World Journal of Mens Health最新文献

{"title":"Sex-Specific Associations of <i>Helicobacter pylori</i> Seropositivity and Intestinal Metaplasia with Colorectal Adenoma: A Korean Multicenter Cross-Sectional Study.","authors":"Hee Jin Kim, Nayoung Kim, Sung Eun Kim, Ju Yup Lee, Kwangwoo Nam, Hyun Joo Song, Wan Sik Lee, Seon Hee Lim, Hyun Jin Kim, Gwang Ho Baik, Min Woo Lee, Suck Chei Choi","doi":"10.5534/wjmh.260174","DOIUrl":"10.5534/wjmh.260174","url":null,"abstract":"<p><strong>Purpose: </strong>Male sex is a recognized risk factor for colorectal adenoma, yet whether the associations of <i>Helicobacter pylori</i>, atrophic gastritis (AG), and intestinal metaplasia (IM) with colorectal adenoma differ by sex remains unclear. This study evaluated the sex-stratified and combined associations of anti-<i>H. pylori</i> IgG seropositivity, AG, and IM with conventional colorectal adenoma.</p><p><strong>Materials and methods: </strong>This multicenter cross-sectional study included 806 participants from a Korean health-screening cohort who underwent gastroscopy with <i>H. pylori</i> testing and colonoscopy within 3 years. Anti-<i>H. pylori</i> IgG seropositivity was determined by enzyme-linked immunosorbent assay, AG and IM were assessed endoscopically. Multivariable logistic regression models were adjusted for age, sex, body mass index, smoking, and alcohol consumption.</p><p><strong>Results: </strong>Colorectal adenoma was identified in 209 participants (25.6%). Anti-<i>H. pylori</i> IgG seropositivity was independently associated with colorectal adenoma (adjusted odds ratio [aOR], 1.848; 95% confidence interval [CI], 1.323 to 2.581; p<0.001). AG was not significant after adjustment. IM was independently associated in a separate model (aOR, 1.648; 95% CI, 1.125 to 2.415; p=0.010), but showed only borderline significance in the combined model when including <i>H. pylori</i> seropositivity (aOR, 1.440; 95% CI, 0.973 to 2.131; p=0.068), whereas anti-<i>H. pylori</i> IgG seropositivity remained significant. Participants with both <i>H. pylori</i> seropositivity and IM showed the highest odds of colorectal adenoma. In sex-stratified analyses, anti-<i>H. pylori</i> IgG seropositivity was independently associated in males (aOR, 1.811; 95% CI, 1.147 to 2.860; p=0.011) but not in females, whereas IM was independently associated in females (aOR, 2.086; 95% CI, 1.129 to 3.856; p=0.019) but not in males. Formal interaction tests were not statistically significant.</p><p><strong>Conclusions: </strong>Anti-<i>H. pylori</i> IgG seropositivity and IM were associated with conventional colorectal adenoma, whereas AG was not significant after adjustment. Sex-stratified analyses suggested potential sex-related patterns, with <i>H. pylori</i> seropositivity appearing more prominent in males and IM appearing more prominent in females.</p>","PeriodicalId":54261,"journal":{"name":"World Journal of Mens Health","volume":" ","pages":"1097-1107"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680663","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":"Preoperative Varicocele Severity and Sperm Concentration Are Associated with Absence of Internal Spermatic Vein Reflux in Patients Undergoing Varicocele Embolization: Results from A Cross-Sectional Study.","authors":"Ludovico Maria Basadonna, Federica Passarelli, Irene Fulgheri, Edoardo Sorba, Giorgio Graps, Fabio Ciamarra, Damiano Dagnino, Franco Gadda, Valentina Parolin, Giancarlo Albo, Elisa De Lorenzis, Anna Maria Ierardi, Gianpaolo Carrafiello, Emanuele Montanari, Luca Boeri","doi":"10.5534/wjmh.250180","DOIUrl":"10.5534/wjmh.250180","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the prevalence and predictors of absence of internal spermatic vein (ISV) reflux during varicocele embolization in infertile male.</p><p><strong>Materials and methods: </strong>Demographic, clinical and laboratory data from 237 infertile males treated with percutaneous varicocele embolization between January 2017 and November 2024 were analyzed. Each patient underwent color Doppler ultrasound (CDUS) and semen analysis, both repeated 6 months post-procedure. Semen analysis values were based on 2021 World Health Organization reference criteria. Descriptive statistics and logistic regression models tested the association between predictors and embolization failure.</p><p><strong>Results: </strong>Median age was 28 (IQR 22-34) years. Median preoperative semen parameters included sperm concentration of 22 (10.0-44.5) ×10⁶/mL, progressive motility of 35% (25%-40%), and normal morphology of 3% (2%-5%). Nearly half (48.9%) had CDUS grade ≥4 varicocele. Venous access was achieved via the right internal jugular vein in 46.4% and right common femoral vein in 53.6% of cases. Treatment was not performed in 1.3% of patients due to failure in catheterizing the spermatic vein and in 10.5% due to absence of ISV insufficiency during Valsalva. ISV reflux was more frequently absent in patients with grade III <i>vs.