World Journal of Mens Health最新文献

{"title":"Global Andrology Forum (GAF) Clinical Guidelines on the Management of Infertile Men with Varicocele.","authors":"Selahittin Çayan, Germar-M Pinggera, Widi Atmoko, Taha Hamoda, Rupin Shah, Armand Zini, Eric Chung, Giovanni Maria Colpi, Amarnath Rambhatla, Hiva Alipour, Edmund Y Ko, Nicholas Tadros, Parviz Kavoussi, Manaf Al Hashimi, Taymour Mostafa, Hyun Jun Park, Mikkel Fode, Christopher Chee Kong Ho, Edoardo Pescatori, Ahmed El-Sakka, Mohamed Arafa, Ayman Rashed, Marco Falcone, Gokhan Calik, Aleksei Igorevich Ryzhkov, Tan V Le, Giorgio Ivan Russo, Tuncay Toprak, Fotios Dimitriadis, Shingai Bertrand Angelo Mutambirwa, Muhammad Ujudud Musa, Iman Shamohammadi, Hussein Kandil, Murat Gül, Haitham Elbardisi, Ahmad Tarek Motawi, Sava Micic, Murat Dursun, Taras Shatylko, Coskun Kaya, Ryan Patrick Smith, Nasser Mogharabian, Kareim Khalafalla, Mustafa Kadihasanoglu, Raghavender Kosgi, Osvaldo Rajmil, Yassir Jassim Mohammed, Ashok Agarwal","doi":"10.5534/wjmh.250004","DOIUrl":"https://doi.org/10.5534/wjmh.250004","url":null,"abstract":"<p><strong>Purpose: </strong>Varicocele is among the most common reversible causes of male infertility. Although varicocele is prevalent and there is a growing body of literature on the subject, there are still numerous debates surrounding the matter. This study presents Global Andrology Forum (GAF) clinical guidelines on the management of infertile men with varicocele.</p><p><strong>Materials and methods: </strong>A team of clinicians and reproductive experts reviewed contemporary evidence on all aspects of varicocele, including systematic reviews, meta-analyses, and the results of the GAF global survey of practices. They then formulated expert statements and recommendations, subject to a modified Delphi process until a consensus was reached. The final statements and recommendations were rated using the GRADE system.</p><p><strong>Results: </strong>A total of 31 statements and recommendations on the evaluation and management of varicocele were introduced and scored by 24 experts. All experts agreed with the final statements. Varicocele is a significant contributor to male infertility. Its diagnosis is based mainly on physical examination, although imaging can be used in certain cases. Clinical varicocele associated with abnormal sperm parameters is the primary unanimous indication of varicocele repair. However, other indications can still be considered, and recommendations for a tailored approach to controversial situations have been presented. There is inadequate evidence on the use of medical therapy for varicocele.</p><p><strong>Conclusions: </strong>These clinical guidelines on the management of infertile men with varicocele, based on the GAF surveys, systematic reviews, and meta-analyses, point out the pivotal importance of varicocele in modern Andrology. Continued research is crucial to improving diagnostic accuracy and treatment outcomes, ultimately enhancing reproductive health for men with varicocele. Therefore, the current guidelines allow clinicians to develop effective management strategies for a common issue and address practical questions where evidence is lacking.</p>","PeriodicalId":54261,"journal":{"name":"World Journal of Mens Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Andrology Forum Clinical Guidelines on the Relevance of Sperm DNA Fragmentation in Reproductive Medicine.","authors":"Selahittin Çayan, Ala'a Farkouh, Ashok Agarwal, Widi Atmoko, Christine Wyns, Mohamed Arafa, Armand Zini, Rupin Shah, Hiva Alipour, Eric Chung, Ramadan Saleh, Germar-Michael Pinggera, Charalampos Konstantinidis, Manaf Al Hashimi, Edoardo Pescatori, Amarnath Rambhatla, Tuncay Toprak, Aldo E Calogero, Murat Gül, Hyun Jun Park, Baris Altay, Marco Falcone, Ayman Rashed, Tan V Le, Fahmi Bahar, Taras Shatylko, Sadık Görür, Ahmed I El-Sakka, Barış Saylam, Selcuk Sarikaya, Ryan Patrick Smith, Luca