Semen Analysis in Cancer Patients Referred for Sperm Cryopreservation before Chemotherapy over a 15-Year Period in Korea

PURPOSE: This study evaluated the demographics and semen parameters of males with cancer who banked their sperm prior to chemotherapy. MATERIALS AND METHODS: This is a retrospective study of 66 cases referred for sperm banking prior to initiation of chemotherapy over a 15-year period (1999~2014). Patients who had previously received cancer treatment including chemotherapy or radiotherapy were not included in this study. RESULTS: We studied a total of 66 cancer patients referred for cryopreservation of sperm prior to chemotherapy. The mean age of the patients at the time of banking was 32.0+/-7.9 years (range, 19~58 years). The types of cancer were testicular cancer (31 cases, 47.0%), non-Hodgkin's disease (10 cases, 15.1%), Hodgkin's disease (5 cases, 7.6%), leukemia (8 cases, 12.1%), gastrointestinal malignancy (5 cases, 7.6%), and musculoskeletal malignancy (5 cases, 7.6%). There were significant differences in sperm concentration and viability among the various types of cancer, but no significant difference in semen volume or sperm motility and morphology. CONCLUSIONS: In this study we found that sperm quality could decrease even before chemotherapy. Because chemotherapy can also negatively affect spermatogenesis, sperm cryopreservation prior to treatment should be strongly recommended for cancer patients of reproductive age.

The Attitudes of Infertile Male Patients Toward the Use of Artificial Insemination by Donor: A Korean Regional Survey

PURPOSE: Infertile couples interested in nonspouse artificial insemination by donor (AID) not only require a thorough understanding of the medical procedure but also must scrutinize the effects it will have on family relationships, including those on the infant to be born. We conducted a series of surveys in couples with male infertility to collect information necessary for AID counseling. MATERIALS AND METHODS: A total of 384 cases with noncurable male infertility were enrolled in this inquiry survey. The questionnaire consisted of 18 items that assessed demographic characteristics, background information concerning the choice to use AID, subjective experiences, long-term effects, and an overall evaluation. RESULTS: A total of 126 surveys were returned (32.8%). AID was first suggested by the husband in about half of the cases. The major reason for considering the procedure was to form a complete family. Two-thirds of the couples were anxious about the procedure, most often about possible congenital or acquired deformities in the infant. After the birth of the child, most couples were positive about their decision to have used AID. About half of the couples felt that the child was their own and expected not to tell the child about AID. Overall, about 50% of the couples were satisfied with the procedure. CONCLUSIONS: Those who underwent AID experienced various psychological effects, including anxiety about the child to be born. To overcome these problems, sufficient medical information and consultation about the process of selecting the donor and about AID procedures should be provided before the procedure is used.

Perirenal Lymphangiomatosis

Lymphangioma is a rare, benign mesenchymal neoplasm, which is characterized by numerous intercommunicating cystic spaces containing lymphatic fluid. It is considered a congenital disease resulting from the obstruction of regional lymph drainage during the developmental period. Lymphangioma may be focal/unilateral or diffuse/bilateral, and in the latter case, it is referred to as lymphangiomatosis. Here, we report a case of a 38-year-old man with perirenal lymphangiomatosis. The patient's chief complaint was left flank pain, and left pleural effusion was found on radiological examination. After radical nephrectomy, the pathological examinations revealed that the kidney was enclosed by a multicystic mass with intrarenal cystic dilatations. We report the case and discuss the management of perirenal lymphangiomatosis with a literature review.

Perirenal Lymphangiomatosis

Lymphangioma is a rare, benign mesenchymal neoplasm, which is characterized by numerous intercommunicating cystic spaces containing lymphatic fluid. It is considered a congenital disease resulting from the obstruction of regional lymph drainage during the developmental period. Lymphangioma may be focal/unilateral or diffuse/bilateral, and in the latter case, it is referred to as lymphangiomatosis. Here, we report a case of a 38-year-old man with perirenal lymphangiomatosis. The patient's chief complaint was left flank pain, and left pleural effusion was found on radiological examination. After radical nephrectomy, the pathological examinations revealed that the kidney was enclosed by a multicystic mass with intrarenal cystic dilatations. We report the case and discuss the management of perirenal lymphangiomatosis with a literature review.

Is Self-Report of Erectile Dysfunction Associated with Severity, Cardiovascular Disease Risk Factors, and Depression?

PURPOSE: The aim of this study was to evaluate whether cardiovascular disease risk factors and depression are associated with the frequency of self-report in patients with erectile dysfunction (ED). MATERIALS AND METHODS: Randomly selected men more then 40 years of age who visited the department of urology between January 2005 and July 2008 were evaluated by clinical examination and questionnaires. Trained doctors assessed the participants by using structured questionnaires that included medical history as well as report of ED. All participants were evaluated for cardiovascular disease risk factors. The group with unreported ED was defined as men with an International Index of Erectile Function-5 (IIEF-5) score of < or =21 who did not self-report ED. The group with self-reported ED was defined as men as above who self-reported ED. Symptoms of depression were assessed by the Center for Epidemiological Studies-Depression Scale (CES-D). RESULTS: The mean age of a total of 459 enrolled patients was 53.4+/-7.8 years. The overall frequency of ED was 39.8%. Of the total study group, 25.9% were categorized in the unreported ED group and 13.9% in the self-reported ED group. The men with self-reported ED had significantly severe forms of ED and a higher frequency of cardiovascular disease risk factors than did the men with unreported ED. Moreover, the self-reported ED group had a significantly higher frequency of symptoms of depression. CONCLUSIONS: Our results suggest that men with self-reported ED had a higher frequency of cardiovascular disease risk factors and symptoms associated with depression than did men with unreported ED. Furthermore, men with self-reported ED had more severe ED than did men with unreported ED.