DOCSLIB.ORG

The Effects of Repeated Ejaculations on the Quality of Sperms Following Spinal Cord Injury

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Effects of Repeated Ejaculations on the Quality of Sperms Following Spinal Cord Injury THE EFFECTS OF REPEATED EJACULATIONS ON THE QUALITY OF SPERMS FOLLOWING SPINAL CORD INJURY Rizwan Hamid MBBS FRCS Ed, FRCS (Urol) London Spinal Injuries Unit Royal National Orthopaedic Hospital, Stanmore & Institute of Urology, University College London A Thesis for submission to the University College London for the Degree of MD (Res) 2013 AUTHOR’S STATEMENT I, Rizwan Hamid, confirm that the work presented in this thesis is my own. Where information has been derived from other sources, I confirm this has been indicated in the thesis. This work was performed at Spinal Research Centre at the London Spinal Injuries Unit, Royal National Orthopaedic Hospital, Stanmore by me under the supervision of Professor Michael Craggs, Professor of Applied Physiology, University College London. This project was part funded by ASPIRE (Spinal Cord Injury Charity). However the opinions in this thesis are those of the author. I confirm that this thesis has not been submitted elsewhere. 2 ABSTRACT Ejaculatory dysfunction after spinal cord injury (SCI) is common with more than 90% of SCI men unable to produce an ejaculate. If the ejaculate is obtained by vibro or electro ejaculation the motility, morphology and forward progression are all subnormal. The exact cause of deterioration of sperms is not known although a number of factors can lead to poor quality semen. A randomized control trial was designed to evaluate if repeated ejaculation with a Ferticare® vibrator can improve the sperm quality in chronic SCI men. All had a spinal cord lesion above thoracic level 10 with a minimum duration of 6 months. The subjects who vibro- ejaculated (VE) with a Ferticare® vibrator were randomised into the study or control arms. In the study arm VE was applied weekly for 3 months. In the control arm VE was given only once at the beginning and end of 3 months. The semen analysis was performed by two observers according to World Health Organization (WHO) criteria. A paired Student t test was used for statistical analysis. Forty two of 79 subjects (53%) vibro-ejaculated successfully. Thirty four were randomized into study (n=18) and control (n=16) arms. No serious adverse events were encountered. Only morphology and forward progression on WHO criteria demonstrated significant improvement. There was no statistical improvement in either volume, count or motility. It is concluded that repeated ejaculation can improve some parameters of sperm in the semen of SCI men. Hence, patients with a SCI above the level of T10 can improve their sperm quality by applying VE weekly for at least 3 months. It is hoped that larger scale multi-centre studies will be undertaken to confirm the effectiveness of repeated ejaculations. 3 ACKNOWLEDGEMENTS There are a number of people who helped me tremendously in this project. First and foremost I would like to thank Professor Mike Craggs. He envisaged the project and offered support and constructive critique at all stages of this work. Without his help this project would not have been completed. I would like to thank Mr Shah for giving me an opportunity to work in the Neuro-urology department and offering guidance all through my training in urology. His help in my career progression is greatly appreciated. This project would not have run smoothly without the dedication and support of Helen Bywater. I would like to thank her for patiently helping me set up, run and assist in completing this project. I would especially like to thank Sarah Knight for providing the most valuable input throughout my work, particularly in finalising the thesis. She always had time for my most basic enquiries and offered sincere help and support at the most crucial