Boeri, Ozan Efesoy, Erman Ceyhan, Giorgio Ivan Russo, Cevahir Ozer, Christopher Chee Kong Ho, Nur Dokuzeylul Gungor, Deniz Noyan Özlü, Juan Manuel Corral Molina, Muhammad Ujudud Musa, Akira Tsujimura, Fatih Gokalp, Mohamed Saeed Mohamed, Keisuke Okada, Kareim Khalafalla, Shinnosuke Kuroda, Saleh Binsaleh, Ahmad Tarek Motawi, Iman Shamohammadi, Nasser Mogharabian, Manh Truong Manh, Emad Abdelraheem Taha, Konstantinos Makarounis, Siu King Mak, Shedeed Ashour Shedeed, Charalampos Thomas, Taymour Mostafa","doi":"10.5534/wjmh.250005","DOIUrl":"https://doi.org/10.5534/wjmh.250005","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the evidence on sperm DNA fragmentation (SDF) and its clinical applications in reproductive medicine, highlighting benefits, limitations, and guidelines for its use to assist clinicians in objective decision-making.</p><p><strong>Materials and methods: </strong>A multidisciplinary team of clinicians and reproductive experts from the Global Andrology Forum (GAF) reviewed the latest evidence on SDF, covering indications, testing methods, recurrent pregnancy loss, varicocele and its repair, assisted reproductive technologies (ART), treatment of associated conditions, antioxidant therapy, and sperm selection for ART. Expert statements and recommendations were developed and graded with the GRADE system using a modified Delphi process.</p><p><strong>Results: </strong>Based on the GAF surveys, systematic reviews, and meta-analyses related to SDF, 52 experts introduced and scored 24 statements and recommendations using the GRADE system. Of these, 87.5% (21/24) achieved strong ratings, reflecting broad consensus, while 12.5% (3/24) were rated weak. The guidelines provide evidence-based recommendations for clinical scenarios, including the role of SDF in infertility, recurrent pregnancy loss, and ART outcomes.</p><p><strong>Conclusions: </strong>While there is growing interest and evidence regarding the clinical benefit of SDF testing and its utility in managing male infertility, significant gaps in the literature limit its routine use in clinical practice. The guidelines offer a structured framework for integrating SDF testing into male infertility management, emphasizing a tailored approach based on individual clinical scenarios. Clinicians must balance the benefits and limitations of SDF testing and antioxidant treatment to optimize care in reproductive medicine. These guidelines are critical for advancing evidence-based practices in male infertility management.</p>","PeriodicalId":54261,"journal":{"name":"World Journal of Mens Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse Effects of Nicotine on Human Sperm Nuclear Proteins.","authors":"Amir Masoud Firouzabadi, Ralf Henkel, Maryam Tofighi Niaki, Farzaneh Fesahat","doi":"10.5534/wjmh.240072","DOIUrl":"10.5534/wjmh.240072","url":null,"abstract":"<p><p>The effects of smoking on human health have long been documented. However, only a few studies have highlighted the direct effects of nicotine on sperm function. Nicotine, as a chemical compound found in tobacco, has been shown to modulate different aspects of spermatogenesis and sperm functions. Nicotine can lead to a reduction in the number of sperm, their motility and functionality. It can change the molecular expressions involved in sperm function, including genes encoding sperm nuclear proteins. The most important nuclear proteins that play a critical role in sperm function are known as H2B histone family, member W, testis-specific (H2BFWT), transition protein 1 (TNP1), transition protein 2 (TNP2), protamine-1 (PRM1), and protamine-2 (PRM2). These proteins are involved in sperm chromatin condensation, which in turn affects fertilization and embryonic development. Any alteration in the expression of these genes due to nicotine exposure/usage may lead to adverse implications in couples' fertility and the health of future generations. Since research in this area is still relatively new, it underscores the importance of understanding the potential side effects of environmental factors such as nicotine on reproductive health.