</i> grade IV-V varicocele (72.0% <i>vs.</i> 48.3%, p=0.02). After 2020, expert-driven ultrasound reduced the rate of phlebography-negative varicoceles (40% <i>vs.</i> 60%, p=0.03). Patients with confirmed varicocele had lower sperm concentration (20 ×10⁶/mL <i>vs.</i> 26 ×10⁶/mL, p=0.02). Grade III varicocele (OR 5.2; p=0.01) and higher sperm concentration (OR 1.1; p=0.03) were independent predictors of absent ISV reflux. Those with grade III varicocele and sperm count >20 ×10⁶/mL had a 96% likelihood of reflux absence.</p><p><strong>Conclusions: </strong>Grade III varicocele and higher preoperative sperm concentration independently predicted the absence of ISV reflux, highlighting their role in patient selection. After expert-driven US implementation, the rate of no varicocele at phlebography significantly decreased.</p>","PeriodicalId":54261,"journal":{"name":"World Journal of Mens Health","volume":" ","pages":"1037-1045"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233918","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":"Effects of Radiation Therapy on the Incidence of Bladder Cancer and Rectal Cancer in Patients with Prostate Cancer: A Nationwide Nested Case-Control Study in Korean Population.","authors":"Jongkyou Kwon, Jinhyung Jeon, Hye Sun Lee, Soyoung Jeon, Sungun Bang, Kwang Suk Lee, Kyo Chul Koo, Kang Su Cho, Do Kyung Kim","doi":"10.5534/wjmh.250298","DOIUrl":"10.5534/wjmh.250298","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess the risk of secondary bladder and colorectal cancers following radiotherapy for prostate cancer using a nationwide nested case-control design based on Korea's Health Insurance Review and Assessment database.</p><p><strong>Materials and methods: </strong>We conducted a nationwide nested case-control study using database, including men newly diagnosed with prostate cancer between 2011 and 2020. Patients were classified into radiotherapy and non-radiotherapy groups and matched 1:1 based on age, comorbidity index, and follow-up duration. Conditional logistic regression was used to assess the association between radiotherapy and secondary bladder and colorectal cancer incidences.</p><p><strong>Results: </strong>In the crude cohort, radiotherapy was not significantly associated with secondary bladder or colorectal cancer. Kaplan-Meier analysis showed no significant differences in the cumulative incidence between radiotherapy and non-radiotherapy groups. However, nested case-control analysis revealed a significantly increased risk of secondary bladder cancer in the radiotherapy group (adjusted hazard ratio, 1.38; 95% confidence interval, 1.02 to 1.86), while no association was found for colorectal cancer (adjusted hazard ratio, 0.96; 95% confidence interval, 0.72 to 1.27).</p><p><strong>Conclusions: </strong>Radiotherapy was linked to an increased bladder cancer risk but not colorectal cancer risk, underscoring the need for targeted long-term surveillance.</p>","PeriodicalId":54261,"journal":{"name":"World Journal of Mens Health","volume":" ","pages":"1086-1096"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229727","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":"Does Testosterone Therapy Increase Risk of Atrial Fibrillation? Appraisal of the Contemporary Scientific and Clinical Evidence.","authors":"Abdulmaged M Traish, Karim Sultan Haider, Farid Saad","doi":"10.5534/wjmh.260004","DOIUrl":"10.5534/wjmh.260004","url":null,"abstract":"<p><p>Here we review the evidence whether \"testosterone\" (T) therapy in hypogonadal men contributes to onset and increases the incidence of atrial fibrillation (AF). A MEDLINE review of the literature was performed, and relevant studies were analyzed and discussed. The effect of T therapy (TTh) on the incidence of AF is a controversial clinical issue that remains hotly debated. Few studies have purported that TTh increases the incidence of AF. However, a closer look at these studied suggest that several confounding factors may have contributed to the authors' conclusion that T increases the incidence of AF. On the contrary, a much larger number of studies have demonstrated that T deficiency contributes to incidence of AF and TTh does not increase the incidence of AF. Because this clinical issue is of critical importance in management of men with hypogonadism, it is critical that more clinical studies with AF as the primary outcome measure need to be considered. However, to date, none of the clinical trials have focused on AF as the primary outcome and in most of the reported studies AF was a secondary or tertiary outcome measure. Thus, lack of accurate clinical data on this issue will remain in the helm of debate, until new clinical trial data becomes available. We conclude that the findings of numerous studies suggest that low circulating levels (T deficiency) are associated with greater incidence of AF and higher endogenous T levels or TTh in hypogonadal men are associated with lower incidence of AF.