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Book Review: Androgen Deficiency and Testosterone Replacement: Current Controversies and Strategies.

Du Geon MOON

The World Journal of Men's Health.2015;33(2):121-121. doi:10.5534/wjmh.2015.33.2.121

No abstract available.
Testosterone*

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The Testis Completely Replaced by a Huge Epidermal Cyst in an Older Man.

Kyung Kgi PARK ; Chang Lim HYUN ; Sung Dae KIM ; Young Joo KIM ; Jung Sik HUH

The World Journal of Men's Health.2015;33(2):117-120. doi:10.5534/wjmh.2015.33.2.117

Epidermal cysts are commonly encountered, slow-growing superficial cysts in the hair-bearing areas of the body, and are usually discovered in the second and fourth decades of life. These cysts tend to be superficial, meaning that they can be easily found by ultrasound and digital palpation at a moderate degree of growth. However, we found a huge testicular cyst that went undetected until old age. In this report, we describe the interesting case of a patient in whom the right testis was totally replaced with an epidermal cyst. The cyst was found by ultrasonography and further evaluated with magnetic resonance imaging. We performed orchiectomy under the impression of an epidermal cyst. The pathologic report confirmed this clinical impression. Over 24 months of follow-up, we did not find any recurrence of a growing mass on the testis.
Aged, 80 and over ; Epidermal Cyst* ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Orchiectomy ; Palpation ; Recurrence ; Testicular Neoplasms ; Testis* ; Ultrasonography

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The Effect of Vitis vinifera L. Juice on Serum Levels of Inhibin B, Sperm Count in Adult Male Rats.

Mohammad Reza AFZALZADEH ; Akram AHANGARPOUR ; Ashraf AMIRZARGAR ; Mohammad Kazemi VARNAMKHASTI ; Hadi GANJALIDARANI

The World Journal of Men's Health.2015;33(2):109-116. doi:10.5534/wjmh.2015.33.2.109

PURPOSE: Vitis vinifera is a species of Vitis that is native to the Mediterranean region, central Europe, and southwestern Asia, and has been used as a drug in traditional medicine. Traditional medicinal plants have been used for medical purposes with increasing effectiveness. It is important to identify drugs that inhibit spermatogenesis. Therefore, the present study aimed to investigate the effect of grape juice (GJ) on serum levels of inhibin B and sperm count in normal male rats. MATERIALS AND METHODS: Thirty-five adult male rats were randomly divided into five groups, each containing seven rats. Rats in the control group received 1 mL of normal saline over the course of the study. The experimental groups received GJ (100, 200, 400, and 1,600 mg/kg, orally, for 35 days consecutively). At the end of the treatment period, fertility indices were measured, including body weight difference, sex organ weight, sperm motility and count, epididymal sperm reserve, daily sperm production (DSP), and serum inhibin B levels. RESULTS: We found that GJ reduces body weight difference, was associated with decreased sperm motility and count in all treatment groups (p< or =0.05 and p< or =0.001, respectively). Moreover, DSP was significantly decreased in all treatment groups compared to the control group (p< or =0.05), except in the group receiving 100 mg/kg of GJ. Inhibin B levels were significantly decreased in all treatment groups (p< or =0.05). CONCLUSIONS: The results of our study suggest that GJ in all doses, but especially in higher doses, may decrease fertility in male rats.
Adult* ; Animals ; Asia ; Body Weight ; Europe ; Fertility ; Humans ; Inhibins* ; Male* ; Medicine, Traditional ; Mediterranean Region ; Organ Size ; Plants, Medicinal ; Rats* ; Sex Characteristics ; Sperm Count* ; Sperm Motility ; Spermatogenesis ; Spermatozoa* ; Vitis*

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Chronic Prostatitis: A Possible Cause of Hematospermia.