</p>","PeriodicalId":54261,"journal":{"name":"World Journal of Mens Health","volume":" ","pages":"291-303"},"PeriodicalIF":4.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Which Dermal Filler is Better for Penile Augmentation for Aesthetic Purposes? A Prospective, Single-Surgeon Study Based on Real-World Experience.","authors":"Doo Won Kim, Hyun Cheol Jeong, Kyungtae Ko, Dae Yul Yang, Jong Keun Kim, Seong Ho Lee, Tae Hyo Kim, Won Ki Lee","doi":"10.5534/wjmh.240105","DOIUrl":"10.5534/wjmh.240105","url":null,"abstract":"<p><strong>Purpose: </strong>Several types of dermal fillers have been recently introduced and used for penile augmentation (PA). However, few studies have compared outcomes after the injection of different fillers. This study aimed to compare the clinical outcomes of hyaluronic acid (HLA), polylactic acid (PLA), and polymethyl methacrylate (PMA) filler injections, which are the most commonly used for aesthetic purposes.</p><p><strong>Materials and methods: </strong>This prospective study was conducted for 24 weeks after a filler injection by a surgeon between March 2017 and December 2021. Healthy adult men complaining of small penis were enrolled. Penile girth, satisfaction, and injection-associated adverse events (AEs) were assessed at baseline and 4, 12, and 24 weeks after injection.</p><p><strong>Results: </strong>Of the 301 men who received filler injections, 125, 134, and 42 received HLA, PLA, and PMA fillers, respectively. The augmentation effect was in the order of PMA, HLA, and PLA, respectively, at 24 weeks (PMA <i>vs.</i> HLA, p<0.001; HLA <i>vs.</i> PLA, p=0.006). Satisfaction levels increased significantly at 24 weeks in all groups (each with p<0.001). However, the increase in satisfaction levels was smaller in the PMA group (PMA <i>vs.</i> HLA or PLA, p<0.05, for both penile appearance and sexual life). No serious or systemic AEs were recorded. Filler injection-associated local AEs in the HLA, PLA, and PMA groups occurred in 9 (7.2%), 16 (11.9%), and 6 (14.3%) men, respectively. There was no significant difference in AEs among the groups (p=0.299).</p><p><strong>Conclusions: </strong>The augmentative effect was greater in the PMA group than in the HLA and PLA groups, whereas the increase in satisfaction levels was smaller in the PMA group. Our study demonstrated the clinical course of different types of fillers and suggests that the filler type should be selected after detailed counseling considering individual characteristics and preferences.</p>","PeriodicalId":54261,"journal":{"name":"World Journal of Mens Health","volume":" ","pages":"428-436"},"PeriodicalIF":4.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urethral Sparing <i>versus</i> Trans-Vesical Robot-Assisted Simple Prostatectomy: A Comparative Analysis of Perioperative, Postoperative Outcomes, and Ejaculation Preservation.","authors":"Yu Seob Shin, Shang Weon Pak, Wonku Hwang, Seon Beom Jo, Jong Wook Kim, Mi Mi Oh, Hong Seok Park, Du Geon Moon, Sun Tae Ahn","doi":"10.5534/wjmh.240023","DOIUrl":"10.5534/wjmh.240023","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the perioperative and postoperative outcomes between traditional trans-vesical robot-assisted simple prostatectomy (TV-RASP) and the newly introduced urethral-sparing (US) RASP.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed 42 patients who underwent TV-RASP (n=22) or US-RASP (n=20) performed by two experienced surgeons at two tertiary centers. Perioperative outcomes including operation time, estimated blood loss, length of hospital stay, and catheterization time were assessed. Postoperative outcomes were evaluated using the International Prostate Symptom Score (IPSS), quality of life (QoL), uroflowmetry parameters, Male Sexual Health Questionnaire-Ejaculation Dysfunction-Short Form (MSHQ-EjD-SF) scores, and maintenance of anterograde ejaculation.