Psychological burden prediction based on demographic variables among infertile men with sexual dysfunction / 亚洲男科学杂志(英文版)

There has been increasing interest in the psycho-socio-relational and sexual disorders of infertility, as the risk of psychological burden among infertile men with sexual dysfunctions is significant. The purpose of this study was to develop and to validate a predictive model to estimate individual psychological burden among infertile men with sexual dysfunction and study the association between them. Comprehensive data were collected for infertile men (n = 480) who sought treatment for infertility in a reproductive medicine center between June 2012 and December 2013. Using independent predictors of psychological burden from the least absolute shrinkage and selection operator, univariable and multivariable analyses were developed into two models. Predictive accuracy was compared between the models. We explored the association between sexual dysfunction and psychological burden. A total of 480 patients were analyzed using 10-fold cross-validation. Independent predictors of psychological burden were incorporated into a model to measure anxiety (corrected-area under curve (AUC): 77.3%) and a model to measure depression (corrected-AUC: 70.2%). Anxiety and depression were both associated with erectile dysfunction (P < 0.05), with anxiety demonstrating the strongest association. Only anxiety was associated with premature ejaculation (P < 0.05). Premature ejaculation was not found to be associated with depression (P > 0.05). Predictive models for psychological burden among infertile men with sexual dysfunction are presented, and we found that there is an association between psychological burden and sexual dysfunction. According to the models, proper counseling and treatment of sexual dysfunction in infertile men may reduce the psychological burden, help attain natural pregnancy, and improve the quality of life.

Expression of the NMDA receptor in the rat model of orchialgia / 中华男科学杂志

Objective@#To explore the expression of the N-methyl-D-aspartate (NMDA) receptor in the rat model of orchialgia and its possible mechanisms.@*METHODS@#According to Yoshioka's method, the male rats in the control group were injected with 0.2 ml saline, and those in the experimental group with 0.2 ml 2% acetic acid solution. Then we tested the behavioral responses of the rats and determined the expressions of the subunits NR1 and NR2B of the NMDA receptor in the dorsal root ganglion and spinal dorsal horn by Western blot, RT-qPCR and immunofluorescence staining.@*RESULTS@#The withdrawal latency was decreased in the model rats, reaching the lowest value at 4 hours after modeling, significantly lower than in the controls (［4.15 ± 0.84］ vs ［12.32 ± 1.05］, P 0.05).@*CONCLUSIONS@#The NMDA receptor plays an important role in pathogenesis of orchialgia in rats. In the early stage of pain, upregulating the expression of the subunit NR2B of the NMDA receptor can mediate peripheral hyperalgesia and consequently orchialgia.

A novel experience of deferential vessel-sparing microsurgical vasoepididymostomy / 亚洲男科学杂志(英文版)

Microsurgical longitudinal intussusception vasoepididymostomy (LIVE) has been widely used to treat epididymal obstructive azoospermia since 2004. Although the deferential vasculature plays an important role in supplying blood to the testis and epididymis, little attention has been paid to the potential benefits of sparing the deferential vessels during the anastomosis in LIVE. This study aimed to evaluate the efficacy and safety of deferential vessel-sparing LIVE in humans. From December 2013 to December 2015, 69 azoospermic men with epididymal obstruction due to a genital infection, trauma, or idiopathic factors underwent deferential vessel-sparing LIVE in the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China. The outcomes of these patients were analyzed retrospectively. The mean age was 31.1 years for men and 28.3 years for their partners. Fifty-nine (85.5%, 59/69) men were followed up after surgery for approximately 16 months. Patency was noted and confirmed by semen analysis (>10 000 sperm/ml) in 83.1% (49/59) of men. The natural pregnancy rate was 40.7% (24/59) by the end of the study, with 87.5% (21/24) of these natural pregnancies achieved within 12 months after surgery. No severe adverse events or complications were observed. In this study, we present a novel technique for sparing the deferential vessels during LIVE. The preliminary outcomes show this technique to be safe with favorable patency and pregnancy rates.

