Effectiveness of antibiotic treatment in infertile patients with sterile leukocytospermia induced by tobacco use.

Our study investigated whether antibiotic therapy in infertile tobacco users with sterile leukocytospermia and a history of former sexual transmitted disease (STD) has an advantage over cessation of smoking alone. For this study, 80 male infertile smokers were divided into two subgroups. The first group numbered 40 patients treated with a two week course of doxycycline, 100 mg, twice daily, while the second group simply ceased smoking. A control group of 20 patients with chronic abacterial prostatitis (CPPS III a) were treated with the same antibiotic for two weeks. Patients from the first group exhibited significantly higher values in semen volume, total motility, and progressive motility of spermatozoa, when compared with the second group, two weeks post treatment. The latter two measures persisted during the 12 week follow up period. In both groups of patients, the correlation coefficient between the number of leukocytes and progressive motility was determined as statistically significant. However, in the control group the correlation was not statistically significant; however progressive motility, total motility, and vitality were significantly improved after a two week course of antibiotics. Our study implies that antibiotic treatment is perhaps effective in treating sterile leukocytospermia in smokers with a former STD and is a more effective treatment option in improving sperm parameters over smoking cessation alone. ABBREVIATIONS: STD: sexual transmitted disease; CPPS IIIa: chronic abacterial prostatitis; PSA: prostatic specific antigen; EPS: expressed prostatic secretion; WBC: white blood count; LUTS: lower urinary tract symptoms; PPMT: pre-massage and post-massage urine test; VAS: visual analogue scale.

Blood groups and acute aortic dissection type III.

INTRODUCTION: Acute aortic type III dissection is one of the most catastrophic events, with in-hospital mortality ranging between 10% and 12%. The majority of patients are treated medically, but complicated dissections, which represent 15% to 20% of cases, require surgical or thoracic endovascular aortic repair (TEVAR). For the best outcomes adequate blood transfusion support is required. Interest in the relationship between blood type and vascular disease has been established. The aim of our study is to evaluate distribution of blood groups among patients with acute aortic type III dissection and to identify any kind of relationship between blood type and patient's survival. MATERIAL AND METHODS: From January 2005 to December 2014, 115 patients with acute aortic type III dissection were enrolled at the Clinic of Vascular and Endovascular Surgery in Belgrade, Serbia and retrospectively analyzed. Patients were separated into two groups. The examination group consisted of patients with a lethal outcome, and the control group consisted of patients who survived. RESULTS: The analysis of the blood groups and RhD typing between groups did not reveal a statistically significant difference (p = 0.220). CONCLUSIONS: Our results indicated no difference between different blood groups and RhD typing with respect to in-hospital mortality of patients with acute aortic dissection type III.

Vacuum erection device in treatment of organic erectile dysfunction and penile vascular differences between patients with DM type I and DM type II.

The aim of this study is to investigate changes in the vascular system and hemodynamics between patients with organic erectile dysfunction (ED) (DM type I and II), as well as to compare the quality of sexual life between those two groups after the treatment with vacuum erection device (VED). Study enrolled 50 males with DM, aged from 35 to 67 years, who have attended the urologic clinic due to inability to attain and maintain an erection of the penis sufficient to permit satisfactory sexual intercourse. Patients were using VED and six months later were assessed for therapy results. The International Index of Erectile Function (IIEF) was used to quantify erectile dysfunction. Alprostadil injection test was also used, with Doppler color flow imaging system, to evaluate the peak systolic velocity (PSV) and diameter of cavernosal artery (DCA). Significantly higher values of PSV were obtained in patients with DM type II. Also, DCA showed significant difference between two groups of patients. There was significant improvement in three items of IIEF after six months of treatment among both groups of examinees. Patients with DM type I had more serious risk for development of arteriogenic ED. VED could be a good alternative therapy for patients who denied peroral therapy.

The therapeutic potential of royal jelly in benign prostatic hyperplasia. Comparison with contemporary literature.

The aim of this study is to establish the scientific benefit of royal jelly (RJ) on prostatic-specific antigen (PSA), post-void residual (PVR) volume and International Prostate Symptom Score (IPSS) in benign prostatic hyperplasia. For the study, a group of 40 men were administered 38 mg of RJ over a period of three months, their PSA values, prostate volumes and the volumes of their transitory prostate zones, PVR and IPPS values were measured at the end of the first month, and at the end of the third month. The results of this study confirm the potential of RJ in reducing PSA scores and improving IPSS values. Since the use of RJ did not lead to any significant reduction in PVR, prostate volume, or to any involution of the transitory zone, it appears that it may only affect the blood marker of prostatic hyperplasia and to improve quality-of-life (QoL) in those patients. Overall, in comparison to phytotherapy and conventional therapy, RJ had similar positive effects on QoL in patients with BPH, however it exhibited markedly better effects on reducing PSA levels in blood. The therapeutical use of RJ exhibited no side effects.

Reborn of Internal-External Carotid Artery Transposition as a Repair Method for Shotgun Injury of Neck Zone 2.

A 26-year-old male presented to the emergency center having been shot in the neck. Multislice computed tomography angiography revealed injury of the right internal carotid artery at level of the carotid bifurcation with hematoma and injury of right internal jugular vein. Under general anesthesia, transposition of internal carotid artery to external carotid artery, with ligation of internal jugular vein, was successfully performed. This case emphasizes the value of "old fashion" surgical treatment in modern endovascular age.

