treatment is not associated with increased risk of prostate cancer or worsening of lower urinary tract symptoms: prostate health outcomes in the Registry of Hypogonadism in Men

Author

Debruyne, Frans M.J., Behre, Hermann M., Roehrborn, Claus G., Maggi, Mario, Wu, Frederick C.W., Schröder, Fritz H., Jones, Thomas Hugh, Porst, Hartmut, Hackett, Geoffrey, Wheaton, Olivia A., Martin-Morales, Antonio, Meuleman, Eric, Cunningham, Glenn R., Divan, Hozefa A., Rosen, Raymond C., Dohle, G., Arver, S., Lenzi, A., Stroberg, P., Maggio, M., Cruz, N., Balercia, G., Yassin, A., Reisman, C., Bassa, L., Pescatori, E., Salamanca, Martinez J.I., Otero, Romero J., and Jockenhoevel, F.

Published
2017
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9. Vitamin D and thyroid disease: to D or not to D?

Author

Muscogiuri, G., Tirabassi, G., Bizzaro, G., Orio, F., Paschou, S.A., Vryonidou, A., Balercia, G., Shoenfeld, Y., and Colao, A.

Subjects
Vitamin D deficiency -- Development and progression, Thyroid diseases -- Risk factors, Food/cooking/nutrition, Health
Abstract

The main role of vitamin D is to maintain calcium and phosphorus homeostasis, thus preserving bone health. Recent evidence has demonstrated that vitamin D may also have a role in a variety of nonskeletal disorders such as endocrine diseases and in particular type 1 diabetes, type 2 diabetes, adrenal diseases and polycystic ovary syndrome. Low levels of vitamin D have also been associated with thyroid disease, such as Hashimoto's thyroiditis. Similarly, patients with new-onset Graves' disease were found to have decreased 25-hydroxyvitamin D concentrations. Impaired vitamin D signaling has been reported to encourage thyroid tumorigenesis. This review will focus on the role of vitamin D in thyroid diseases, both autoimmune diseases and thyroid cancer, and will summarize the results of vitamin D supplementation studies performed in patients with thyroid disorders. Although observational studies support a beneficial role of vitamin D in the management of thyroid disease, randomized controlled trials are required to provide insight into the efficacy and safety of vitamin D as a therapeutic tool for this dysfunction. European Journal of Clinical Nutrition (2015) 69, 291-296; doi: 10.1038/ejcn.2014.265; published online 17 December 2014, INTRODUCTION The most important role of vitamin D is to maintain calcium and phosphorus homeostasis and to preserve bone health. (1) However, animal and human studies have demonstrated that vitamin [...]

Published
2015
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15. Neuropsychiatric Aspects in Men with Klinefelter Syndrome

Author

Giagulli, Va, Campone, B, Castellana, M, Salzano, C, Fisher, Ad, de Angelis, C, Pivonello, R, Colao, A, Pasquali, D, Maggi, M, Triggiani, V, Balercia, G, Bonomi, M, Calogero, Ae, Corona, G, Giorgino, F, Fabbri, A, Ferlin, A, Ferrante, E, Francavilla, F, Jannini, E, Lanfranco, F, Pizzocaro, A, Radicioni, A, Rochira, V, Vignozzi, L, Giagulli, Vito Angelo, Capone, Beatrice, Castellana, Marco, Salzano, Ciro, Fisher, Alessandra, de Angelis, Cristina, Pivonello, Rosario, Colao, Annamaria, Pasquali, Daniela, Maggi, Mario, and Triggiani, Vincenzo

Subjects
Male, Klinefelter Syndrome, Hypergonadotropic hypogonadism, testosterone, autism, schizophrenia, attention deficit, hyperactivity disorder, depression, anxiety, Psychosis, Pediatrics, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Hypergonadotropic hypogonadism, autism, Comorbidity, Article, 03 medical and health sciences, Klinefelter Syndrome, 0302 clinical medicine, medicine, Humans, Immunology and Allergy, Attention deficit hyperactivity disorder, 030219 obstetrics & reproductive medicine, business.industry, Hypogonadism, Mental Disorders, Brain, medicine.disease, schizophrenia, Phenotype, Schizophrenia, testosterone, depression, attention deficit, hyperactivity disorder, Autism, Anxiety, Klinefelter syndrome, medicine.symptom, business, Neurocognitive, 030217 neurology & neurosurgery
Abstract