Gilho LEE

The World Journal of Men's Health.2015;33(2):103-108. doi:10.5534/wjmh.2015.33.2.103

PURPOSE: While hematospermia is mainly caused by genitourinary inflammatory disorders, very few studies have been published on prostatitis-associated hematospermia (PAH) diagnosed using robust prostatitis evaluation methods. Therefore, we have evaluated the incidence of PAH by using systematic methods for evaluating prostatitis. MATERIALS AND METHODS: We evaluated 37 hematospermia patients from a single hospital over the last five years. We classified the patients into PAH versus hematospermia without any evidence of prostatitis (HWP) by using a NIH-Chronic Prostatitis Symptom Index questionnaire and expressed prostatic secretion studies. RESULTS: The mean age was 55.89+/-14.87 years, and the patients were grouped into two groups: one group had 12 HWP patients and the other 25 PAH patients. PAH patients were further sub-classified: chronic bacterial prostatitis (3 patients), chronic nonbacterial prostatitis (10 patients), prostadynia (7 patients), and asymptomatic prostatitis (5 patients). We found Enterococcus faecalis in the three chronic bacterial prostatitis patients. We could not find any statistically significant difference between the PAH and the HWP groups in terms of the age interval, serum prostate-specific antigen level, and prostate volume. Even though there was no statistically significant difference in the items about urination between the two groups, we found a statistically significant difference in the quality of life (QoL) impact for the patients in this study. CONCLUSIONS: Two-thirds of the hematospermia patients were associated with some evidence of prostatitis. Further, the patients with PAH revealed poor QoL compared with the patients with HWP. Therefore, we must evaluate the presence of prostatitis in hematospermia patients and alleviate the prostatitis-associated symptoms to improve their QoL.
Enterococcus faecalis ; Hemospermia* ; Humans ; Incidence ; Prostate ; Prostate-Specific Antigen ; Prostatitis* ; Quality of Life ; Urination

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Penile Fracture: Our Experience in a Tertiary Care Hospital.

Rajkumar Singha MAHAPATRA ; Anup Kumar KUNDU ; Dilip Kumar PAL

The World Journal of Men's Health.2015;33(2):95-102. doi:10.5534/wjmh.2015.33.2.95

PURPOSE: Penile fracture is rare, but it is a urological emergency that always requires immediate attention. Moreover, penile fracture has been reported more frequently in recent years. It may have devastating physical, functional, and psychological consequences if not properly managed in time. MATERIALS AND METHODS: The objective of this study was to highlight the causes, clinical presentation, and outcomes of cases of penile fracture. This was a prospective observational study extending from November 2012 to November 2014. Each patient underwent a thorough clinical evaluation and received proper treatment. RESULTS: Twenty patients with penile fracture, aged 19 to 56 years (mean, 28 years) were evaluated in this study. Vaginal intercourse was the most common mechanism of injury. Most of the patients (95%) were diagnosed clinically with a proper history and clinical examination. Nineteen patients were treated surgically. The patients underwent six months of follow-up, and were evaluated with local examinations, questionnaires, and colour Doppler ultrasonography as necessary. CONCLUSIONS: Although penile fracture is an under-reported urological emergency, its incidence is increasing. It is usually diagnosed based on a clinical examination, but ultrasonography can be very helpful in diagnosis. Especially in cases where treatment is delayed, surgery is preferable to conservative management, because it is associated with better outcomes and fewer long-term complications.
Diagnosis ; Emergencies ; Follow-Up Studies ; Humans ; Incidence ; Male ; Observational Study ; Penile Diseases ; Penile Prosthesis ; Prospective Studies ; Tertiary Healthcare* ; Ultrasonography ; Ultrasonography, Doppler ; Urogenital System

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Letter to the Editor regarding ‘Treatment of Men for “Low Testosterone”: A Systematic Review’ by Huo et al.; Testosterone Replacement Therapy: Toward to the Robust Evidence and Facts.

Jae Hung JUNG ; Sang Kuk YANG

The World Journal of Men's Health.2016;34(3):224-225. doi:10.5534/wjmh.2016.34.3.224

No abstract available.
Humans ; Male ; Testosterone*

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Diagnosis and Treatment of Premature Ejaculation by Urologists in South Korea.

