The association of medications and supplements with human male reproductive health: a systematic review.

Some medications used to treat comorbidities and conditions in reproductive-aged individuals could have a negative impact on fertility. This may occur through hormonal disruption, toxicity to germ cells and spermatozoa, functional impact on the sperm, teratogenicity potential, or ejaculatory abnormalities. Having knowledge of these potential interactions between medications and reproductive potential is important for clinicians to be aware of and guide the patient, along with their treating clinicians, to reproductively favorable alternatives when available. This review aims to summarize the state of the literature regarding medication interactions with human male reproduction using the Anatomical Therapeutic Chemical Classification System of medications.

Subclinical inflammation as a predictor for erectile dysfunction after brachytherapy for localized prostate cancer.

PURPOSE: Neutrophil-to-lymphocyte ratio (NLR), a marker for subclinical inflammation, has been previously shown to be associated with erectile dysfunction (ED). We studied the potential predictive value of the NLR on ED after prostate brachytherapy (PB) for PCa. METHODS AND MATERIALS: Between July 2005 and January 2021, 842 patients were included in this retrospective study of a prospectively maintained database. ED was assessed using the Common Terminology Criteria for Adverse Events (CTCAE) physician-reported scale. ED was defined as a Grade 2 or 3 function. NLR count was determined 1-2 months before PB and separated into values PB <2 and ≥2. Patient characteristics and erectile function at last follow-up were compared for patients with a Univariate and multivariate analyses were performed to evaluate the predictive value of baseline NLR ≥2 on post-PB ED. RESULTS: Baseline NLR ≥2 was found to be a statistically significant predictor of post-PB ED on both univariate (p = 0.002) and multivariate analyses (p = 0.008). Furthermore, the difference in ED prevalence between the NLR <2 and NLR ≥2 groups became more pronounced with longer follow-up after PB. The ED rate at 5 years post-PB was 43% for the NLR ≥2 groups, compared to 29% for the NLR <2 groups. CONCLUSIONS: Subclinical systemic inflammation is a potentially important factor for predicting sexual toxicity after pelvic radiotherapy. NLR may be used as a proxy for predicting post-PB ED.

Objective structured clinical examinations (OSCE) performance among Quebec urology residents: A retrospective study from 2008-2019.

INTRODUCTION: We aimed to compare objective structured clinical examinations (OSCE) performance of residents from four Canadian urology programs, based on resident and station characteristics. We also aimed to evaluate OSCE contents by station type and subspecialty. METHODS: Scores of 109 postgraduate year (PGY)-3 to PGY-5 residents were retrospectively reviewed from 19 OSCEs from May 2008 to February 2019. Scores were grouped by station type/subspecialty, PGY level, medical graduate type (Canadian medical graduate [CMG], international medical graduate [IMG]), sex, and choice of fellowship/practice. Linear mixed modelling was performed to obtain least square means to account for repeated measures. RESULTS: Score increases from PGY-3 to PGY-5 were significant for all station types and subspecialties (p≤0.001). Scores were similar between male and female residents, and between CMGs and IMGs, except in visual recognition examinations (VREs) (males: 44.3±1.0, females: 39.0±1.6, p=0.005; IMG: 47.3±1.7, CMG: 41.6±0.9, p=0.004). Relative to uro-oncology stations, scores were lower in andrology (p=0.010) and functional urology (p<0.001). More female residents chose pediatric (14.3% vs. 1.5%, p=0.024) and functional urology fellowships (17.9% vs. 2.9%, p=0.021). More male residents chose endourology/robotic fellowships (30.9% vs. 10.7%, p=0.042). No associations between subspecialty scores and choice of fellowship/practice were found. Oral stations and VREs were more frequent than telephone stations. Uro-oncology and pediatric urology were more frequent than other subspecialties. CONCLUSIONS: Scores improved with higher PGY level. IMGs and male residents scored better in VREs. Scores were lower in functional urology. There was no correlation between subspecialty score and choice of fellowship/practice. Subspecialties and forms of evaluation were not equally represented.