Background and objective: Klinefelter Syndrome (KS) is the most common sex chromosome aneuploidy (47, XXY) and cause of male hypergonadotropic hypogonadism. It is characterized by an extreme clinical heterogeneity in presentation, including infertility, hypogonadism, language delay, metabolic comorbidities, and neurocognitive and psychiatric disorders. Since testosterone is known to have organizational, neurotrophic and neuroprotective effects on brain, the condition of primary hypogonadism could play a role. Moreover, given that KS subjects have an additional X, genes on the extra-chromosome could also exert a significant impact. The aim of this narrative review is to analyze the available literature on the relationship between KS and neuropsychiatric disorders.Methods:To extend to the best of published literature on the topic, appropriate keywords and MeSH terms were identified and searched in Pubmed. Finally, references of original articles and reviews were examined.Results:Both morphological and functional studies focusing on the brain showed that there were important differences in brain structure of KS subjects. Different psychiatric disorders such as Schizophrenia, autism, attention deficit hyperactivity disorder, depression and anxiety were frequently reported in KS patients according to a broad spectrum of phenotypes. T supplementation (TRT) was not able to improve the psychotic disorders in KS men with or without overt hypogonadism.Conclusion:Although the risk of psychosis, depression and autism is increased in subjects with KS, no definitive evidence has been found in studies aiming at identifying the relationship between aneuploidy, T deficit and the risk of psychiatric and cognitive disorders in subjects affected by KS.

Published
2019

28. Thyroid function in Klinefelter syndrome: a multicentre study from KING group

Author

Balercia, G., Bonomi, M., Giagulli, V. A., Lanfranco, F., Rochira, V., Giambersio, A., Accardo, G., Esposito, D., Allasia, S., Cangiano, B., De Vincentis, S., Condorelli, R. A., Calogero, A., Pasquali, D., Aversa, A., Corona, G., Giorgino, F., Fabbri, A., Ferlin, A., Ferrante, E., Francavilla, F., Giagulli, V., Jannini, E., Maggi, M., Pivonello, R., Pizzocaro, Anna, Radicioni, A., Vignozzi, L., Barchi, M., Cordeschi, G., D'Andrea, S., Mambro, A. D., Foresta, C., Francavilla, S., Garolla, A., Giovannini, L., Granata, A. R. M., La Vignera, S., Motta, G., Negri, L., Pelliccione, F., Persani, L., Salzano, C., Santi, D., Selice, R., Simoni, M., Tatone, C., Tirabassi, G., Tresoldi, A. S., Vicari, E., Balercia, G., Bonomi, M., Giagulli, V. A., Lanfranco, F., Rochira, V., Giambersio, A., Accardo, G., Esposito, D., Allasia, S., Cangiano, B., De Vincentis, S., Condorelli, R. A., Calogero, A., Pasquali, D., Aversa, A., Corona, G., Giorgino, F., Fabbri, A., Ferlin, A., Ferrante, E., Francavilla, F., Giagulli, V., Jannini, E., Maggi, M., Pivonello, R., Pizzocaro, A., Radicioni, A., Vignozzi, L., Barchi, M., Cordeschi, G., D'Andrea, S., Mambro, A. D., Foresta, C., Francavilla, S., Garolla, A., Giovannini, L., Granata, A. R. M., La Vignera, S., Motta, G., Negri, L., Pelliccione, F., Persani, L., Salzano, C., Santi, D., Selice, R., Simoni, M., Tatone, C., Tirabassi, G., Tresoldi, A. S., and Vicari, E.

Subjects
Adult, Male, endocrine system, Pediatrics, medicine.medical_specialty, Hashimoto’s thyroiditi, Adolescent, endocrine system diseases, Kallmann syndrome, Thyroid hormones, Endocrinology, Diabetes and Metabolism, Thyroid Gland, Hypergonadotropic hypogonadism, Thyrotropin, 030209 endocrinology & metabolism, Hashimoto Disease, Thyroid Function Tests, Thyroiditis, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Hypogonadotropic hypogonadism, medicine, Humans, Testosterone, Klinefelter syndrome, Aged, Academic Medical Centers, business.industry, Hypogonadism, Thyroid, Hashimoto’s thyroiditis, Middle Aged, Thyroid disease, medicine.disease, Thyroid diseases, medicine.anatomical_structure, Italy, Case-Control Studies, 030220 oncology & carcinogenesis, Concomitant, Female, Thyroid function, business
Abstract

