Factors influencing the postoperative resolution of varicocele-associated scrotal pain / 中华男科学杂志

Objective@#To investigate the factors influencing the postoperative resolution of varicocele-associated scrotal pain.@*METHODS@#Using the keywords "varicocele", "testicular pain", "scrotal pain", "painful varicocele", "ligation", and "varicocelectomy", we searched the PubMed, Embase, Cochrane Collaboration's Database, CNKI, Wanfang, and VIP Database up to October 2016 for the studies relating to surgical treatment of varicocele-associated scrotal pain. We assessed the quality of the cohort studies included using the Newcastle-Ottawa Scale and that of the randomized controlled trials included with the Cochrane Collaboration's tool. We conducted a meta-analysis using the RevMan software.@*RESULTS@#Finally 14 studies were included in this meta-analysis, of which, 2 involved the history of disease, 8 involved the nature of pain, 2 involved the intensity of pain, 9 involved the grade of varicocele, 3 involved the side of varicocele, 9 involved surgical approaches, 3 involved surgical techniques, and 4 involved postoperative recurrence. The pain resolution rate was significantly higher after subinguinal ligation than after high or inguinal ligation (RR = 0.82, 95% CI: 0.76－0.89, P <0.01; RR = 0.92, 95% CI: 0.86－0.99, P = 0.02), and so was it after microsurgery than after laparoscopic varicocelectomy (RR = 0.77, 95% CI: 0.60－0.99, P = 0.04).@*CONCLUSIONS@#Subinguinal varicocelectomy and microsurgery are more effective options than laparoscopic and high or trans-inguinal ligation of the spermatic vein for resolution of varicocele-associated scrotal pain, while the history of disease, the nature and intensity of pain, the grade and side of varicocele, or postoperative recurrence cannot be regarded as the influencing factors.

Correlation between metabolic syndrome and nocturnal penile tumescence test results / 中华泌尿外科杂志

Objective To investigate the correlation between nocturnal penile tumescence (NPT) test results and metabolic syndrome (MS).Methods In this prospective study,75 cases were enrolled,including 25 healthy volunteers (group A),25 erectile dysfunction (ED) patients with normal NPT results (group B),and 25 ED patients with abnormal NPT results (group C).At the time of recruitment,all the participants had serum total testosterone higher than 9.9 nmol/L,and were free of MS.At baseline,there was no significant differences in waistline,body mass index,fasting plasma glucose (FPG),mean arterial pressure (MAP),triglyceride,high density lipoprotein (HDL),cholesterol,and serum total testosterone among the three groups (P＞0.05).And there was no significant difference in international index of erectile function 5 score between group B and C.A follow-up survey was conducted three years after baseline to measure the above metabolic indicators and to compare the incidence of MS among the three groups.Results In the three-year follow-up survey,2 participants in group A were lost to follow-up,compared to 3 participants in group B and 5 participants in group C.In the three-year follow-up survey,there was no significant difference in all the indicators between group A and B; between group A and C,significant differences were observed in MAP,FPG,HDL,and cholesterol (P＜0.05); between group B and C,significant differences were observed in MAP and HDL (P＜0.05).In the three-year follow-up survey,2 participants in group A developed MS,compared to 3 MS patients in group B and 7 MS patients in group C.There was a significant difference in the incidence of MS among the three groups (P＜0.05).Conclusions To some extent,NPT reflects and predicts the development and progress of MS.Therefore,NPT can be used as an early indicator of MS.

Nocturnal penile tumescence and the effect of tadalafil on erectile dysfunction / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the correlation between the results of the nocturnal penile tumescence (NPT) test and the efficacy of tadalafil in the treatment of ED.</p><p><b>METHODS</b>A total of 188 ED patients were divided into a normal NPT group (n = 136) and an abnormal NPT group (n = 52) according to the results of the NPT test. All of them were treated with tadalafil at 20 mg 3 times a week. The IIEF-5 score, SEP2, SEP3 and GAQ score were compared between the two groups before and 1 month after the treatment.</p><p><b>RESULTS</b>Tadalafil treatment significantly improved IIEF-5 score, SEP2 and SEP3 of both groups of the patients (P < 0.01). Compared with the abnormal NPT group, the normal NPT group showed a remarkable increase in the IIEF-5 score, SEP2, SEP3 (P < 0.05) and GAQ score (P < 0.01).</p><p><b>CONCLUSION</b>After 1 month of tadalafil treatment, the normal NPT group achieved a more significant improvement of erectile function and sexual satisfaction than the abnormal NPT group, suggesting that tadalafil has a better therapeutic effect for ED patients with normal NPT.</p>