</p>","PeriodicalId":54261,"journal":{"name":"World Journal of Mens Health","volume":" ","pages":"779-787"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392604","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":"ETS Homologous Factor Drives Endothelial Dysfunction in Diabetes-Related Erectile Dysfunction <i>via</i> Regulating SPRY1 Ubiquitination and NOS3 Autophagy.","authors":"Chunhui Liu, Ning Liu, Zonghao You, Shuqiu Chen, Jianping Wu, Jia Zhao, Ming Chen, Shenghui Liang, Chao Sun","doi":"10.5534/wjmh.250095","DOIUrl":"10.5534/wjmh.250095","url":null,"abstract":"<p><strong>Purpose: </strong>Diabetes mellitus (DM)-related erectile dysfunction (DMED), a prevalent complication of diabetes, is closely associated with endothelial dysfunction. This study investigated the role of E26 transformation-specific homologous factor (Ehf) in mediating endothelial dysfunction in DMED and explored its downstream molecular mechanisms.</p><p><strong>Materials and methods: </strong>Rat corpus cavernosum endothelial cells (CCECs) were cultured under high glucose (HG) conditions to simulate a diabetic environment <i>in vitro</i>. Endothelial function was assessed through functional assays, including tube formation and Evans blue permeability tests, following overexpression or knockdown of <i>Ehf</i>, <i>Spry1</i>, or <i>Nos3</i>. Co-immunoprecipitation, ChIP, and dual-luciferase reporter assays were utilized to evaluate molecular interactions and regulatory mechanisms.</p><p><strong>Results: </strong><i>Ehf</i> expression was significantly elevated in HG-treated CCECs and impaired endothelial function through two distinct mechanisms. First, <i>Ehf</i> stabilized the angiogenesis inhibitor SPRY1 by promoting its acetylation at lysine 300 <i>via</i> ESCO1, thereby reducing its ubiquitination by NEDD4. Second, <i>Ehf</i> induced NOS3 degradation through autophagy by upregulating ATG5 and enhancing the NOS3-NBR1 interaction. These dual mechanisms suppressed angiogenesis and increased vascular permeability, contributing to endothelial dysfunction in DMED.</p><p><strong>Conclusions: </strong><i>Ehf</i> exacerbates DMED by disrupting penile endothelial function through SPRY1 stabilization and NOS3 degradation. These findings present novel molecular targets for potential therapeutic strategies in DMED.</p>","PeriodicalId":54261,"journal":{"name":"World Journal of Mens Health","volume":" ","pages":"1003-1016"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229750","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":"Localization and Expression of Pericytes in the Corpus Cavernosum of Castrated Rats.","authors":"Soo Kyung Cho, Hyun-Suk Lee, Kwangsung Park, Ho Seok Chung","doi":"10.5534/wjmh.250224","DOIUrl":"10.5534/wjmh.250224","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to investigate the localization and expression of pericytes in the rat corpus cavernosum (CC) following testosterone deficiency induced by castration and after testosterone replacement therapy (TRT).</p><p><strong>Materials and methods: </strong>Thirty 12-week-old male Sprague-Dawley rats were assigned to three groups: control (n=10), castration-only (n=10), and castration groups treated with daily testosterone propionate injections (n=10). After 4 weeks, markers for endothelial cells (ECs; CD34, Flk1, and VE-cadherin), pericytes (NG2), and smooth muscle cells (smooth muscle actin) were analyzed using immunofluorescence and western blot analysis.</p><p><strong>Results: </strong>Confocal microscopy revealed that EC markers were predominantly localized within the cavernosal sinusoidal endothelium, while NG2⁺ pericytes were primarily observed in the subtunical region. Castrated rats exhibited reduced immunoreactivity of CD34⁺ ECs, SMA⁺ SMCs, and NG2⁺ pericytes compared to those of the control group. TRT restored these markers to levels approaching those of the control group. Protein expression levels of CD34 and NG2 exhibited similar patterns.</p><p><strong>Conclusions: </strong>Pericytes are predominantly located in the subendothelial region of the CC, and testosterone levels significantly influence their expression. Further studies are necessary to evaluate the effect of different durations of TRT on cellular expression.