Purpose: The prevalence and the etiopathogenesis of thyroid dysfunctions in Klinefelter syndrome (KS) are still unclear. The primary aim of this study was to evaluate the pathogenetic role of hypogonadism in the thyroid disorders described in KS, with the scope to distinguish between patients with KS and hypogonadism due to other causes (Kallmann syndrome, idiopathic hypogonadotropic hypogonadism, iatrogenic hypogonadism and acquired hypogonadotropic hypogonadism after surgical removal of pituitary adenomas) called non-KS. Therefore, we evaluated thyroid function in KS and in non-KS hypogonadal patients. Methods: This is a case–control multicentre study from KING group: Endocrinology clinics in university-affiliated medical centres. One hundred and seventy four KS, and sixty-two non-KS hypogonadal men were enrolled. The primary outcome was the prevalence of thyroid diseases in KS and in non-KS. Changes in hormonal parameters were evaluated. Exclusion criterion was secondary hypothyroidism. Analyses were performed using Student’s t test. Mann–Whitney test and Chi-square test. Results: FT4 was significantly lower in KS vs non-KS. KS and non-KS presented similar TSH and testosterone levels. Hashimoto’s thyroiditis (HT) was diagnosed in 7% of KS. Five KS developed hypothyroidism. The ratio FT3/FT4 was similar in both groups. TSH index was 1.9 in KS and 2.3 in non-KS. Adjustment for differences in age, sample size and concomitant disease in multivariate models did not alter the results. Conclusions: We demonstrated in KS no etiopathogenic link to hypogonadism or change in the set point of thyrotrophic control in the altered FT4 production. The prevalence of HT in KS was similar to normal male population, showing absence of increased risk of HT associated with the XXY karyotype.

Published
2019

30. Use and effects of follicle-stimulating hormone (FSH) for idiopathic male infertility in Italy: results from a multicentre, observational, cohort, prospective, real world, clinical practice survey

Author

Santi, D, De Vincentis, S, Alfano, P, Balercia, G, Calogero, Ae, Cargnelutti, F, Coccia, Me, Condorelli, ROSITA ANGELA, Dal Lago, A, De Angelis, C, Gallo, M, Iannantuoni, N, Lombardo, F, Marino, A, Mazzella, M, Pallotti, F, Paoli, D, Pivonello, R, Rago, R, Rampini, M, Salvio, G, and Simoni, M

Subjects
open registry, FSH, follicle-stimulating hormone, FSH, male idiopathic infertility, open registry, male idiopathic infertility, follicle-stimulating hormone
Published
2020

34. The European Academy of Andrology (EAA) ultrasound study on healthy, fertile men: Scrotal ultrasound reference ranges and associations with clinical, seminal, and biochemical characteristics

Author

Lotti, F, primary, Frizza, F, additional, Balercia, G, additional, Barbonetti, A, additional, Behre, HM, additional, Calogero, AE, additional, Cremers, JF, additional, Francavilla, F, additional, Isidori, AM, additional, Kliesch, S, additional, La Vignera, S, additional, Lenzi, A, additional, Marcou, M, additional, Pilatz, A, additional, Poolamets, O, additional, Punab, M, additional, Peraza Godoy, MF, additional, Rajmil, O, additional, Salvio, G, additional, Shaeer, O, additional, Weidner, W, additional, Maseroli, E, additional, Cipriani, S, additional, Baldi, E, additional, Degl’Innocenti, S, additional, Danza, G, additional, Caldini, AL, additional, Terreni, A, additional, Boni, L, additional, Krausz, C, additional, and Maggi, M, additional

Published
2021
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42. Phenotypic variation within European carriers of the Y-chromosomal gr/gr deletion is independentof Y-chromosomal background

Author

Krausz, C., Giachini, C., Xue, Y., O'Bryan, M.K., Gromoll, J., Rajpert-de Meyts, E., Oliva, R., Aknin-Seifer, I., Erdei, E., Jorgensen, N., Simoni, M., Ballesca, J.L., Levy, R., Balercia, G., Piomboni, P., Nieschlag, E., Forti, G., McLachlan, R., and Tyler-Smith, C.

Subjects
Chromosome deletion -- Demographic aspects, Chromosome deletion -- Research, Genetic variation -- Demographic aspects, Genetic variation -- Research, Y chromosome -- Abnormalities, Health
Published
2009

43. Characteristics, geographical distribution and age at diagnosis of patients with Klinefelter Syndrome in Italy: a cohort study from the Klinefelter Italian Group (KING)

Author

Pasquali, D., Garolla, A., Accardo, G., Chiodini, P., Simeon, V., Ferlin, A., Maggi, M., Vignozzi, L., Corona, G., Lanfranco, F., Rochira, V., Calogero, A., Giagulli, V., Bonomi, M., Pivonello, R., Balercia, G., Pizzocaro, A., Salacone, P., and Aversa, A.

