5HT-1A receptor polymorphism effects ejaculatory function in Egyptian patients with lifelong premature ejaculation / Efectos del polimorfismo del gen del receptor de 5-HT1A en la función eyaculatoria de pacientes egipcios con eyaculación precoz permanente

INTRODUCTION AND OBJECTIVES: Lifelong premature ejaculation (LPE) is identified as the inability to delay ejaculation for more than 1min after vaginal penetration occurring on all or almost all sexual experiences together with feelings of frustration of both the patient and his partner with avoidance of sexual intimacy. Recently, a role for (HTR1A)-C (1019) G gene polymorphism in patients with LPE was postulated. MATERIALS AND METHODS: Three hundred and fifty participants were prospectively enrolled in this study. They were recruited from the outpatient clinic of Andrology & STDs Department Cairo University from December 2015 to January 2017. Two hundred and forty-five of them were suffering from lifelong premature ejaculation joined this study, in addition to 105 controls. We instructed the wives of the patients to measure the intra-vaginal ejaculation latency time (IELT) of the first intercourse only using a stopwatch for 1 month. Genotyping was performed at the end of the study. RESULTS: The results showed that the majority of the patients were CG, while; the controls were GG. This difference revealed a statistically significant association (p-value<0.001). A highly significant statistical association was found between the studied gene polymorphisms and the IELT among cases (p-values=0.001). CONCLUSION: The study replicated the potential role of 5HT-1A receptor gene polymorphisms in patients with lifelong premature ejaculation

INTRODUCCIÓN Y OBJETIVOS: La eyaculación precoz permanente (LPE) se identifica como la incapacidad para retrasar la eyaculación más de 1min después de la penetración vaginal, que en todas o casi todas las experiencias sexuales provoca sentimientos de frustración tanto en el paciente como en su pareja y conduce a la abstención de las relaciones sexuales. Recientemente, se ha propuesto que el polimorfismo del gen (HTR1A)-C (1019) G tiene un papel en pacientes con LPE. MATERIALES Y MÉTODOS: Se incluyó a 350 participantes en este estudio. Se los reclutó en la clínica ambulatoria del Departamento de Andrología y ETS de la Universidad del Cairo entre diciembre de 2015 y enero de 2017. Doscientos cuarenta y cinco de ellos con eyaculación precoz permanente se incorporaron a este estudio, además de 105 controles. Instruimos a las esposas de los pacientes para medir el tiempo de latencia de la eyaculación (TLE) intravaginal de la primera relación sexual utilizando solamente un cronómetro durante 1 mes. La genotipificación se realizó al final del estudio. RESULTADOS: Los resultados mostraron que la mayoría de los pacientes fueron CG, mientras los controles fueron GG. Esta diferencia reveló una asociación estadísticamente significativa (valor de p < 0,001). Se encontró una asociación estadística muy significativa entre los polimorfismos de los genes estudiados y el TLE entre casos (valores de p = 0,001). CONCLUSIÓN: El estudio reprodujo el papel potencial de los polimorfismos del gen del receptor de 5-HT1A en pacientes con eyaculación precoz permanente

5HT-1A receptor polymorphism effects ejaculatory function in Egyptian patients with lifelong premature ejaculation.

INTRODUCTION AND OBJECTIVES: Lifelong premature ejaculation (LPE) is identified as the inability to delay ejaculation for more than 1min after vaginal penetration occurring on all or almost all sexual experiences together with feelings of frustration of both the patient and his partner with avoidance of sexual intimacy. Recently, a role for (HTR1A)-C (1019) G gene polymorphism in patients with LPE was postulated. MATERIALS AND METHODS: Three hundred and fifty participants were prospectively enrolled in this study. They were recruited from the outpatient clinic of Andrology & STDs Department Cairo University from December 2015 to January 2017. Two hundred and forty-five of them were suffering from lifelong premature ejaculation joined this study, in addition to 105 controls. We instructed the wives of the patients to measure the intra-vaginal ejaculation latency time (IELT) of the first intercourse only using a stopwatch for 1 month. Genotyping was performed at the end of the study. RESULTS: The results showed that the majority of the patients were CG, while; the controls were GG. This difference revealed a statistically significant association (p-value<0.001). A highly significant statistical association was found between the studied gene polymorphisms and the IELT among cases (p-values=0.001). CONCLUSION: The study replicated the potential role of 5HT-1A receptor gene polymorphisms in patients with lifelong premature ejaculation.

Systematic review of hormone replacement therapy in the infertile man.

OBJECTIVES: To highlight alternative treatment options other than exogenous testosterone administration for hypogonadal men with concomitant infertility or who wish to preserve their fertility potential, as testosterone replacement therapy (TRT) inhibits spermatogenesis, representing a problem for hypogonadal men of reproductive age. MATERIALS AND METHODS: We performed a comprehensive literature review for the years 1978-2017 via PubMed. Also abstracts from major urological/surgical conferences were reviewed. Review was consistent with the Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) criteria. We used Medical Subject Heading terms for the search including 'testosterone replacement therapy' or 'TRT' and 'male infertility'. RESULTS: In all, 91 manuscripts were screened and the final number used for the review was 56. All studies included were performed in adults, were written in English and had an abstract available. CONCLUSIONS: Exogenous testosterone inhibits spermatogenesis. Hypogonadal men wanting to preserve their fertility and at the same time benefiting from TRT effects can be prescribed selective oestrogen receptor modulators or testosterone plus low-dose human chorionic gonadotrophin (hCG). Patients treated for infertility with hypogonadotrophic hypogonadism can be prescribed hCG alone at first followed by or in combination from the start with follicle-stimulating hormone preparations.

Obesity, An Enemy of Male Fertility: A Mini Review.

Obesity is a highly prevalent non-communicable disease worldwide and is commonly associated with male infertility. Several etiopathological theories have been mentioned in the literature by which obesity affects spermatogenesis, thus affecting the male fertility potential. Mechanisms for explaining the effect of obesity on male infertility include endocrinopathy, increased aromatization activity, associated erectile dysfunction, psychological and thermal effects, obstructive sleep apnea, increased leptin and oxygen free radicals, and associated inflammatory and obstructive elements of epididymitis. Treatment of such a complex problem includes weight reduction (by lifestyle modification and increased physical activity), optimization of altered testosterone-to-estradiol ratio using aromatase inhibitors and/or gonadotropins, treatment of associated comorbidities by phosphodiesterase inhibitors for erectile dysfunction, and insulin-sensitizing agents for the management of diabetes. The aim of this mini-review is to highlight the pathological basis of this problem and to focus on obesity as an etiology of male infertility.