</p>","PeriodicalId":54261,"journal":{"name":"World Journal of Mens Health","volume":" ","pages":"1108-1116"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936448","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 Effect of Micro-Energy Treatment for Erectile Dysfunction: A Systematic Review and Meta-Analysis Based on Randomized Controlled Trials.","authors":"Hao Li, Wenchao Xu, Tao Wang, Jihong Liu, Meiliyang Wu","doi":"10.5534/wjmh.250151","DOIUrl":"10.5534/wjmh.250151","url":null,"abstract":"<p><strong>Purpose: </strong>As an emerging therapeutic option for erectile dysfunction (ED), micro-energy treatment (MET) including low-intensity extracorporeal shockwave therapy, low-intensity pulsed ultrasound, and electromagnetic fields, has attracted increasing attention. We summarized the current literature to assess the therapeutic effect and find optimal treatment scheme of MET for ED.</p><p><strong>Materials and methods: </strong>A comprehensive search of PubMed, Web of Science, and Embase up to April 2025 was performed. Studies reporting on ED treated with various METs were included. The International Index of Erectile Function and the Erection Hardness Score were used to evaluate the therapeutic effect. Subgroup analysis was performed to explore the influence of energy type, treatment course, treatment frequency, patients' characteristics, combination therapy, and setup parameters on efficacy.</p><p><strong>Results: </strong>A total of 32 randomized controlled trials with 1,986 patients were enrolled. MET group demonstrated better erectile function than control at 1, 3, 6, and 12 months post-treatment (p<0.05). No significant difference was observed among different energy types, treatment courses, or setup parameters. Patients' comorbidities and responsiveness to phosphodiesterase 5 inhibitors did not influence efficacy. Treatment twice weekly was superior to once (p<0.05). Vasculogenic ED responded better than neurogenic ED (p<0.05). Combination with other basic therapies enhanced efficacy of MET (p<0.05).</p><p><strong>Conclusions: </strong>MET was effective for various types of ED, especially vasculogenic ones, with efficacy lasting up to 1 year and no discrepancy among different energy forms. Twice-weekly treatment with course no more than 4 weeks was an appropriate therapeutic protocol. Moreover, combining MET with other therapies could produce synergistic effect.</p>","PeriodicalId":54261,"journal":{"name":"World Journal of Mens Health","volume":" ","pages":"844-863"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234078","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":"Sexual Orientation Disparities in Mental Health Vulnerabilities: Exploring Body Image Dissatisfaction and Desired Changes in Physical Attributes among Cisgender Heterosexual, Homosexual, and Bisexual Men in Taiwan.","authors":"Jiun-Hau Huang, Michelle Wang, Jen-Hao Chu","doi":"10.5534/wjmh.250108","DOIUrl":"10.5534/wjmh.250108","url":null,"abstract":"<p><strong>Purpose: </strong>Little is known about Asian cisgender men's body image dissatisfaction (BID) and its variation among heterosexual, homosexual, and bisexual men. This study aimed to explore and better understand their specific BID concerns regarding various body parts and desired changes in physical attributes (DCPA), shedding light on the intersection of BID and sexual orientation among Asian men.</p><p><strong>Materials and methods: </strong>A cross-sectional anonymous survey was conducted among participants recruited through the popular online forum, PTT, which attracts a large youth population in Taiwan. The inclusion criteria were: cisgender men; aged 18 years or older; Taiwanese citizens. The prevalence and levels of BID for nine specific body parts and prevalence of DCPA were compared by sexual orientation. Pairwise mean differences and multivariable logistic regression models, adjusting for age and body mass index, were estimated for subgroup comparisons.</p><p><strong>Results: </strong>Of 632 participants, 376 self-identified as heterosexual, 185 as homosexual, and 71 as bisexual. The overall BID score and four body-part BID scores (<i>i.e.</i>, facial features, skin, muscles, and penis) significantly differed by sexual orientation, with homosexual and bisexual men exhibiting higher BID than heterosexual men. Further DCPA analysis found significant sexual orientation differences regarding 27 DCPA items. Homosexual men most often reported desiring to change 18 of these DCPA, whereas bisexual men most often endorsed the remaining nine DCPA (<i>e.g.</i>, an upward curve of the penis, a larger glans).</p><p><strong>Conclusions: </strong>These findings reveal sexual orientation disparities in BID and DCPA, providing valuable insights for addressing body image concerns among Asian men.