Subjects
Klinefelter, Klinefelter, diagnosis, cohort study, diagnosis, cohort study
Published
2019

44. Diagnostic and therapeutic workup of erectile dysfunction: results from a delphi consensus of andrology experts

Author

Isidori, A. M., Giammusso, B., Corona, G., Verze, P., Albanesi, L., Antomarchi, F., Arcaniolo, D., Balercia, G., Barbonetti, A., Barletta, D., Barrese, F., Bellastella, G., Biggio, A., Bitelli, M., Botturi, A., Brancato, T., Branchina, A., Cai, T., Canale, D., Capone, L., Capone, M., Carluccini, A., Citarrella, R., Cocci, A., Corvese, F., Cozza, P. P., Creta, M., D'Andrea, S., Dalena, G., Damiano, R., Defeudis, G., Del Grasso, A., Delbarba, A., Delle Rose, A., Di Crosta, G., Filippo, Di, Di Lena, S., Di Martino, M., Di Millo, F., Di Palma, P., Diazzi, D., Dicuio, M., Diosi, D., Fabbri, A., Fattorini, G., Florio, M., Formiconi, A., Franco, G., Galdiero, M., Giambersio, A. M., Gianfrilli, D., Giovannone, R., Granata, A. M., Iafrate, M., Iapicca, G., Iatrino, G., Ilacqua, N., Innocenti, F., Italiano, E., Izzo, A., Izzo, P., Lamartina, M., Ledda, A. F., Lepri, L., C. F., Lo, Lombardo, F., Luca, G., Macchione, L., Maga, T., Matteo, M., Malvestiti, G. M., Marella, G., Maretti, C., Maturo, G., Mazzaferro, D., Mazzilli, R., Migliorini, F., Milardi, D., Minardi, V., Moiso, A., Mondaini, N., Moretti, M., Motta, G., Nerva, F., Pastore, A. L., Paulis, G., Piazza, N., Pili, M., Pistone, A., Pivonello, R., Pizzocaro, A., Polverini, M., Provinzano, V., Rastrelli, G., Risi, O., Rocchegiani, A., Rolle, L., Romanelli, F., Romano, G., Russo, G. I., Salemi, G., Salzano, C., Sanna, F., Sansone, A., Santi, D., Scalese, G. A., Scarano, P., Scroppo, F. I., Serrao, M. F., Sidoti, G., Silvestre, G., Simone, O., Sorrentino, M., Tallis, V., Tammaro, R., Ughi, G., Vagnoni, V., Vavallo, A., Vecchio, D., Vita, A., Zicarelli, P., and Zucchi, A.

Subjects
Consensus, erectile dysfunction, Urology, Endocrinology, Diabetes and Metabolism, media_common.quotation_subject, education, 030232 urology & nephrology, lcsh:Medicine, Dermatology, Delphi, Consensus method, Likert scale, Andrology, 03 medical and health sciences, Behavioral Neuroscience, 0302 clinical medicine, Endocrinology, Erectile Dysfunction, PDE5 Inhibitors, Treatment, Voting, medicine, PDE5 inhibitors, computer.programming_language, media_common, 030219 obstetrics & reproductive medicine, treatment, business.industry, lcsh:R, lcsh:Other systems of medicine, medicine.disease, lcsh:RZ201-999, consensus, delphi, Phosphodiesterase Type 5 Inhibitors, Clinical Practice, Psychiatry and Mental health, Erectile dysfunction, Hot topics, Reproductive Medicine, business, computer
Abstract

Introduction Erectile dysfunction is a highly prevalent condition. Existing guidelines provide recommendations for diagnosis and treatment, but they are often disregarded in clinical practice in favor of a “patient-tailored” approach. Objectives We planned a Delphi consensus method to bridge the gap between evidence-based medicine and the real-life approach in daily practice. Materials and Methods The Advisory Board prepared 15 statements on debated topics in andrology, each including 4–6 items designed as a 5-point Likert scale. After a validation phase, the questionnaire was sent by e-mail to a panel of experts for a first round of voting; members of the panel were later invited to a second round of voting, preceded by discussion of the “hot topics” identified in the first round. Results The first round of the Delphi consensus involved 101 experts; 71 (70%) also took part in the second round of voting. The Advisory Board deemed 22 items to be worthy of debate, and these underwent the second round of voting. “Real-life” results from the survey proved quite different from evidence-based recommendations. Conclusion Although guidelines suggest the best approach for a “standard” patient, real-life settings require flexibility. Diagnostic and therapeutic approaches should be tailored to the patients’ needs. Phosphodiesterase type 5 inhibitors are recognized as the first-line therapy in both settings, including the newly introduced sildenafil orodispersible film. Indications from the panel might help close the gap between recommendations from guidelines and real-life practice in relation to the diagnosis and treatment of erectile dysfunction.

Published
2019

48. The impotent couple: low desire

Author

CORONA, G., PETRONE, L., MANNUCCI, E., RICCA, V., BALERCIA, G., GIOMMI, R., FORTI, G., and MAGGI, M.

Published
2005

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

Author

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

Abstract

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

Published
2019

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