times. I want to thank ASPIRE, spinal cord injury charity for the financial support. Thanks to my parents who are my inspiration. I am grateful for their blessings and unconditional love for which there is no substitute and which I know will always continue. I dedicate this thesis to them. To my sons, Saad, Humza and Saiff, who motivate me and are the joy in my life. And finally to someone who has made this and all I do possible, my dearest wife, Sumur. I love you. 4 LIST OF CONTENTS Page Title page 1 Author’s statement 2 Abstract 3 Acknowledgements 4 List of contents 5 List of Abbreviations 12 List of Figures 13 List of Tables 19 List of Appendices 20 1 - INTRODUCTION 21 1.1 Spinal Cord Injury – Introduction 22 1.2 Normal sperm production and ejaculatory function 26 1.2.1 Normal sperm production 26 1.2.2 Neuro-anatomy of ejaculatory function 27 1.2.3 Autonomic nervous system 29 1.2.4 Somatic nervous system 31 1.2.5 Neuro-physiology of ejaculation 31 1.3 Characteristics of normal ejaculate 32 1.3.1 Semen analysis 32 1.3.2 Prostatic and seminal fluid 33 1.4 Patho-physiology of Ejaculatory failure in SCI men 33 1.4.1 Neuro-anatomy 33 1.4.2 Neuro-physiology 34 5 1.5 Literature Review 35 1.5.1 Characteristics of ejaculate after SCI 35 1.5.2 Ejaculatory dysfunction in SCI men 36 1.5.3 Medications for ejaculatory dysfunction in SCI men 37 1.5.4 Invasive techniques for sperm retrieval in SCI men 37 1.5.4.1 Direct aspiration from vas deferens 38 1.5.4.2 Electroejaculation for ejaculatory failure 38 1.5.4.3 Vibroejaculation for ejaculatory failure 41 1.5.4.4 Prostatic massage for ejaculatory failure 44 1.5.5 Distinctive semen profile in SCI men 45 1.5.5.1 Semen characteristics during acute phase following SCI 45 1.5.5.2 Semen characteristics during chronic phase following SCI 46 1.5.5.3 Role of seminal fluid in poor quality semen following SCI men 53 1.5.6 SCI men achieving successful fatherhood 56 1.5.6.1 Home insemination programme with intravaginal insemination 56 1.5.6.2 Home insemination programme with intrauterine programme 57 6 1.5.6.3 Assisted techniques for conception 57 1.5.7 Techniques to improve semen quality in SCI men 58 1.5.8 Deficiencies in the literature 59 1.6 Aim of the study 60 1.6.1 Null hypothesis 61 1.7 Summary 61 2 - MATERIALS AND METHODS 63 2.1 Overview of the project setting 64 2.2 Regulatory requirements 64 2.3 Study design 65 2.4 Subject selection 65 2.5 Subjects 66 2.6 Material & equipment 68 2.6.1 Microscope 68 2.6.2 Mini-therm stage warmer 70 2.6.3 Microscope slides and cover slips 72 2.6.4 Pipettes 72 2.6.5 pH strips 75 2.6.6 Plastic bottles 75 2.6.7 Haemocytometer 75 2.6.8 Solutions for assessment of morphology 77 2.6.9 Ferticare® personal vibrator 77 7 2.7 Performance of vibratory stimulus 79 2.7.1 Pre-procedure preparation 79 2.7.2 Demonstration of the Ferticare® personal vibrator 80 2.7.3 Use of Ferticare® vibrator to obtain semen sample 81 2.7.4 Collection of semen samples 84 2.7.5 Safe handling of semen samples 84 2.7.6 Loan of Ferticare® personal vibrator 84 2.8 Semen analysis 85 2.8.1 Macroscopic Examination 85 2.8.1.1 Liquefaction 85 2.8.1.2 Appearance 86 2.8.1.3 Volume 86 2.8.1.4 Viscosity 86 2.8.1.5 pH 87 2.8.2 Microscopic Examination 87 2.8.2.1 Preparation of sample for analysis of motility and forward progression 87 2.8.2.2 Assessment of sperm motility 88 2.8.2.3 Assessment of forward progression 91 2.8.2.4 Assessment of sperm count 91 2.8.2.5 Assessment of sperm morphology 98 2.9 Statistical analysis 101 8 3 - RESULTS 103 3.1 Overall account of subjects 104 3.2 Comparison between responders and non-responders 105 3.3 Predictors for successful ejaculations 105 3.4 Summary of total subjects attending for screening 109 3.5 Demographics of subjects entering the project 110 3.6 Analysis of subjects dropped from the project 114 3.7 Results of the experiment in study and control arms 115 3.7.1 Volume 115 3.7.2 pH 118 3.7.3 Motility 121 3.7.4 Forward