Expressions of TRPV1 and TRPA1 in the dorsal root ganglion in the rat model of orchialgia / 中华男科学杂志

Objective@#To explore the expressions of transient receptor potential vanilloid 1 (TRPV1) and TRP ankyrin 1 (TRPA1) in the dorsal root ganglion (DRG) and their action mechanisms in the rat model of orchialgia.@*METHODS@#The models of orchialgia were established in male SD rats by injection of 2% acetic acid into the testis. Then the number of spontaneous pain responses and withdrawal latency in the model rats were recorded by behavioral tests and the expressions of TRPV1 and TRPA1 in T13－L1 DRGs determined by RT-qPCR, Western blot and immunofluorescence staining.@*RESULTS@#Compared with the normal control rats, the orchialgia models showed a significant increase in the number of spontaneous pain responses (0.13 ± 0.35 vs 22.63 ± 3.42, P<0.01) and a decrease in the withdrawal latency at 4 hours after injection (［12.75 ± 1.50］ vs ［4.85 ± 1.00］ s, P<0.05). The mRNA expressions of both TRPV1 and TRPA1 were observed in the membrane of the neurons in the DRG, the former increased by 1.77 times and the latter by 1.75 times that of the control (P<0.05).@*CONCLUSIONS@#The expressions of TRPV1 and TRPA1 were up-regulated in the DRG of the rat models of orchialgia, which may be involved in the allodynia and hyperalgesia of the rats.

Animal models of male genital tract chlamydia infection: An update / 中华男科学杂志

Chlamydia trachomatis infection is one of the most prevalent sexually transmitted diseases in males and studies on its pathogenic and immunologic mechanisms are rather limited. Animal models play an important role in studying the pathogenesis, course and treatment of human diseases, and those of male genital tract chlamydial infection are relatively few and not well developed. This article focuses on the chlamydia species, animal species, infection route, infected organ, and infection process of chlamydia, as well as its impact on reproduction, aiming to provide some help for further studies of male genital tract chlamydial infection.

Updated diagnosis and management of chronic orchialgia / 中华男科学杂志

Chronic orchialgia (CO) is a common complaint in urology or andrology. Due to its complicated pathogenesis, the diagnosis and treatment of CO are quite challenging. Based on different etiologies, CO can be idiopathic or secondary. Idiopathic CO accounts for approximately 50% of the cases and is probably associated with Wallerian degeneration in the spermatic cord nerves and peripheral sensitization. Secondary CO can be attributed to direct causes and its treatment focuses on the pathologic condition identified. The main methods for the treatment of CO include conservative and surgical strategies, among which microsurgical spermatic cord denervation ( MSCD) is an effective and minimally invasive option, while orchiectomy is but the last alternative when no other means is left.

Retrospective analysis of one-year outcomes after modified single-armed suture technique for microsurgical intussusception vasoepididymostomy / 中华显微外科杂志

Objective To retrospectively analyze the one-year outcomes of modified single-armed suture technique for microsurgical vasoepididymostomy in men with epididymal obstructive azoospermia (EOA).Methods From February,2012 to November,2013,microsurgical longitudinal intussusception vasoepididymostomies using a modified single-armed suture technique in 51 men with EOA was performed.The followed-up period was designed as 1 year.The correlations between the sperm motility in epididymal fluid,unilateral or bilateral procedure,anastomotic site,and the female partner age and the patency or pregnancy rate were analyzed.Results Followups were carried out for 39 (76.5％) men.The patency was noted in 24 (61.5％) men and pregnancy was reported in 15 (38.5％) female partners,including 1 received in vitro fertilization using fresh ejaculated sperm.Motile sperms in epididymal fluid were observed intraoperatively in 14 (58.3％) patent men and 3 (20.0％) nonpatent men,respectively (P ＜ 0.05).In patent cohort,the mean ages of the pregnant and non-pregnant female partners were 26.5 and 32.7 years(P ＜ 0.05),respectively.Conclusion The modified single-armed suture technique showed favourable patency and pregnancy rates in this study.It's a practical alternative in the areas without the specialized double armed suture.

Correlation between chronic prostatitis and erectile dysfunction / 中华泌尿外科杂志

Objective To discuss the clinical correlation between chronic prostatitis (CP) and erectile dysfunction (ED).Methods A retrospective analysis was made on the clinical data from patients who were diagnosed as CP in urology department of the First People's Hospital of Yunnan Province and the First Affiliated Hospital of Sun Yat-sen University.Patients' data were collected from July 2005 to July 2012.All the patients were diagnosed as CP based on their clinical manifestation,the NIH Chronic Prostatitis Symptom Index,prostatic fluid examination,routine urine examination and ultrasonography.The condition of erectile function was inquired on every patient and recorded.Results There were 4 315 patients diagnosed as CP in present study,while their age ranged from 17 to 64 years (average,31 years).Sixty-one (1.41％) patients were identified as moderate and severe types of ED (International Index of Erectile Function 5 ≤ 11),while 42 (0.97％) patients were confirmed as ED after they got CP.435/4 315 patients (10.08％)felt obviously sexuality descent after they got CP,and the sexuality was reported improved in 426/435 pa-tients after prostatitis symptomatic relief.Conclusions The incidence rate of ED in CP patients is not ob-viously higher than that in common community.And sexuality descent in patients might be caused by localindisposition and anxiety after CP.