Deok Ha SEO ; Seong Uk JEH ; See Min CHOI ; Sung Chul KAM ; Sae Woong KIM ; Dae Yul YANG ; Du Geon MOON ; Sang Kuk YANG ; Ki Ha MOON ; Jae Seog HYUN

The World Journal of Men's Health.2016;34(3):217-223. doi:10.5534/wjmh.2016.34.3.217

PURPOSE: This study discusses the treatment of premature ejaculation (PE) using various approaches with the goal of evaluating the methods of diagnosis and treatment of PE in clinical practice in 2014 in South Korea. MATERIALS AND METHODS: We surveyed 200 urologists and andrologists who treated patients with PE from July 1, 2014 to July 29, 2014 using an online questionnaire. The questionnaire was composed of 4 parts: disease, comorbidities, diagnosis, and treatment. Using the answers to this survey, current trends in the diagnosis and treatment of PE were investigated using weighted averages. RESULTS: The median number per month of patients who were diagnosed with PE was 14 patients (interquartile range, 7~24). The time to ejaculation necessary for a diagnosis of PE was considered to be <1 minute by 12% of respondents, <2 minutes by 27%, <3 minutes by 28%, <5 minutes by 13%, and 20% stated that diagnosis was based on a patient's subjective complaint. The treatment methods preferred by PE patients were reported to be pharmacological treatment (87%), surgical treatment (9.5%), and behavioral management (3.5%). The treatment methods used by respondents were pharmacological treatment (77%), surgical treatment (15%), and behavioral management (14%). The most commonly used pharmacological treatment was the oral administration of dapoxetine (97%). CONCLUSIONS: In 2014 in South Korea, various methods were used to diagnose and treat PE. The most commonly used treatment for PE was the oral administration of dapoxetine. It was also found that surgical treatment was applied in some cases.
Administration, Oral ; Comorbidity ; Diagnosis* ; Ejaculation ; Humans ; Korea* ; Male ; Premature Ejaculation* ; Surveys and Questionnaires

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Effects of Betulinic Acid on the Male Reproductive System of a Streptozotocin-Nicotinamide-Induced Diabetic Mouse Model.

Akram AHANGARPOUR ; Ali Akbar OROOJAN ; Layasadat KHORSANDI ; Golshan ARZANI ; Golshan AFSHARI

The World Journal of Men's Health.2016;34(3):209-216. doi:10.5534/wjmh.2016.34.3.209

PURPOSE: The present study was conducted to evaluate the favorable or harmful effects of betulinic acid (BA) on a diabetic reproductive system. MATERIALS AND METHODS: In this experimental study, 60 male Naval Medical Research Institute mice (20∼25 g) were randomly divided into 6 groups: control, diabetes, diabetes+BA (10, 20, and 40 mg/kg), and diabetes+ metformin (200 mg/kg). A diabetic model was induced by a single dose of streptozotocin (STZ) (65 mg/kg) injection intraperitoneally 15 minutes after an intraperitoneal administration of nicotinamide (NA) (120 mg/kg). BA and metformin were gavaged for 2 weeks after confirmed diabetes induction in the treatment groups. One day after the last treatment, plasma luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone levels were evaluated. The cauda epididymis and testis were removed to analyze the sperm count and testis histopathology. RESULTS: LH levels increased in diabetic (p<0.001) and diabetic BA-treated mice (p=0.009). Plasma levels of testosterone (p< 0.001) and sperm count (p=0.04) decreased in these groups when compared to the control group. Furthermore, administration of 10 mg/kg (p=0.001), 20 mg/kg (p=0.004), or 40 mg/kg (p<0.001) of BA led to a greater reduction in plasma testosterone levels compared to the diabetes group. Seminiferous tubule vacuole numbers increased in diabetic and diabetic BA-treated mice, but testis morphology and FSH level assessment revealed no significant differences between the groups. CONCLUSIONS: STZ-NA can induce diabetic alterations in the male reproductive system and the administration of BA in diabetic treated mice resulted in a worse outcome.
Academies and Institutes ; Animals ; Diabetes Mellitus ; Epididymis ; Follicle Stimulating Hormone ; Humans ; Luteinizing Hormone ; Male* ; Metformin ; Mice* ; Niacinamide ; Plasma ; Seminiferous Tubules ; Sperm Count ; Spermatozoa ; Streptozocin ; Testis ; Testosterone ; Vacuoles

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Lower Urinary Tract Symptoms: Prevalence, Perceptions, and Healthcare-Seeking Behavior amongst Nigerian Men.

