Semen expulsion under the ureterocystoscope / 中华男科学杂志

<p><b>OBJECTIVE</b>To determine the exact location of the opening of the ejaculatory duct in men and provide some basic anatomical evidence for seminal vesiculoscopy and the treatment of ejaculatory duct obstruction.</p><p><b>METHODS</b>We performed ureterocystoscopy for 21 male patients aged 26 - 47 years with hematuria (n = 12), hematospermia (n = 2), glandular cystitis (n = 6), and anejaculation after radical resection of rectal carcinoma (n = 1), and meanwhile, with the consent of the patients, massaged the prostate and ejaculatory duct and observed the outlet of the expelled fluid. Under the microscope, we described the fluid samples with sperm as the expulsion from the ejaculatory duct.</p><p><b>RESULTS</b>Ureterocystoscopy showed that the exact anatomical sites of the expulsion of prostatic fluid and semen in the patients were the side and lower side of the prostatic utricle opening above the verumontanum and the ventral side of the verumontanum. Quantities of sperm were found in the expulsion fluid of 13 of the patients, and no expulsion, including semen, was seen from the prostatic utricle opening.</p><p><b>CONCLUSION</b>Anatomically, the ejaculatory duct openings of males are located at the two sides of the verumontanum adjacent to the opening of the prostatic utricle, rather than in the prostatic utricle above the verumontanum.</p>

Outcomes of IVF-ET and percentage of morphologically normal sperm before and after swim-up treatment / 中华男科学杂志

<p><b>OBJECTIVE</b>To study the relationship between sperm morphology and the outcomes of in vitro fertilization-embryo transfer (IVF-ET) before and after swim-up treatment of sperm on the day of oocyte retrieval.</p><p><b>METHODS</b>This study included 94 couples to be treated by IVF-ET for tubal factor infertility. Sperm samples were collected on the day of oocyte retrieval and sperm morphology evaluated according to the Kruger criteria before and after swim-up treatment. Based on the results of morphological evaluation, the sperm samples were divided into groups A1 (morphologically normal sperm > or = 10% after swim-up treatment), A2 (morphologically normal sperm < 10% after swim-up treatment), B1 (morphologically normal sperm > or = 10% before swim-up treatment) and B2 (morphologically normal sperm < 10% before swim-up treatment). The outcomes of IVF-ET treatment were compared between groups A1 and A2 as well as between B1 and B2.</p><p><b>RESULTS</b>After swim-up treatment, the rates of fertilization, cleavage, good quality embryo, clinical pregnancy and embryo implantation of group A1 were (72.72 +/- 3.35)%, (95.64 +/- 2.04)%, (24.39 +/- 4.57)%, 50.00% and 23.87%, respectively, while those of group A2 were (70.27 +/- 8.82)%, (94.82 +/- 4.94)%, (13.45 +/- 7.39)%, 9.52% and 6.25%, respectively, the latter three indexes remarkably higher in A1 than in A2 (P < 0.05), but the differences in the former two not statistically significant (P > 0.05). Before swim-up treatment, the above five indexes were (72.90 +/- 4.23)%, (95.20 +/- 2.61)%, (23.35 +/- 5.19)%, 39.58% and 18.35% in group B1, as compared with (71.33 +/- 5.10)%, (95.71 +/- 2.88)%, (20.18 +/- 6.15)%, 41.86% and 21.28% in group B2, with no statistically significant differences between the two groups (P > 0.05).</p><p><b>CONCLUSION</b>The percentage of morphologically normal sperm after swim-up treatment on the day of oocyte retrieval may be a valuable predictor of the outcomes of IVF-ET.</p>

Alternate-day oral tadalafil for erectile dysfunction with no successful intercourse at the baseline / 中华男科学杂志

<p><b>OBJECTIVE</b>To summarize the experience in the treatment of erectile dysfunction (ED) with no successful intercourse at the baseline with tadalafil.</p><p><b>METHODS</b>We retrospectively analyzed 21 cases of ED with no successful intercourse at the baseline treated with tadalafil on alternate days combined with sex guidance.</p><p><b>RESULTS</b>After 4 weeks of tadalafil treatment, 19 of the patients achieved successful sexual intercourse, and the IIEF-5 score was remarkably improved as compared with pre-medication (3.24 +/- 1.55 vs 18.95 +/- 3.02, P<0.0001). Mild adverse reactions were observed in 6 cases, including 2 cases of mild headache and 4 cases of facial blush.</p><p><b>CONCLUSION</b>Tadalafil on alternate days combined with sex guidance can significantly improve ED with no successful intercourse at the baseline.</p>