</p><p><strong>Results: </strong>This study analyzed 22 and 20 patients who underwent TV-RASP and US-RASP, respectively. Except for the TV-RASP group being older (70.0 years) than the US-RASP group (64.5 years) (p=0.028), no differences among other baseline characteristics existed. Perioperative outcomes indicated that hospital stay and catheterization time were significantly shorter in the US-RASP group than in the TV-RASP group (p<0.001). At postoperative month 1, the median IPSS and QoL scores were significantly better in the US-RASP group than in the TV-RASP group (p=0.001 and p=0.002, respectively). However, at months 6 and 12, no significant differences were noted in IPSS, QoL, maximum flow rate, and postvoid residual urine between the two groups. Sexually active patients in the US-RASP group maintained postoperative MSHQ-EjD functional and bother scores, whereas the TV-RASP group experienced a decline. Notably, 75.0% of patients in the US-RASP group preserved antegrade ejaculation, compared to only 20.0% in the TV-RASP group (p<0.001).</p><p><strong>Conclusions: </strong>US-RASP is not inferior to TV-RASP in terms of functional outcomes. In addition, US-RASP yielded more rapid symptom improvements and preserved antegrade ejaculation than TV-RASP. However, larger prospective studies are required to confirm these findings and to further investigate the long-term efficacy and safety of US-RASP.</p>","PeriodicalId":54261,"journal":{"name":"World Journal of Mens Health","volume":" ","pages":"387-395"},"PeriodicalIF":4.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141307407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic Effects of Mesenchymal Stem Cell Conditioned Medium in Rat Varicocele Model.","authors":"Ege Can Serefoglu, Bircan Kolbasi, Muhammet Volkan Bulbul, Seda Karabulut, Cagri Cakici, Reyhan Zeynep Gundogdu Ozdemir, Ilknur Keskin","doi":"10.5534/wjmh.240059","DOIUrl":"10.5534/wjmh.240059","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to examine the therapeutic effects of injection of conditioned medium of adipose-derived mesenchymal stem cells (ADMSC-CM) in a surgically created varicocele model in comparison with varicocelectomy.</p><p><strong>Materials and methods: </strong>Twenty-eight male Wistar Albino rats were randomly divided into four groups: sham group, varicocele group, varicocelectomy group, and ADMSC-CM injection group. Sperm parameters were analyzed in samples taken from the epididymis after treatment. Malondialdehyde and superoxide dismutase (SOD) levels in blood samples were examined by biochemical analysis. The testicular tissues were stained with hematoxylin-eosin for histological examination (Johnsen's Score). Additionally, Western Blot analyzes were performed to detect Claudin-11 levels, the functional protein of the blood-testis barrier, in testicular tissues.</p><p><strong>Results: </strong>Varicocelectomy and ADMSC-CM treatments significantly improved mean sperm parameters (concentration, progressive motility, motility, normal sperm morphology) (p≤0.05 for all). Both treatment groups had increased SOD levels along with a decrease in malondialdehyde levels (p≤0.05 for all). No significant difference was observed between the ADMSC-CM group and the varicocelectomy group in preserving normal testicular histology according to Johnsen's Score (p=0.114). Levels of Claudin-11 were significantly higher in the varicocelectomy and ADMSC-CM groups compared to the varicocele group (p≤0.05 for all).</p><p><strong>Conclusions: </strong>The therapeutic effects of ADMSC-CM in varicocele model may involve secretion of anti-inflammatory and regenerative factors from ADMSC. ADMSC-CM injection appears to be a promising new strategy in the treatment of varicocele.