Progression 124 3.7.5 Morphology 127 3.7.6 Count 130 3.7.7 Liquefaction 133 3.8 Detailed analysis of semen parameters in the study arm at monthly intervals 135 3.8.1 Volume 135 3.8.2 pH 137 3.8.3 Motility 139 3.8.4 Forward progression 141 3.8.5 Morphology 143 9 3.8.6 Count 145 3.9 Statistical comparison between the study and control arms 147 3.10 Statistical comparison of results within study and control arms 149 3.11 Dropouts due to non-compliance with protocol 151 3.12 Adverse events 151 4 - DISCUSSION 152 4.1 Summary of Results 153 4.2 Comparison of results with significant improvement 155 4.3 Comparison of results with no significant improvement 159 4.4 Predictors of success with vibro-ejaculations 161 4.5 Role of seminal fluids in poor semen quality following SCI 162 4.6 Methodological weaknesses 164 4.6.1 Uncontrollable variables 164 4.6.1.1 Enrolment of subjects 164 4.6.1.2 Effect of medications on sperm quality 165 4.6.1.3 Impact of urine infections on results 165 4.6.1.4 Weekly vibro-ejaculations at home 166 4.6.1.5 Monthly visit for study arm subjects 167 4.6.1.6 Dropout of subjects 167 4.6.2 Preparation and analysis of semen samples 167 4.6.3 Bliniding of the observers to evaluation 168 4.6.4 Success with vibro-ejaculation 169 10 4.7 Future Implication 170 4.7.1 The importance of finding statistical changes 170 4.7.2 Significance of unchanged parameters 171 4.7.3 Role of seminal plasma in poor quality semen in SCI men 171 4.7.4 The role of repeated ejaculations in improving sperm quality within home settings-yet defined 172 4.7.5 Cost implications 172 4.7.6 Need for large multicentre randomised control trial 173 4.8 Conclusions 174 4.9 Future research 175 Appendices 176 5 - REFERENCES 188 11 LIST OF ABBREVIATIONS BCR bulbo-cavernous reflex C cervical EEJ electro-ejaculation FDA federal drug administration FSH follicle stimulating hormone HR hip reflex ICSI Intracytoplasmic sperm insemination IVF in vitro fertilization
Load more

Recommended publications
  • 1997 Asa Program.Pdf
    Friday, February 21 12:00 NOON- 11:00 PM Executive Council Meeting (lunch and supper served) (Chesapeake Room NB) Saturday, February 22 8:00-9:40 AM Postgraduate Course (Constellation 3:00-5:00 PM Postgraduate Course (Constellation Ballroom A) Ballroom A) 9:40-1 0:00 AM Refreshment Break 6:00-7:00 PM Student Mixer (Maryland Suites-Balti­ 10:00-12:00 NOON Postgraduate Course (Constellation more Room) Ballroom A) 7:00-9:00 PM ASA Welcoming Reception (Atrium 12:00-1 :00 PM Lunch (on your own) Lobby) 7:00-9:00 PM Exhibits Open (Constellation Ball­ I :00-2:40 PM Postgraduate Course (Constellation Ballroom A) rooms E, F) 2:40-3:00 PM Refreshment Break 9:00- 1 I :00 PM Executive Council Meeting (Chesa­ peake Room NB) Sunday, February 23 7:45-8:00 AM Welcome and Opening Remarks 12:00-1 :30 PM Women in Andrology Luncheon (Ches­ (Constellation Ballroom A) apeake Room NB) 8:00-9:00 AM Serono Lecture: "Genetics of Prostate Business Meeting 12:00-12:30 Cancer" Patrick Walsh (Constellation Speaker and Lunch 12:30-1:30 Ballroom A) I :30-3:00 PM Symposium I: "Regulation of Testicu­ 9:00-10:00 AM American Urological Association Lec­ lar Growth and Function" (Constellation ture: "New Medical Treatments of Im­ Ballroom A) potence" Irwin Goldstein (Constella­ Patricia Morris tion Ballroom A) Martin Matzuk 10:00-10:30 AM Refreshment Break/Exhibits 3:00-3:30 PM Refreshment Break/Exhibits (Constellation Ballrooms E, F) (Constellation Ballrooms E, F) 10:30-12:00 NOON Oral Session I: "Genes and Male Repro­ 3:30-4:30 PM Oral Session II: "Calcium Channels duction" (Constellation Ballroom A) and Male Reproduction" (Constellation Ballroom A) 12:00- 1 :30 PM Lune (on your own) � 4:30-6:30 PM Poster Session I (Constellation Ball­ �4·< rooms C, D) \v\wr 7:30-11:00 PM Banquet (National Aquarium) Monday, February 24 7:00-8:00 AM Past Presidents' Breakfast 12:00-1 :30 PM Simultaneous Events: (Pratt/Calvert Rooms) I.