Comparison of Sperm Parameters in Patients with Infertility Induced by Genital Infection versus Varicocele.

BACKGROUND: Male infertility is a common and complex problem and, despite much research in this field, the major cause of infertility unfortunately remains unknown. Genital infection and varicocele are important causes of infertility. AIMS: To compare the influence of genital infection and varicocele individually on male infertility based on semen analysis. STUDY DESIGN: Cross-sectional study. METHODS: The study included 120 infertile patients divided into two groups according to the presence of genital infection or varicocele. The first group included 60 examinees with proven genital infection, but without varicocele formation. The second included 60 patients with varicocele, regardless of the varicocele grade, but without genital infection. The fertile parameters were compared and an assessment was performed on the impact on quality of spermatogenesis due to infection and varicocele. RESULTS: There is a statistically significant difference regarding abnormal forms of spermatozoids (45.94±9.79 vs. 25.27±6.54) and progressive motility (8.15±1.24 vs. 24.95±7.2), between two groups of patients. However, acidity of ejaculates, minimum sperm concentration, total spermatozoid motility and ejaculate volume showed no statistically significant difference. CONCLUSION: The study showed a stronger negative influence of genital infection on fertile parameters over varicocele. The significance of our study is the lack of contemporary researches comparing varicocele and genital infection influence on male infertility individually.

Restricting sports activity in reducing the rate of varicocele and related infertility parameters in athletes.

INTRODUCTION: The aim of this study is to test the hypothesis that the cessation of sports training in young athletes reduces the prevalence of varicocele. MATERIAL AND METHODS: 1,013 young males were divided into three age-matched groups based on their sport activity. The first group consisted of 305 athletically active boys in basketball, volleyball, handball, or football; the second of 44 active water-polo players, and the third of 664 sport-inactive controls. All participants had been initially examined for the presence of varicocele, and positive ones were submitted to orchidometry and seminal fluid analysis. Those with varicocele were then asked to cease all sport activity for the following six months, and the reassessing was performed. RESULTS: The results showed a significantly higher percentage of varicocele present in the first group than in the control group (p < 0.49), while the percentage of young males diagnosed with varicocele in the second proved to be even lower than that of the control group (9.09% vs. 12.35%). After the 6-month period of cessation and abstention from all sporting activity, every parameter of the seminal fluid analysis improved in the first group, wherein statistical significance for both sperm concentration (p < 0.001) and sperm motility (p < 0.023) was found. The testicular volume was found not to have increased significantly in either group (p > 0.05). CONCLUSIONS: The study shows that sport-associated varicocele has a positive prognosis when diagnosed early and upon the cessation of sports training.

Correlation between nitric oxide levels, the hypo-osmotic swelling test for sperm membranes and semen analysis in patients with varicocele.

OBJECTIVE: Nitric oxide (NO) is a well-known oxidative stress agent that directly inhibits mitochondrial respiration and the synthesis of DNA. A case-control study of the concentration of NO in infertile patients with varicocele versus car-accident controls was performed. The concentration of NO in infertile patients with varicocele, and its correlation with the sperm fertility test named the hypo-osmotic swelling (HOS) test for sperm membranes and semen analysis, was also examined. MATERIAL AND METHODS: A spectrophotometric method was used to measure the concentration of NO in infertile subjects, and the HOS test was carried out according to Jeyendran's original protocol. NO values from left testicular vein and left cubital vein of 19 infertile patients with left-sided varicocele were compared to 15 patients in the control group who underwent explorative laparoscopies after car accidents. Semen analysis and the HOS test were performed only in the left-sided varicocele group and compared to the NO outcomes. RESULTS: The results indicate that the concentration of NO was significantly higher in the testicular vein than in the peripheral veins of patients with varicocele, as well as being significantly higher than in the testicular vein of control patients. An increased NO concentration in the testicular vein, higher sperm count and higher sperm motility in infertile patients with varicocele followed negative or suspicious findings of the HOS test for sperm membranes. There was also a significant correlation between NO concentration and sperm count in patients with varicocele. CONCLUSIONS: Further studies with more patients, related to NO concentrations and the HOS test are needed to verify these results.

Influence of dihydroergotoxine, bromocriptine, and ergotamine on penile erection in Wistar rats.

The pilot study presented was conducted to determine as to whether ergot alkaloids (alpha-adrenergic blockers) have a potential effect on penile erectile function. The influence of dihydroergotoxine, bromocriptine, and ergotamine was studied on the erection ability in intact, two-grade outbred male Wistar albino rats that were out of their estrous phase. The experimental animals were injected intrapenially with the substances under examination: dihydroergotoxine mesylate (0.1 mg/0.1 mL, 0.3 mg/0.1 mL, and 1 mg/0.1 mL), bromocriptine mesylate (0.3 mg/0.1 mL, 1 mg/0.1 mL, and 3 mg/0.1 mL), and ergotamine tartrate (0.1 mg/0.1 mL, 0.3 mg/0.1 mL, and 1mg/0.1 mL). Every dose was tested on a pattern of 30 rats. These mentioned substances were injected in the amount of 1 mm to the left of the proximal part of the superficial dorsal vein of the penis, in the region of the penis root. After injection, the animals were then observed within the next 90 minutes. In the trial, the following was observed: the number of rats with an erection achieved, the period of time from intrapenial application to the appearance of the first erection, and the duration of the erection. Ultimately, the research results confirm the efficiency of dihydroergotoxine and bromocriptine as erectogenic agents, as well as ergotamine as a detumescent compared with saline solutions.