</p>","PeriodicalId":54261,"journal":{"name":"World Journal of Mens Health","volume":" ","pages":"437-447"},"PeriodicalIF":4.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weight Loss as Therapeutic Option to Restore Fertility in Obese Men: A Meta-Analytic Study.","authors":"Daniele Santi, Carla Greco, Arcangelo Barbonetti, Manuela Simoni, Mario Maggi, Giovanni Corona","doi":"10.5534/wjmh.240091","DOIUrl":"10.5534/wjmh.240091","url":null,"abstract":"<p><strong>Purpose: </strong>Weight loss has been shown to significantly elevate testosterone serum levels, though the impact on semen analysis parameters and fertility remains incompletely understood. The objective of this study was to examine the influence of body weight loss on semen parameters in obese men.</p><p><strong>Materials and methods: </strong>A meta-analysis was performed that included clinical trials in which a semen analysis before and after weight loss was evaluated. All strategies potentially available for weight loss were considered eligible. The primary outcome was the comparison of conventional semen analysis parameters before and after weight loss.</p><p><strong>Results: </strong>Twelve studies were considered including 345 subjects (mean age 37.6±7.9 years; mean baseline body mass index 45.4±6.0 kg/m²). Weight loss resulted in a significant increase of sperm concentration (effect size 0.495, standard error 0.251 [0.003, 0.986], p=0.049) and progressive motility (effect size 0.567, standard error 0.372 [0.370, 0.764], p<0.001). Moreover, a significant decrease of sperm DNA fragmentation index after weight loss (effect size -0.689, standard error 0.278 [-1.123, -0.255], p=0.002) was observed.</p><p><strong>Conclusions: </strong>This meta-analytic analysis confirmed that body weight loss may improve qualitative and quantitative sperm characteristics providing evidence for suggesting weight loss to male partners with obesity and semen analysis alteration in couples attempting conception.</p>","PeriodicalId":54261,"journal":{"name":"World Journal of Mens Health","volume":" ","pages":"333-343"},"PeriodicalIF":4.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Varicocele Repair on Assisted Reproductive Technique Outcomes in Infertile Men: A Systematic Review and Meta-Analysis.","authors":"Ayad Palani, Rossella Cannarella, Ramadan Saleh, Gianmaria Salvio, Ahmed M Harraz, Andrea Crafa, Fahmi Bahar, Kadir Bocu, Naveen Kumar, Priyank Kothari, Germar-Michael Pinggera, Selahittin Cayan, Giovanni M Colpi, Widi Atmoko, Rupin Shah, Ashok Agarwal","doi":"10.5534/wjmh.240132","DOIUrl":"10.5534/wjmh.240132","url":null,"abstract":"<p><strong>Purpose: </strong>In this systematic review and meta-analysis, we investigated assisted reproductive technology (ART) success in infertile men with clinical varicocele and abnormal semen parameters who underwent varicocele repair (VR) before the ART procedure as compared to those who did not.</p><p><strong>Materials and methods: </strong>A comprehensive search of the Scopus, PubMed, Embase, and Cochrane Library databases was conducted using a specific query string to identify studies examining the impact of VR on ART outcomes, including fertilization rate, clinical pregnancy, pregnancy loss, and live-birth rate, until October 2023. Outcomes were analyzed based on the type of ART. Studies on VR in infertile men with non-obstructive azoospermia and those who underwent ART only due to female factor infertility were excluded from the study.</p><p><strong>Results: </strong>Out of 1,554 articles reviewed, only 9 met the inclusion criteria for the study. All the included articles were observational studies. The variability in study quality in the included literature resulted in a moderate overall risk of bias. Data analysis showed that for intrauterine insemination, there was no difference in the clinical pregnancy rate (odds ratio [OR] 1.01, 95% confidence interval [CI]: 0.42, 2.45; p=0.97). However, for intracytoplasmic sperm injection (ICSI), men with VR showed a significant improvement in fertilization rate (mean difference 10.9, 95% CI: 5.94, 15.89; p<0.01), clinical pregnancy rate (OR 1.38, 95% CI: 1.07, 1.78; p=0.01) and live-birth rate (OR 2.07, 95% CI: 1.45, 2.97; p<0.01), compared to men who did not undergo VR.