Andrology最新文献

{"title":"The negative correlation between triglyceride glucose-body mass index and hormone levels in young and middle-aged patients with clinical varicocoele: A cross-sectional study.","authors":"Hong Xiao, Yi-Lang Ding, Peng Yang, Qiang Chen, Hai-Lin Huang, Xi Chen, Guo-da Song, Mao-Yuan Wang, Song-Xi Tang, Hui-Liang Zhou","doi":"10.1111/andr.70032","DOIUrl":"https://doi.org/10.1111/andr.70032","url":null,"abstract":"<p><strong>Background: </strong>Varicocoele may influence testosterone levels; however, their relationship remains controversial. Insulin resistance (IR) is a significant factor in metabolic disorders that may affect sex hormone levels. Triglyceride glucose-body mass index (TyG-BMI) is an important indicator of IR, but its relationship with sex hormones in patients with varicocoele and its clinical significance require further investigation.</p><p><strong>Objective: </strong>To investigate whether different severity grades of clinically palpable varicocoeles are associated with changes in testosterone levels. This study also seeks to explore the association between TyG-BMI and sex hormones and to evaluate the effectiveness of TyG-BMI compared to other IR indicators in predicting testosterone deficiency.</p><p><strong>Materials and methods: </strong>This cross-sectional study included 431 patients with palpable varicocoeles. Varicocoele severity was classified based on clinical grading, color Doppler ultrasound grading, and reflux status. Additionally, TyG-BMI was categorized according to interquartile ranges, and linear regression analysis was used to examine the relationship between TyG-BMI and sex hormones, along with a subgroup analysis. Additionally, four IR indices were used to predict testosterone deficiency.</p><p><strong>Results: </strong>In young and middle-aged patients with clinically palpable varicocoeles, testosterone levels did not differ significantly across varying degrees of severity. TyG-BMI significantly and negatively correlated with testosterone, inhibin B (INHB), and prolactin levels, particularly in patients with higher TyG-BMI. However, no linear relationships were found between TyG-BMI and follicle-stimulating hormone, luteinizing hormone, or estradiol levels. The linear association between TyG-BMI and testosterone levels remained significant across different levels of varicocoele severity. Additionally, TyG-BMI demonstrated a superior predictive capability for testosterone deficiency compared to other IR indices.</p><p><strong>Discussion and conclusion: </strong>Varicocoele severity was not associated with variations in testosterone levels. TyG-BMI was significantly negatively correlated with testosterone and INHB levels, and this relationship suggests a factor beyond the hypothalamic-pituitary-gonadal axis.</p>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anogenital distance in Klinefelter syndrome: A case-control study.","authors":"Chiara Bughetti, Alessandro Brunetti, Giulia Maida, Emanuela Morenghi, Walter Vena, Luciano Negri, Renzo Benaglia, Antonio Bossi, Fabio Vescini, Gherardo Mazziotti, Andrea Lania, Alessandro Pizzocaro","doi":"10.1111/andr.70030","DOIUrl":"https://doi.org/10.1111/andr.70030","url":null,"abstract":"<p><strong>Background: </strong>Fall in total testosterone (tT) levels in Klinefelter syndrome (KS) may occur at different times of sexual development, although overt hypogonadism generally occurs after puberty. Nevertheless, it is still debated whether patients with KS are exposed to normal androgen levels during fetal life. Anogenital distance (AGD) is an anthropometric measure reflecting androgenization during the fetal period. A shorter AGD in men was associated with infertility, genital anomalies, and testicular cancer. Although other androgen-dependent anthropometric measures such as testicular volume and stretched penile length have been investigated in KS, this is to our knowledge the first study examining AGD in this population.</p><p><strong>Objectives: </strong>To investigate the role of AGD as an anthropometric marker of androgenization in adults with KS.</p><p><strong>Methods: </strong>We measured AGD, testicular volume, stretched penile length in 50 patients with KS and in 101 Caucasian men with normal total testosterone (tT) levels (> 12 nmol/L), using a digital caliper for AGD, an orchidometer for testicular volume and a common meter for stretched penile length. AGD was then correlated with anthropometric features and hormone levels (tT, LH, FSH).</p><p><strong>Results: </strong>AGD was similar between patients with KS and controls (p = 0.843), with mean values of 6.8 ± 1.6 cm (95% CI 6.4 to 7.3) and 6.9 ± 1.4 cm (95% CI 6.6 to 7.2), respectively. In both groups, AGD did not correlate with testicular volume, stretched penile length, arm span, or tT levels. Interestingly, AGD significantly correlated with waist circumference (p = 0.004), body mass index (p < 0.001) in patients with KS, while no relevant correlation was found among controls.</p><p><strong>Conclusions: </strong>AGD is not decreased in KS despite lower testosterone levels. This finding suggests that patients with KS are exposed to sufficient androgenization during fetal life.