Microsurgical management of male infertility in china: 15-year development and prospects / 中华男科学杂志

Male infertility is a common and complex disease in urology and andrology, and for many years there has been no effective surgical treatment. With the emergence of microsurgery and assisted reproductive medicine (IVF/ICSI), rapid development has been achieved in the treatment of male infertility. The Center for Male Reproductive Medicine and Microsurgery at Weill Cornell Medical College of Cornell University has been playing an important leading role in developing microsurgical techniques for the management of male infertility. The development of microsurgical treatment of male infertility in China has experienced the 3 periods of emerging, making, and boosting ever since its systematic introduction from Weill Cornell Medical College 15 years ago. At present, many Chinese hospitals have adopted microsurgery in the management of male infertility, which has contributed to the initial establishment of a microsurgical treatment system for male infertility in China. However, some deficiencies do exist concerning microsurgical treatment of male infertility, as in normalized technical training programs for competent surgeons, unified criteria for evaluation of surgical outcomes, and detailed postoperative follow-up data. This article presents an overview on the 15-year development of microsurgical management of male infertility in China, points out the existing deficiencies, and offers some propositions for the promotion of its development.

Yimusake Tablet: safe and efficacious for premature ejaculation / 中华男科学杂志

<p><b>OBJECTIVE</b>To objectively evaluate the efficacy and safety of Yimusake Tablet in the treatment of premature ejaculation (PE) through a multi-centered large-sample trial.</p><p><b>METHODS</b>We conducted a multi-centered, open, fixed-dose, and self-compared clinical trial among 300 patients with diagnosed PE. The trial lasted 12 weeks, including 4 weeks without any medication and 8 weeks of treatment with Yimusake Tablet, 2 pills (1 g) per night. We observed the intravaginal ejaculation latency time (IELT) before and after treatment, evaluated the safety of medication, and performed a questionnaire investigation on the patients' satisfaction.</p><p><b>RESULTS</b>Of the 300 PE patients, 288 accomplished the clinical trial. The patients ranged in age from 22 to 60 years, averaging at 31.6 years. The mean IELT of the patient was 62.5 seconds at baseline, 168.9 seconds after 4 weeks of treatment with Yimusake Tablet, and 222.2 seconds after 8 weeks of medication. Among the 157 patients with normal erectile function (IIEF >21), the mean IELT was 71.4 seconds before treatment, 147.4 seconds after 4 weeks of medication, and 172.5 seconds after 8 weeks of medication. The patients' satisfaction was significantly increased after treatment. Those complicated by mild to moderate erectile dysfunction achieved different degrees of improvement in the IIEF-5 score, with a mean increase of 3.8. Only a few patients experienced mild adverse events, including constipation, dry mouth, nose bleeding, abdominal pain, and lumbosacral pain, which were all relieved without drug withdrawal.</p><p><b>CONCLUSION</b>Yimusake Tablet is a safe and effective medicine for the treatment of PE.</p>

Roles of pericytes in the urological and reproductive systems / 中华男科学杂志

Pericyte, also known as mural cell or Rouget cell, is one of the main cells that make up the wall of capillaries. Pericytes play important roles not only in the maturation, stability, and function maintenance of blood vessels, but also in the growth and development of tissues and organs, wound repair, and other physiological and pathological processes. Researches on the functions of pericytes are mainly concentrated on their multipotency, adjustment of vascular functions, and process of fibrosis, as well as on renal fibrosis, renal blood flow regulation, and glomerular filtration in urology, but are quite insufficient in andrology. This article reviews the location, origin, distribution, morphology, markers, and functions of pericytes, aiming to induce further studies of pericytes in andrology.