    [Show full text]
  • Guidelines on Paediatric Urology S
    Guidelines on Paediatric Urology S. Tekgül (Chair), H.S. Dogan, E. Erdem (Guidelines Associate), P. Hoebeke, R. Ko˘cvara, J.M. Nijman (Vice-chair), C. Radmayr, M.S. Silay (Guidelines Associate), R. Stein, S. Undre (Guidelines Associate) European Society for Paediatric Urology © European Association of Urology 2015 TABLE OF CONTENTS PAGE 1. INTRODUCTION 7 1.1 Aim 7 1.2 Publication history 7 2. METHODS 8 3. THE GUIDELINE 8 3A PHIMOSIS 8 3A.1 Epidemiology, aetiology and pathophysiology 8 3A.2 Classification systems 8 3A.3 Diagnostic evaluation 8 3A.4 Disease management 8 3A.5 Follow-up 9 3A.6 Conclusions and recommendations on phimosis 9 3B CRYPTORCHIDISM 9 3B.1 Epidemiology, aetiology and pathophysiology 9 3B.2 Classification systems 9 3B.3 Diagnostic evaluation 10 3B.4 Disease management 10 3B.4.1 Medical therapy 10 3B.4.2 Surgery 10 3B.5 Follow-up 11 3B.6 Recommendations for cryptorchidism 11 3C HYDROCELE 12 3C.1 Epidemiology, aetiology and pathophysiology 12 3C.2 Diagnostic evaluation 12 3C.3 Disease management 12 3C.4 Recommendations for the management of hydrocele 12 3D ACUTE SCROTUM IN CHILDREN 13 3D.1 Epidemiology, aetiology and pathophysiology 13 3D.2 Diagnostic evaluation 13 3D.3 Disease management 14 3D.3.1 Epididymitis 14 3D.3.2 Testicular torsion 14 3D.3.3 Surgical treatment 14 3D.4 Follow-up 14 3D.4.1 Fertility 14 3D.4.2 Subfertility 14 3D.4.3 Androgen levels 15 3D.4.4 Testicular cancer 15 3D.5 Recommendations for the treatment of acute scrotum in children 15 3E HYPOSPADIAS 15 3E.1 Epidemiology, aetiology and pathophysiology
    [Show full text]
  • Prostatitis Explained Prostatitis
    Prostate information Prostatitis Explained Prostatitis Prostatitis (prost-a-ty-tus) is the most common prostate problem for men under 50, but it can affect men of all ages. In fact, almost 1 out of 2 men between 18 and 50 may have at least one bout of prostatitis in their lifetime. Prostatitis is often described as an infection of the prostate but it can also mean that the prostate is inflammed or irritated. If you have prostatitis, you may have a burning feeling when passing urine, pass urine more often, be in a lot of pain, have a fever and chills and feel very tired. Once your doctor has diagnosed your symptoms as prostatitis, then the outlook tends to be good. There are many treatments available and your doctor will work with you to find the treatment(s) most suitable for you depending on the type of prostatitis you have. So, it may take slightly longer for some men to see an improvement in their symptoms. However, even when you feel your symptoms are starting to improve you should still continue with your treatment or medication. It may be reassuring to know that prostatitis is neither connected with cancer nor does it mean there is an increased risk of developing prostate cancer in the future, but it can cause worrying symptoms. Table of contents Page Types of prostatitis 3 Acute bacterial prostatitis 5 Chronic bacterial prostatitis 8 Chronic pelvic pain syndrome 9 Treatment for CBP and CPPS 13 Coping with pain 14 Tips to relieve prostatitis 16 Prostatitis There are different types of prostatitis.
