Steroidogenic enzyme gene expression and testosterone production are developmentally modulated by bone morphogenetic protein receptor-1B in mouse testis.

Bone morphogenetic proteins (BMPs) and receptors (BMPR-1A, BMPR-1B, BMPR-2) have been shown to be vital for female reproduction, while their roles in males are poorly described. Our study was undertaken to specify the function of BMPR-1B in steroidogenic enzyme gene expression, testosterone production and reproductive development in male mice, given that Bmpr1b mRNA is expressed in mouse testis and Bmpr1b knockout results in compromised fertility. Male mice were passively immunized for 6 days with anti-BMPR-1B in the presence or absence of exogenous gonadotrophins. We then measured the effects of anti-BMPR-1B on testicular hydroxysteroid dehydrogenase isoforms (Hsd3b1, Hsd3b6, and Hsd17b3) and aromatase (Cyp19) mRNA expression, testicular and serum testosterone levels, and testis and seminal vesicle weight. In vitro testosterone production in response to anti-BMPR-1B was determined using testicular culture, and Leydig cell culture in the presence or absence of gonadotrophins. In Leydig cell culture the contribution of seminiferous tubules and Leydig cells were examined by preconditioning the media with these testicular constituents. In adult mice, anti-BMPR-1B increased testosterone and Hsd3b1 but decreased Hsd3b6 and Cyp19 mRNA. In adult testicular culture and seminiferous tubule conditioned Leydig cell culture, anti-BMPR-1B reduced testosterone, while in normal and Leydig cell conditioned Leydig cell culture it increased testosterone levels. In pubertal mice, anti-BMPR-1B reduced gonadotrophin stimulated seminal vesicle growth. In conclusion, BMPR-1B has specific developmental functions in the autocrine and paracrine regulation of testicular steroidogenic enzyme gene expression and testosterone production in adults and in the development of seminal vesicles during puberty.

The impact of passive immunisation against BMPRIB and BMP4 on follicle development and ovulation in mice.

The primordial follicle reserve is the corner stone of female fertility and determines the longevity and quality of reproduction. Complete depletion of this reserve will lead to primary infertility, and the key-limiting step of follicle depletion is the transition from primordial to primary follicles. It has been reported that this process is gonadotrophin-independent, but other conflicting reports are indicated otherwise and this discrepancy needs to be unequivocally clarified. The aim of this study was to investigate the role of bone morphogenetic proteins (BMPs) in the regulation of folliculogenesis in mice passively immunised against BMP receptor 1B (BMPRIB) and BMP4. While a stereological study revealed that the numbers of primordial follicles in immunised mice were significantly higher when compared with control animals, treatment with equine chorionic gonadotrophin showed no effect. In parallel, immunofluorescence microscopy revealed the presence of BMPRIB but not FSH receptor in primordial follicles. The number of primary follicles in immunised mice were also significantly increased when compared with control animals. After puberty, the rates of depletion of primordial and primary follicles were increased with age, particularly in treated animals; however, there was no significant difference between the treatment groups of the same age. Based on these results together with our previous reports in sheep and mice, we confirm that the attenuation of BMP signalling system can be an effective approach to sustain the primordial follicle reserve while promoting the development of growing follicles, ovulation and consequently overall female fertility.

Fractures of the penis seen in Abu Dhabi.

We report on 9 patients with fracture of the penis seen during 5 years in a single hospital serving only part of a city population of less than 300,000 persons. Of the 9 patients 7 were expatriates unaccompanied by their wives. This factor possibly is significant in the social etiology of this injury. Two patients presented late and were managed conservatively, with a poor result in 1 who was not lost to followup. Of the 7 patients who underwent immediate penile exploration, evacuation of hematoma and repair of the defect 6 had no resultant penile deformity and 1 had mild shaft curvature on erection, while all retained erectile potency. We advocate an operation as the method of treatment.

Disrupting injuries of the membranous urethra--the case for early surgery and catheter splinting.

We reviewed the outcome following primary definitive repair by catheter splinting in 16 patients presenting with total posterior urethral disruption following pelvic injury. There were two deaths in the early post-operative period due to pulmonary embolism associated with other serious injuries. Five patients were judged to have a significant stricture at the site of injury, but all proved amenable to management with endoscopic treatment or periodic dilatation. None required a urethroplasty. The two cases with stress incontinence were related to concomitant injury of the bladder neck. Impotence persisted in 2 or 5 patients followed for longer than 12 months. Complications from catheter traction were not seen using the system of light interrupted traction described. A case is made for primary management by catheter splinting of such urethral injuries.

Evaluating bilharzial ureteropathy for surgery.

In a study of 115 ureters showing chronic bilharzial changes, 4 main patterns of ureteropathy are defined. Type A is benign, shows mild fusiform dilatation localised to the distal ureteric segment and requires no surgery. Type B presents with distal ureteric stricture, without extensive fibrosis, is rare, and shows good results following resection and ureterovesical reimplantation. Type C shows extensive bilharzial changes without stricture and is difficult to evaluate unless fluoroscopy is added to standard urographic investigation. If peristaltic dysfunction is severe, these ureters will require placement with an ileal segment. Type D ureteropathy presents with fixed tortuosity, mainly in the upper ureteric segment, and conservative surgery, involving freeing and straightening the entire ureter, has shown good results. Staging the presenting ureteropathy has proved valuable in evaluation and follow-up.