Rufus Wale OJEWOLA ; Ezekiel Sofela ORIDOTA ; Olanrewaju Samuel BALOGUN ; Ezra Olatunde OGUNDARE ; Taiwo Opeyemi ALABI

The World Journal of Men's Health.2016;34(3):200-208. doi:10.5534/wjmh.2016.34.3.200

PURPOSE: The aim of this study was to determine the prevalence of lower urinary tract symptoms (LUTS) and the factors influencing the healthcare-seeking behavior of men with LUTS. MATERIALS AND METHODS: A cross-sectional survey was performed of 658 men selected using multi-staged sampling techniques. They were interviewed about LUTS and their healthcare-seeking behavior. The data were analysed using PASW Statistics ver. 18. Associations between specific factors and healthcare-seeking behavior were examined using the chi-square and Fisher exact tests. RESULTS: The overall prevalence of LUTS was 59.1%. Storage symptoms (48.2%) were more prevalent than voiding (36.8%) or post-micturition (29.9%) symptoms. Approximately a quarter (25.5%) had a poor quality of life (QoL) score. The average duration of symptoms before seeking help was 3.4 years. Almost half (46.8%) of the men with LUTS had never sought help. Perceptions of LUTS as an inevitable part of ageing, subjective feelings of wellness, financial constraints, and fear of surgery were the most common reasons for not seeking help. The most common reasons for seeking help were to moderate-severe symptoms, impaired QoL, and fear of cancer. Severe LUTS, impaired QoL, and the concomitant presence of erectile dysfunction, dysuria, or haematuria were clinical factors that positively influenced healthcare-seeking behavior. CONCLUSIONS: In this population-based study, we found that the prevalence of LUTS was very high amongst adult males. However, only about half of these men sought medical attention. Their healthcare-seeking behavior was influenced by severity of symptoms, QoL scores, and socio-demographic factors such as educational status.
Adult ; Cross-Sectional Studies ; Dysuria ; Educational Status ; Erectile Dysfunction ; Humans ; Lower Urinary Tract Symptoms* ; Male ; Patient Acceptance of Health Care ; Prevalence* ; Quality of Life

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Effect of Testosterone Replacement Therapy on Cognitive Performance and Depression in Men with Testosterone Deficiency Syndrome.

Hyun Jin JUNG ; Hong Seok SHIN

The World Journal of Men's Health.2016;34(3):194-199. doi:10.5534/wjmh.2016.34.3.194

PURPOSE: We aimed to evaluate the effect of testosterone replacement therapy (TRT) on cognitive function and depression in men with testosterone deficiency syndrome. MATERIALS AND METHODS: We carried out a prospective, placebo-controlled trial involving 106 men with total testosterone levels <3.3 ng/mL and symptoms of hypogonadism. Based on whether the patients received TRT (injection with 1,000 mg testosterone undecanoate) or a placebo (advice to modify lifestyle), the study population was divided into a TRT group (n=54) and a control group (n=52). RESULTS: The age among patients in the TRT and control groups was 56.7±12.6 years and 57.8±11.4 years, respectively (p> 0.05). At baseline, no significant differences between the TRT and control groups were noted regarding serum testosterone or prostate-specific antigen levels, or regarding the scores for aging symptoms (Aging Males' Symptoms scale), erectile function (5-item International Index of Erectile Function questionnaire), cognitive function (Korean Mini-Mental State Examination), and depression (Beck Depression Inventory). At 8 months after intervention total serum testosterone levels and erectile function scores had significantly increased (p<0.05), whereas the scores for aging symptoms and depression had significantly decreased (p<0.05) in the TRT group; no significant improvement in any parameters was noted for the control group. Notably, significant improvement in cognitive function was noted among patients with cognitive impairment at baseline (cognitive function score <25) who received TRT. CONCLUSIONS: TRT may be considered in men with testosterone deficiency syndrome if low testosterone levels are associated with depression or cognitive impairment.
Aging ; Cognition ; Cognition Disorders ; Depression* ; Humans ; Hypogonadism ; Male ; Prospective Studies ; Prostate-Specific Antigen ; Testosterone*

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