    [Show full text]
  • Vasectomy Reversal (VR)
    Vasectomy Reversal (VR) ! Need to know Please read this before your Vasectomy Reversal Preparing for the VR • Do not eat or drink after midnight if your operation is in the morning and not after 7.00am if it is in the afternoon. • Please shave the hair at the front and sides of the scrotum from the base of the penis down. You do not need to shave the pubic hair • Take supportive underpants (not your best) or a jockstrap into the hospital with you and to theatre to wear after the operation. • Arrange a week off work. • Avoid intercourse for two weeks after the operation and heavy lifting for four weeks. REF 0000.0 – 12/15 What to expect during the VR • An infection of the scrotum rarely occurs but if it does, • An incision is placed on each side of the scrotum that will present a few days after the surgery and is apparent are a little larger than those used for the vasectomy. because the pain becomes worse rather than better and the scrotum becomes red. • The vas is a very small muscular tube with a 2mm outer diameter and an inner diameter through which If you experience any of the above complications or sperm flow (the lumen), of less than 1/2mm. Since the have any other problem occur after your VR, please structure is so small, the stitches must be placed very call the Clinic or your Surgeon if outside clinic exactly so that there is minimal scarring. Too much hours. scarring can cause the lumen of the vas to close and the procedure to fail.
    [Show full text]
  • Seminal Vesicles in Autosomal Dominant Polycystic Kidney Disease
    Chapter 18 Seminal Vesicles in Autosomal Dominant Polycystic Kidney Disease Jin Ah Kim1, Jon D. Blumenfeld2,3, Martin R. Prince1 1Department of Radiology, Weill Cornell Medical College & New York Presbyterian Hospital, New York, USA; 2The Rogosin Institute, New York, USA; 3Department of Medicine, Weill Cornell Medical College, New York, USA Author for Correspondence: Jin Ah Kim MD, Department of Radiology, Weill Cornell Medical College & New York Presbyterian Hospital, New York, USA. Email: [email protected] Doi: http://dx.doi.org/10.15586/codon.pkd.2015.ch18 Copyright: The Authors. Licence: This open access article is licenced under Creative Commons Attribution 4.0 International (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/ Users are allowed to share (copy and redistribute the material in any medium or format) and adapt (remix, transform, and build upon the material for any purpose, even commercially), as long as the author and the publisher are explicitly identified and properly acknowledged as the original source. Abstract Extra-renal manifestations of autosomal dominant polycystic kidney disease (ADPKD) have been known to involve male reproductive organs, including cysts in testis, epididymis, seminal vesicles, and prostate. The reported prevalence of seminal vesicle cysts in patients with ADPKD varies widely, from 6% by computed tomography (CT) to 21%–60% by transrectal ultrasonography. However, seminal vesicles in ADPKD that are dilated, with a diameter greater than 10 mm by magnetic resonance imaging (MRI), are In: Polycystic Kidney Disease. Xiaogang Li (Editor) ISBN: 978-0-9944381-0-2; Doi: http://dx.doi.org/10.15586/codon.pkd.2015 Codon Publications, Brisbane, Australia.
    [Show full text]
  • The Fine Art of Prostate Massage
    The Fine Art of Prostate Massage Part I: What exactly are we dealing with here? Or, Anatomy, 101 • What is the prostate gland? Very simply, it is the part of the male body that store and secretes an essential part of semen. More specifically, the prostate gland produces an alkaline fluid that makes up about 30% of the semen. The alkalinity, interestingly, helps offset female vaginal acidity. • Where is the prostate gland? The prostate is located in lower abdominal area, roughly between the bladder and the rectal wall (which makes it easy to feel and to play with). Notice that one part of the prostate (shown in green) runs along the wall near the rectal area. This is the part that we are interested in. The prostate is slightly larger than a walnut, which can make both exams and play a bit challenging. Anatomy is highly variable, which means we have to be patient. • Do biological females have a prostate gland? Not in the same way that a biological male does. There is a small gland, also called the Skene’s Gland or the paraurethural gland. While it is homologous to the male prostate, it serves a slightly different purpose. An authoritative medical group officially called the female prostate such in 2002, and it is thus “officially” known as a prostate. It does play an active role during the female orgasm. The female prostate is located in approximately the same place as the male prostate. The anatomy here, though, is also highly variable. It may play a significant part in female “ejaculation”.
