Male infertility (MI) and male sexual dysfunction (MSD) can often coexist together due to various interplay factors such as psychosexual, sociocultural and relationship dynamics. The presence of each form of MSD can adversely impact male reproduction and treatment strategies will need to be individualized based on patients’ factors, local expertise, and geographical socioeconomic status. The Asia Pacific Society of Sexual Medicine (APSSM) and the Asian Society of Men’s Health and Aging (ASMHA) aim to provide a consensus statement and practical set of clinical recommendations based on current evidence to guide clinicians in the management of MI and MSD within the Asia-Pacific (AP) region. A comprehensive, narrative review of the literature was performed to identify the various forms of MSD and their association with MI. MEDLINE and EMBASE databases were searched for the following English language articles under the following terms: “low libido”, “erectile dysfunction”, “ejaculatory dysfunction”, “premature ejaculation”, “retrograde ejaculation”, “delayed ejaculation”, “anejaculation”, and “orgasmic dysfunction” between January 2001 to June 2022 with emphasis on published guidelines endorsed by various organizations. This APSSM consensus committee panel evaluated and provided evidence-based recommendations on MI and clinically relevant MSD areas using a modified Delphi method by the panel and specific emphasis on locoregional socioeconomic-cultural issues relevant to the AP region. While variations exist in treatment strategies for managing MI and MSD due to geographical expertise, locoregional resources, and sociocultural factors, the panel agreed that comprehensive fertility evaluation with a multidisciplinary management approach to each MSD domain is recommended. It is important to address individual MI issues with an emphasis on improving spermatogenesis and facilitating reproductive avenues while at the same time, managing various MSD conditions with evidence-based treatments. All therapeutic options should be discussed and implemented based on the patient’s individual needs, beliefs and preferences while incorporating locoregional expertise and available resources.

Objective: A thoracolumbar burst fracture (TLBF) is defined as the failure of the anterior and middle columns of the vertebra due to high-energy trauma, such as motor vehicle collisions and falls from heights. Debate has continued for decades regarding the standard treatment, especially for TLBFs without neurological deficits (TLBF-WONDs). The aim of this study was to understand the role of expandable intravertebral titanium implants (EITIs) in treating TLBF-WONDs. Methods: We included patients aged 18–65 years who presented at our hospital Emergency Department with severe back pain (visual analogue scale [VAS] score ≥ 8), were neurologically intact, were diagnosed with TLBF-WOND by either computed tomography or magnetic resonance imaging, underwent percutaneous bilateral transpedicular EITI implantation, and were followed-up for ≥12 months. Radiological and clinical outcomes were analyzed. Results: Thirty patients satisfied the study inclusion criteria, including 9 men and 21 women, with an average age of 48.2 years. Thirteen A3 and 17 A4 burst fractures were included. The mean duration of hospitalization was 3.3 days. The mean follow-up period was 4.4 years. All patients exhibited significant improvements in radiographical (anterior, middle, and posterior vertebral heights); vertebral kyphotic angle (p<0.001); and functional outcomes (VAS and Oswestry Disability Index scores, p<0.001). One case of cement leakage into the paraspinal muscle was observed; however, no major complications occurred. Conclusion Percutaneous bilateral transpedicular EITI placement with cement augmentation under local anesthesia may be an effective strategy for the treatment of high-energy traumatic TLBFs with neurological integrity.

The Aeromonas species, belonging to the family Aeromonadaceae, are opportunistic pathogens found in humans with an incidence rate of 76 cases per million inhabitants in Southern Taiwan. The incidence of Aeromonas septicemia is relatively low, accounting for less than 15% of cases. Patients diagnosed with Aeromonas hydrophila bacteremia who were presented with skin blisters and septic shock have been reported to have a mortality rate of 100%. Aeromonas infection must be considered in the differential diagnosis of gangrene-like tissue damage or skin lesions in patients with end-stage renal disease, due to the potential sources of infections. A 49-year-old Taiwanese diabetic woman with end-stage renal disease had underwent regular hemodialysis. She was referred to our hospital due to a one-day course of fever, dyspnea, hypotension, and fulminant hemorrhagic blisters covering her whole body. A physical examination uncovered multiple hemorrhagic blisters, along with a ruptured blister over the lower left leg. Laboratory tests revealed an elevation of liver enzymes, impaired renal function, lactatemia, and high anion-gap metabolic acidosis. Cultures of both blood and hemorrhagic blister fluid grew Aeromonas hydrophila. However, she experienced persistent shock despite aggressive intravenous fluid, empiric antibiotics, and inotropic agents with norepinephrine and dopamine. Early diagnosis and prompt management using intravenous fluids, antibiotics and surgical debridement is recommended in order to improve a patient's survival rate.

Prostatic abscess is a rare entity with an incidence of 0.5%–2.5% in all prostate diseases and usually occurs in the 5th and 6th decades of life with immunocompromised status. Prostatic abscess might be a process of evolution from acute prostatitis. Klebsiella pneumoniae is the leading microorganism in the diabetic patients of prostatic abscess in Taiwan. A 60-year-old diabetic man, with a one-week history of acute bacterial prostatitis was reported in this study, presenting to the emergency department with sudden altered mental status. The abdominal computed tomographic scan demonstrated lobulated prostatic abscess and multiple septic pulmonary emboli with lung abscesses. Analysis of cerebrospinal fluid showed white blood cells of 10 771 counts/mm