Genetic characterization and protein stability analysis of a Chinese family with Von Hippel-Lindau disease / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Von Hippel-Lindau disease (VHL), a heritable autosomal dominant disease characterized by neoplasia in multiple organ systems, has rarely been reported in Asia. We genetically investigated a unique Chinese family with VHL disease and performed an analysis of the VHL protein stability.</p><p><b>METHODS</b>Genomic deoxyribonucleic acid (DNA) extracted from peripheral blood was amplified by polymerase chain reaction (PCR) to three exons of the VHL gene in 9 members of the Chinese family with VHL disease. PCR products were directly sequenced. We estimated the effects of VHL gene mutation on the stability of pVHL, which is indicated by the free energy difference between the wild-type and the mutant protein (ΔΔG).</p><p><b>RESULTS</b>The Chinese family was classified as VHL type 1. Three family members, including two patients and a carrier, had a T to G heterozygotic missense mutation at nucleotide 515 of the VHL gene exon 1. This missense mutation resulted in the transition from leucine to arginine in amino acid 101 of the VHL protein. There was low stability of the VHL protein (the ΔΔG was 12.71 kcal/mol) caused by this missense mutation.</p><p><b>CONCLUSIONS</b>We first reported a family with this VHL gene mutation in Asia. This missense mutation is predicted to significantly reduce the stability of the VHL protein and contribute to the development of the renal cell carcinoma (RCC) phenotype displayed by this family. The genetic characterization and protein stability analysis of families with VHL disease are important for early diagnosis and prevention of the disease being passed on to their offspring.</p>

Qilin pills combined with levofloxacin for asthenospermia accompanied with accessory sex gland infection: a clinical observation / 中华男科学杂志

<p><b>OBJECTIVE</b>To observe the efficacy of the combination of Qilin Pills and levofloxacin in the treatment of asthenospermia accompanied with accessory sex gland infection.</p><p><b>METHODS</b>We randomly assigned 80 asthenospermia patients with accessory sex gland infection to groups 1 and 2 of equal number, the former treated with Qilin Pills + levofloxacin, and the latter with levofloxacin only. Qilin Pills were administered at the dose of 6 g tid for 30 days, and levofloxacin at the dose of 0.5 g qd for 20 days. We obtained semen parameters, including the percentage of progressively motile sperm and peroxidase-positive white blood cell (WBC) count, before and after medication, and compared the clinical effects between the two groups.</p><p><b>RESULTS</b>All the patients accomplished the clinical trial. The therapeutic effectiveness rates in improving progressive sperm motility were 60% in group 1 and 17.5% in group 2, with statistically significant differences between the two groups (P < 0.05). As for the peroxidase-positive WBC count in semen, the effectiveness rates were 87.5% and 82.5%, respectively, with no significant differences between the two groups (P > 0.05).</p><p><b>CONCLUSION</b>For the treatment of asthenospermia accompanied with accessory sex gland infection, Qilin Pills combined with levofloxacin is evidently better than levofloxacin alone in improving sperm motility, and it has no obvious adverse effects.</p>

Microsurgical denervation of the spermatic cord for treatment of idiopathic chronic orchialgia / 中华医学杂志(英文版)

A patient referred to our hospital, diagnosed with left idiopathic chronic orchialgia, was evaluated with a thorough medical and psychiatric history, physical examination, scrotal ultrasound and magnetic resonance imaging. Conservative management failed. The patient had temporary pain relief after undergoing outpatient cord block three times. Microsurgical denervation of the left spermatic cord was operated in March, 2011. A pain questionnaire was used to determine efficacy before and after operation, and complete pain relief was noted at one week after operation. The follow up period was 12 months, at the end of which the pain score was still zero. No complications, including testicular atrophy and hydrocele, occurred. Microsurgical denervation of the spermatic cord can be a minimally invasive, safe and effective management option for treatment of idiopathic chronic orchialgia.

Surgical treatment of obstructive azoospermia: a report of 56 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the diagnosis and surgical treatment of obstructive azoospermia.</p><p><b>METHODS</b>We analyzed the clinical data of 56 cases of obstructive azoospermia, 43 of them with ejaculatory duct obstruction (EDO), and the other 13 suspected of epididymal obstruction. The diagnostic methods included semen analyses, measurement of fructose and neutral alpha-glucosidase in the seminal plasma, transrectal ultrasonography (TRUS), and vasography when necessary. The 43 patients with EDO were treated by transurethral resection of the ejaculatory duct (TURED), and 11 of the 13 cases of suspected epididymal obstruction were confirmed by scrotal exploration and underwent either bilateral or unilateral vasoepididymostomy. The patients were followed up for 3 -51 months for postoperative semen quality and impregnation.</p><p><b>RESULTS</b>Of the 43 azoospermia patients with EDO treated by TURED, 36 (83.7%) showed improved semen parameters and 11 (25.6%) achieved pregnancies. Among the 11 cases of azoospermia with confirmed epididymal obstruction treated by vasoepididymostomy, 6 (54.5%) had sperm in the semen assay and 3 (27.3%) achieved pregnancies.</p><p><b>CONCLUSION</b>Semen analyses, measurement of fructose and neutral alpha-glucosidase in the seminal plasma, TRUS and vasography are important diagnostic methods for obstructive azoospermia. TURED is effective for azoospermia with EDO, while vasoepididymostomy is preferable for the treatment of azoospermia with epididymal obstruction.</p>