    [Show full text]
  • Semen Parameters of Cancer Patients at Diagnosis
    FERTILITY AND STERILITY௡ VOL. 82, NO. 2, AUGUST 2004 Copyright ©2004 American Society for Reproductive Medicine Published by Elsevier Inc. Printed on acid-free paper in U.S.A. Normal semen parameters in cancer patients presenting for cryopreservation before gonadotoxic therapy Similar sperm qualities in men with and without cancer were found. Patient and physician awareness and early referral for sperm banking are essential in preserving fertility potential in men with malignancies. (Fertil Steril௡ 2004;82:505–6. ©2004 by American Society for Reproductive Medicine.) Prior investigators have reported that more than half of the men of reproductive age with malignancies, such as testicular cancer and lymphoma, have impaired semen quality (1, 2). Chemotherapy or radiotherapy can further damage spermatogenesis, with lasting effects of up to 5 years (3). With increased awareness of the need for sperm banking, men have been presenting for cryopreservation soon after diagnosis. However, physicians might fail to offer cryopreservation to men with cancer, assuming that the semen quality is too impaired and that the fertility potential will further be decreased by the process of cryopreservation (4). With sophisticated assisted reproductive techniques, pregnancies and deliveries have been reported with cryopre- served spermatozoa from cancer patients, without increased risk of congenital anomalies (5, 6). In addition, with excellent cure rates for testicular cancer and increased survival in many urologic and nonurologic malignancies, most cancer survivors want to have children. We present a comparative analysis of sperm quality and postthaw survival in men with and without malignancies. The statistical database of all men seeking sperm cryopreservation at a single licensed and accredited sperm bank was reviewed from 1997 to 2001.
    [Show full text]
  • 2002 Asa Program.Pdf
    schedule at a lance Wednesday, April 24, 2002 • Genetics and Biology of Adult Male Germ Cell 8:00 am Andrology Laboratory Workshop Tumors The Andrology Laboratory of the Future: Raju S.K. Chaganti, Memoria l Sloan-Kettering Impact of the Genomic and Proteomic • Modeling Human Disease Through Transgenesis Revolutions (concludes at 5:00 pm) Sarah Comerford, UTSWMS & HHI • How to Find Cellular Proteins that Sense the 5:30 pm Welcome and Opening Remarks Environment Da vid Garbers, HHM/ 5:45 pm Distinguished Andrologist Award 6:00 pm Serano Lecture 12:00 pm Laboratory Science Lunch • Of Genes and Genomes 1:30 pm Symposium Ill: Do Gene Defects Impact Da vid Botstein, Stanford University Male Reproduction: If So, How? •The Battle of the Sexes: Sry and the Control of Testis 7:15 pm Welcome Reception Organogenesis Blanche Capel, Duke Univ. Med. Ctr. Thursday, April 25, 2002 • Natural Potent Androgens: Lessons from Human Genetic Models 8:00 am Solvay/Unimed Lecture J. /mperato-McGinley, Cornell University •Androgen Therapy in the Older Man-Where • Genetic Defects in Male Reproduction Are We Now and Where Are We Going? Stephanie Seminara, Harvard University Lisa Te nover, Emory University 3:00 pm Refreshment Break and Exhibits 8:55 am Distinguished Service Award 3:15 pm Plenary Lecture 9:05 am Biopore Lecture • The Ins & Outs of PSMA, the Evolving and • Global Analysis of Germline Gene Expression Intriguing Tale of its Prostate Biology & Tumor Sam Wa rd, University of Arizona Targeting WO. Heston, Cleveland Clinic 10:00 am Coffee Break and Exhibits 4:05 pm Schering Lecture 10:30 am Concurrent Oral Sessions I, II, Ill • Bioethics and Stem Cell Research • Basic and Clinical Aspects of Male Sexual Laurie Zoloff, San Fra ncisco State Univ.