</p><p><strong>Conclusions: </strong>The findings of this systematic review and meta-analysis suggest that VR has a positive impact on pregnancy and live birth rates after ICSI. However, biases like small sample sizes and heterogeneous populations highlight the need for larger, well-designed prospective studies to validate these findings.</p>","PeriodicalId":54261,"journal":{"name":"World Journal of Mens Health","volume":" ","pages":"344-358"},"PeriodicalIF":4.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tailoring Treatment: The Role of Sex/Gender-Specific Medicine.","authors":"Nayoung Kim","doi":"10.5534/wjmh.240123","DOIUrl":"10.5534/wjmh.240123","url":null,"abstract":"","PeriodicalId":54261,"journal":{"name":"World Journal of Mens Health","volume":" ","pages":"259-264"},"PeriodicalIF":4.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radial Type Low-Intensity Extracorporeal Shockwave Therapy Enhances Penile Microvascular Perfusion in an Aging Rat Model: A Novel Interventional Strategy to Treat Erectile Dysfunction.","authors":"Saager Tilak Chawla, Jad Shahan, Nolan Soutipan, Samuel Ryan Sorkhi, Yong Sun Choi, Woong Jin Bae, Sae Woong Kim, Tung-Chin Hsieh, Mahadevan Raj Rajasekaran","doi":"10.5534/wjmh.240032","DOIUrl":"10.5534/wjmh.240032","url":null,"abstract":"<p><strong>Purpose: </strong>Physiological aging is associated with microvascular dysfunction, including in the penis, and this may contribute to age-related erectile dysfunction (ED). Low-intensity extracorporeal shockwave therapy (Li-ESWT) is a non-invasive intervention for ED, but its effect on penile microvascular function, remains unclear. Our objectives are to (i) evaluate the effect of Li-ESWT (specifically radial type ESWT [rESWT]) on penile microvascular perfusion (PMP) in aging rats, (ii) elucidate a possible mechanism, and (iii) evaluate its impact on angiogenic and smooth muscle biomarkers in cavernosal tissue.</p><p><strong>Materials and methods: </strong>Male rats (n=9; 15-18 months) were anesthetized and subjected to rESWT while monitoring PMP. The nitric oxide (NO) pathway involvement was assessed by measuring the effect of rESWT on PMP following an intracavernosal injection of N(G)-nitroarginine methyl ester (L-NAME) (NO synthase inhibitor). To elucidate the cellular mechanism, another group of rats received repeated rESWT (n=4) or no treatment (n=4) three times/week for two weeks. Rats were euthanized at the end of the study and penile tissues were analyzed for angiogenic markers (vascular endothelial growth factor-A [VEGF-A], endothelial nitric oxide synthase [eNOS]) and smooth muscle content (α-actin) using immunostaining, Western blot, and quantitative polymerase chain reaction (qPCR).</p><p><strong>Results: </strong>rESWT resulted in more than a 2-fold increase in PMP (from 68.5 arbitrary units; 163.7 AU). L-NAME injection produced a <40%-50% decrease (185.3 to 101.0 AU) in rESWT-induced PMP response. Immunostaining revealed increased α-actin, eNOS, and VEGF-A in the cavernosum and these findings were confirmed by qPCR and Western blot results.</p><p><strong>Conclusions: </strong>rESWT improved PMP, which may be mediated <i>via</i> increased VEGF expression, which stimulates the NO/cyclic guanosine monophosphate pathway, resulting in sustained PMP. rESWT devices could offer a safe, non-invasive treatment for age-related ED.</p>","PeriodicalId":54261,"journal":{"name":"World Journal of Mens Health","volume":" ","pages":"396-406"},"PeriodicalIF":4.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141307406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}