</p>","PeriodicalId":54261,"journal":{"name":"World Journal of Mens Health","volume":" ","pages":"1017-1027"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233826","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":"Clinical Recommendations for the Management of Male Infertility: A Consensus from the Korean Society for Sexual Medicine and Andrology (KSSMA) Clinical Practice Guideline Committee.","authors":"Young Joon Moon, Jae Yong Jeong, Kang Hee Shim, Dong Hyuk Kang, Hae Do Jung, Dong Sup Lee, Seung-Hun Song, Hyun Jun Park, Joo Yong Lee","doi":"10.5534/wjmh.260149","DOIUrl":"10.5534/wjmh.260149","url":null,"abstract":"<p><p>Male infertility significantly contributes to the global reproductive burden and serves as a critical indicator of overall male health. As clinical pathways have historically focused on female-factor evaluation and assisted reproductive technology (ART), there is an increasing need for etiology-directed and time-sensitive male management strategies. This Clinical Recommendation, developed by the Korean Society for Sexual Medicine and Andrology Guideline Committee, synthesizes recent evidence from major international guidelines with specific considerations for the Korean healthcare environment. Management should be couple-centered, integrating the female partner's reproductive timeline to avoid preventable delays in effective therapy. Core recommendations emphasize addressing modifiable risk factors as foundational care, while restricting empiric pharmacotherapy to phenotype-driven, time-limited trials. Disease-specific pathways for varicocele, endocrine disorders, and obstructive/non-obstructive azoospermia are delineated, emphasizing the individualized selection between microsurgical reconstruction and surgical sperm retrieval. In the ART interface, the selective use of intracytoplasmic sperm injection is recommended, prioritizing safety and the prevention of multiple pregnancies. Furthermore, structured follow-up should prioritize patient-important outcomes, such as live birth and treatment burden, over intermediate semen parameter changes. By harmonizing international evidence with local clinical constraints, including national insurance structures and referral patterns, these recommendations aim to facilitate consistent, safe, and patient-centered care for infertile men in Korea.</p>","PeriodicalId":54261,"journal":{"name":"World Journal of Mens Health","volume":" ","pages":"812-828"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632935","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":"Efficacy of <i>Elaeagnus multiflora</i> and <i>Cynanchum wilfordii</i> Complex Extract on Male Lower Urinary Tract Symptoms: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.","authors":"Hwa Jong Lee, Tae Hyung Kim, Soomin Kim, Hyuk Jin Cho, U-Syn Ha, Sae Woong Kim, Ha-Neul Jo, Jaeyong Kim, Dongho Shin, Woong Jin Bae","doi":"10.5534/wjmh.250239","DOIUrl":"10.5534/wjmh.250239","url":null,"abstract":"<p><strong>Purpose: </strong>Lower urinary tract symptoms (LUTS) in men substantially impair quality of life and are commonly treated with alpha-blockers or 5-alpha reductase inhibitors, which may cause adverse effects. <i>Elaeagnus multiflora</i> and <i>Cynanchum wilfordii</i>, traditional herbal remedies, have shown potential benefits in testosterone regulation and benign prostatic hyperplasia (BPH); however, clinical evidence supporting their efficacy in LUTS remains limited. This study evaluated the efficacy and safety of the <i>E. multiflora</i> and <i>C. wilfordii</i> complex (NET1701) in men with LUTS.</p><p><strong>Materials and methods: </strong>In this randomized, double-blind, placebo-controlled trial, 100 men aged 40-80 years with moderate LUTS (International Prostate Symptom Score [IPSS] 8-19) were randomized to receive NET1701 (325 mg/d) or placebo for 12 weeks. The primary outcome was the change in total IPSS from baseline to 12 weeks. Secondary outcomes included IPSS subscores, maximum urinary flow rate (Qmax), post-void residual volume (PVR), serum testosterone levels, and safety.</p><p><strong>Results: </strong>At 12 weeks, the NET1701 group showed a significantly greater reduction in total IPSS compared with placebo (-5.67±3.86 vs. -1.00±4.30; p<0.0001). Significant improvements were observed in several IPSS subscores, including incomplete emptying, frequency, intermittency, and weak stream (p<0.05). Although Qmax and PVR did not differ significantly between groups, urinary symptom-related quality-of-life scores improved significantly in the NET1701 group (p<0.0001). NET1701 was well tolerated, with no severe adverse events reported.</p><p><strong>Conclusions: </strong>The <i>E. multiflora</i> and <i>C. wilfordii</i> complex (NET1701) significantly improved LUTS severity and quality of life without notable adverse effects. These findings suggest that NET1701 may represent a promising phytotherapeutic option for the management of male LUTS. Further long-term studies are needed to confirm its sustained efficacy and safety.</p>","PeriodicalId":54261,"journal":{"name":"World Journal of Mens Health","volume":" ","pages":"1066-1075"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936425","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}