    [Show full text]
  • Aspermia: a Review of Etiology and Treatment Donghua Xie1,2, Boris Klopukh1,2, Guy M Nehrenz1 and Edward Gheiler1,2*
    ISSN: 2469-5742 Xie et al. Int Arch Urol Complic 2017, 3:023 DOI: 10.23937/2469-5742/1510023 Volume 3 | Issue 1 International Archives of Open Access Urology and Complications REVIEW ARTICLE Aspermia: A Review of Etiology and Treatment Donghua Xie1,2, Boris Klopukh1,2, Guy M Nehrenz1 and Edward Gheiler1,2* 1Nova Southeastern University, Fort Lauderdale, USA 2Urological Research Network, Hialeah, USA *Corresponding author: Edward Gheiler, MD, FACS, Urological Research Network, 2140 W. 68th Street, 200 Hialeah, FL 33016, Tel: 305-822-7227, Fax: 305-827-6333, USA, E-mail: [email protected] and obstructive aspermia. Hormonal levels may be Abstract impaired in case of spermatogenesis alteration, which is Aspermia is the complete lack of semen with ejaculation, not necessary for some cases of aspermia. In a study of which is associated with infertility. Many different causes were reported such as infection, congenital disorder, medication, 126 males with aspermia who underwent genitography retrograde ejaculation, iatrogenic aspemia, and so on. The and biopsy of the testes, a correlation was revealed main treatments based on these etiologies include anti-in- between the blood follitropine content and the degree fection, discontinuing medication, artificial inseminization, in- of spermatogenesis inhibition in testicular aspermia. tracytoplasmic sperm injection (ICSI), in vitro fertilization, and reconstructive surgery. Some outcomes were promising even Testosterone excreted in the urine and circulating in though the case number was limited in most studies. For men blood plasma is reduced by more than three times in whose infertility is linked to genetic conditions, it is very difficult cases of testicular aspermia, while the plasma estradiol to predict the potential effects on their offspring.
    [Show full text]
  • Andrological Sciences Official Journal of the Italian Society of Andrology
    Vol. 17 • No. 2 • June 2010 Journal of ANDROLOGICAL SCIENCES Official Journal of the Italian Society of Andrology Cited in Past Editors Editorial Board Fabrizio Menchini Fabris (Pisa) Antonio Aversa (Roma) SCOPUS Elsevier Database 1994-2004 Ciro Basile Fasolo (Pisa) Carlo Bettocchi (Bari) Edoardo Pescatori (Modena) Guglielmo Bonanni (Padova) Paolo Turchi (Pisa) Massimo Capone (Gorizia) 2005-2008 Tommasi Cai (Firenze) Luca Carmignani (Milano) Antonio Casarico (Genova) Editors-in-Chief Carlo Ceruti (Torino) Vincenzo Ficarra (Padova) Fulvio Colombo (Milano) Andrea Salonia (Milano) Luigi Cormio (Foggia) Federico Dehò (Milano) Giorgio Franco (Roma) Editor Assistant Andrea Galosi (Ancona) Ferdinando Fusco (Napoli) Giulio Garaffa (London) Andrea Garolla (Padova) Paolo Gontero (Torino) Managing Editor Vincenzo Gulino (Roma) Vincenzo Gentile (Roma) Massimo Iafrate (Padova) Copyright Sandro La Vignera (Catamia) SIAS S.r.l. • via Luigi Bellotti Bon, 10 Francesco Lanzafame (Catania) 00197 Roma Delegate of Executive Committee Giovanni Liguori (Trieste) of SIA Mario Mancini (Milano) Editorial Office Giuseppe La Pera (Roma) Alessandro Mofferdin (Modena) Lucia Castelli (Editorial Assistant) Nicola Mondaini (Firenze) Tel. 050 3130224 • Fax 050 3130300 Giacomo Novara (Padova) [email protected] Section Editor – Psychology Enzo Palminteri (Arezzo) Pacini Editore S.p.A. • Via A. Gherardesca 1 Annamaria Abbona (Torino) Furio Pirozzi Farina (Sassari) 56121 Ospedaletto (Pisa), Italy Giorgio Pomara (Pisa) Marco Rossato (Padova) Publisher Statistical Consultant Paolo Rossi (Pisa) Pacini Editore S.p.A. Elena Ricci (Milano) Antonino Saccà (Milano) Via A. Gherardesca 1, Gianfranco Savoca (Palermo) 56121 Ospedaletto (Pisa), Italy Omidreza Sedigh (Torino) Tel. 050 313011 • Fax 050 3130300 Marcello Soli (Bologna) [email protected] Paolo Verze (Napoli) www.pacinimedicina.it Alessandro Zucchi (Perugia) www.andrologiaitaliana.it INDEX Journal of Andrological Sciences EDITORIAL PCA3 a promising urine biomarker for prostate cancer diagnosis V.