A multi-center clinical trial of Qianlieantong tablets for chronic prostatitis / 中华男科学杂志

<p><b>OBJECTIVE</b>To observe the efficacy and safety of Qianlieantong Tablets in the treatment of chronic prostatitis.</p><p><b>METHODS</b>A multi-center, self-controlled open clinical trial was conducted. A total of 280 subjects with chronic prostatitis were enrolled and treated by Qianlieantong Tablets, 3 times a day, 5 tablets each time. Before and after 2 and 4 weeks after the administration, NIH-CPSI scores and white blood cell counts in the prostate secretion were recorded.</p><p><b>RESULTS</b>Of the 273 subjects evaluated, the rates of excellence, effectiveness and ineffectiveness were 35.2% (n = 96), 47.6% (n = 130) and 17.2% (n = 47), respectively, with a total effectiveness rate of 82.8%. After 4 weeks'medication, the scores of the subjects on NIH-CPSI pain, voiding and quality of life and white blood cell counts in prostate secretion were significantly decreased compared with pre-treatment (P < 0.01). No adverse events or laboratory abnormality related to the medication were observed.</p><p><b>CONCLUSION</b>Qianlieantong Tablets has a significant effect on chronic prostatitis with high safety, particularly indicated in chronic prostatitis with pelvic pain.</p>

Diagnosis and treatment of iatrogenic ejaculatory duct obstruction following prostatic hyperthermia (report of 3 cases) / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the characteristics of diagnosis and treatment of iatrogenic ejaculatory duct obstruction following prostatic hyperthermia.</p><p><b>METHODS</b>Retrospective analyses were made of the clinical data of 3 cases of ejaculatory duct obstruction following prostatic hyperthermia.</p><p><b>RESULTS</b>The 3 cases were diagnosed as urethrostenosis and deformity of the posterior urethra by transurethral ultrasound and semen analysis. And all the 3 patients had undergone prostatic hyperthermia for prostatitis. Transurethral resection of the ejaculatory duct (TURED) was performed to remove the obstruction and the postoperative semen analysis showed both semen volume and sperm count to be normal.</p><p><b>CONCLUSION</b>Urethra microwave thermotherapy, urethra radiofrequency, or per urethra rheophore ablation can be adopted in the treatment of protatitis, but should be strictly indicated and cautiously selected lest secondary iatrogenic ejaculatory duct obstruction should result. For the treatment of this obstruction, TURED is the first choice.</p>

Minimally Invasive Percutaneous Nephrolithotomy for Calculi in Patients with Congenital Anomalous Kidneys / 中国微创外科杂志

Objective To assess the safety and effectiveness of minimally invasive percutaneous nephrolithotomy(MPCNL) in treating renal stones in patients with congenital anomalous kidneys.MethodsFrom January 2000 to November 2007 a total of 41 patients with renal stones complicated with congenital anomalous kidneys,including 12 cases of horseshoe kidneys,19 cases of duplex kidneys,and 10 cases of malrotated kidneys were treated by MPCNL in our hospital.Of the 41 patients,4 had upper calyx calculi,6 had middle calyx calculi,7 had lower calyx calculi,3 had pelvic calculi,4 had the upper segment calculi in duplex kidney,12 had multiple calculi,and 5 had staghorn calculi.The largest diameter of the stones ranged from 1.0 to 4.0 cm(mean 2.5 cm).Ureteral calculi that were found in 13 of the patients were treated at one time.ResultsThe procedure were completed in all of the cases with the operation time ranged from 45 to 210 minutes(mean 95 minutes),and blood loss ranged from 30 to 150 ml(mean 80 ml).The overall stone-free rate at one session was 85.4%(35/41).One of the duplex kidney cases and two of the horseshoe kidney cases were cured by a second operation.And two of the duplex kidney cases and one of the malrotated kidney cases were treated by ESWL after the MPCNL.One patient,who had malrotated kidney,suffered massive hemorrhage(800 ml) during the MPCNL,and was cured by selective embolization of the renal artery.No severe complications occurred in the other patients.The cases were followed up for 5-12 months,during the Period no patient had recurrence.ConclusionsMPCNL is safe and reliable for the treatment of stones in patients with congenital anomalous kidneys.The treatment must be individualized in terms of the type of the renal abnormalities,and the size and location of the stones.