    [Show full text]
  • Specific Antigen Level and Serum Fasting Glucose, Total Cholesterol
    Original Article DO I: 10.4274/uob.999 Bulletin of Urooncology 2018;17:59-62 Assessment of the Relationship Between Serum Prostate- Specific Antigen Level and Serum Fasting Glucose, Total Cholesterol and Neutrophil-Lymphocyte Ratio in Men Aged 50-70 Years with Prostate-Specific Antigen Level 0-10 ng/mL without Prostate Cancer Diagnosis Bora İrer MD İzmir Metropolitan Municipality Eşrefpaşa Hospital, Clinic of Urology, İzmir, Turkey Abstract Objective: To evaluate the relationship between serum prostate-specific antigen (PSA) level and total cholesterol, fasting blood glucose, and neutrophil- lymphocyte ratio (NLR) in men without prostate cancer. Materials and Methods: Between 2010 and 2017, 2631 male participants aged 50-70 years with a serum PSA level of 0-10 ng/mL were included from a population of 4643 healthy males who participated in a health screening program conducted by the İzmir Metropolitan Municipality Eşrefpaşa Hospital in the district villages of İzmir. Participants’ serum PSA, fasting blood glucose, total cholesterol levels, and NLR were retrospectively assessed. Participants were grouped as those with high and low serum PSA levels, high and low glucose levels, and high and low cholesterol levels. Differences between the groups in terms of serum PSA levels, serum total cholesterol, glucose, and NLR were analyzed. Results: The mean age of the participants was 60.2±5.4 years and the mean serum PSA level was 1.28±1.20 ng/mL. The mean PSA value was higher in the high cholesterol group (1.36±1.33 vs 1.19±1.02, p<0.001) compared to the low cholesterol group, and the mean PSA value in the high glucose group was lower than in the low glucose group (1.08±0.86 vs 1.32±1.25, p<0.001).
    [Show full text]
  • Microsurgical Vasectomy Reversal: Results and Predictors of Success
    9REVUE Andrologie 2005, 15, N~ 167-171 Microsurgical vasectomy reversal : results and predictors of success Gert R. DOHLE, Marij SMIT Andrology unit, Department of Urology, Erasmus University Medical Centre, Rotterdam, The Netherlands ABSTRACT successfully. The results of vasectomy reversal procedu- res can be improved substantially if the surgeon is able to perform a vaso-epididymostomy in cases of a secondary Microsurgical vasectomy reversal is a challenge for the epididymal obstruction, occurring in about 25% of men physician but successful treatment depends on the expe- with an interval of more than 10 years. rience and skills of the surgeon. Fertility can often be res- tored, thus avoiding the need for artificial reproductive techniques. Also, the surgical procedures can be combi- Key words : male infertility, microsurgery, vasectomy rever- ned with sperm aspiration and cryopreservation, to be sal, vasoepididymostemy used for Intracytoplasmic sperm injection (ICSI) in cases of surgical failure. We describe the results of 217 vasova- sostomy procedures, with special emphasis on recent technical refinements and prognostic indicators. I. INTRODUCTION Between 1998 and 2002 we performed 217 vasovasosto- my-procedures in an outpatient clinic setting. Microsurgery in urology is mainly applied in obstructive Refertilisation was successful in 76.5%, spontaneous pre- male infertility and varicocele repair. Other indications are gnancy occurred in 42% of the couples after a follow-up vascular erectile dysfunction and penile or testicular vas- of at least 1 year. The main prognostic factors determi- cular trauma. Obstructions of the male genital tract repre- ning the outcome of the surgery was the interval between sent 5-10% of the causes of male infertility and in 70-80% vasectomy and refertilisation and the age of the female of these men surgical repair can be performed [11].
    [Show full text]