</p>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A cross-tissue transcriptome-wide association study reveals novel susceptibility genes for erectile dysfunction.","authors":"Tianle Zhu, Yukuai Ma, Peng Yang, Zhi Cao, Jingjing Gao, Junhua Du, Pan Gao, Hui Jiang, Xiansheng Zhang","doi":"10.1111/andr.70034","DOIUrl":"https://doi.org/10.1111/andr.70034","url":null,"abstract":"<p><strong>Background: </strong>Erectile dysfunction (ED) is a common condition affecting millions of men worldwide. While genome-wide association studies (GWAS) have identified genetic loci associated with ED risk, the potential causative genes and their biological mechanisms leading to ED remain largely unexplored.</p><p><strong>Objectives: </strong>This study aimed to conduct a comprehensive cross-tissue transcriptome-wide association study (TWAS) to identify susceptibility genes associated with ED risk.</p><p><strong>Materials and methods: </strong>We conducted a cross-tissue TWAS analysis integrating GWAS data for ED with eQTL files from Genotype-Tissue Expression Project (GTEx) V8. We used the unified test for molecular signatures (UTMOST) for cross-tissue analysis and functional summary-based imputation (FUSION) for single-tissue validation. Candidate genes were further validated through multi-marker analysis of genomic annotation (MAGMA), conditional and joint (COJO) analysis, and colocalization analysis.</p><p><strong>Results: </strong>The cross-tissue TWAS analysis identified 118 significant genes associated with ED, while the single-tissue TWAS validation revealed 3804 significant genes. Nine candidate genes (CPT1B, CSF2RB, DNAH7, EHD3, L3MBTL2, LCLAT1, MDH1B, REEP1, and SLC30A6) were consistently identified across the TWAS and MAGMA analyses. COJO analysis revealed that LCLAT1 accounted for most of the signals at their respective loci. Colocalization analysis confirmed LCLAT1 as the primary candidate gene, showing strong colocalization with ED in testis, brain cortex, and heart left ventricle.</p><p><strong>Discussion and conclusion: </strong>This comprehensive cross-tissue TWAS analysis identified LCLAT1 as a primary susceptibility gene for ED, highlighting its potential role in the mitochondrial function and lipid metabolism. The study also revealed several secondary candidate genes that may contribute to ED through pathways related to mitochondrial dynamics, neurotransmission, and cardiovascular function. These findings provide new perspectives on the genetic architecture of ED and suggest potential targets for future research and treatment.</p>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparity in hormone therapy acceptance between genders.","authors":"Edoardo Cervoni","doi":"10.1111/andr.70024","DOIUrl":"https://doi.org/10.1111/andr.70024","url":null,"abstract":"","PeriodicalId":7898,"journal":{"name":"Andrology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRI fingerprints in testes of infertile men with clinical varicocoele: A narrative review.","authors":"Athina C Tsili, Vassiliki Pasoglou, Olga Xiropotamou, Nikolaos Sofikitis, Maria I Argyropoulou","doi":"10.1111/andr.70028","DOIUrl":"https://doi.org/10.1111/andr.70028","url":null,"abstract":"<p><strong>Background: </strong>Varicocoele represents the most common cause of male infertility, although most men with varicocoele remain fertile. Currently, no specific or sufficiently reliable criteria exist to identify patients who would benefit from varicocoele treatment to prevent impaired spermatogenesis. Emerging evidence suggests that magnetic resonance imaging (MRI) may provide valuable noninvasive insights into the mechanisms of testicular parenchymal damage in infertile men with clinical varicocoele.</p><p><strong>Objectives: </strong>The aim of this narrative review was to discuss the applications of advanced MRI techniques, including diffusion-weighted imaging (DWI), diffusion tensor imaging (DTI), dynamic contrast-enhanced MRI (DCE-MRI), and proton magnetic resonance spectroscopy (1H-MRS) in the assessment of testes in infertile men with clinical varicocoele and their role in uncovering the complex mechanisms impairing fertility.</p><p><strong>Materials and methods: </strong>PubMed database was searched for original articles published during 2010-2024.</p><p><strong>Results: </strong>Advanced MRI techniques reveal alterations in apparent diffusion coefficient (ADC), fractional anisotropy (FA), intratesticular vasculature, and testicular metabolites in men with varicocoele compared to healthy controls. Decrease in testicular ADC and FA is detected in men with varicocoele, indicating microstructural abnormalities. Testes with varicocoele enhance fast and strongly during the early phases of dynamic imaging, providing a valuable insight into tissue perfusion. Proton MR spectra of infertile testes with varicocoele show a decrease in concentrations of choline, myoinositol, Glx complex, and lipids, signifying metabolic signatures of deranged spermatogenesis.</p><p><strong>Conclusions: </strong>Preliminary findings from advanced MRI techniques, including DWI, DTI, DCE-MRI, and 1H-MRS have demonstrated potential as noninvasive biomarkers of impaired spermatogenesis, by evaluating testicular microstructure, perfusion, and biochemical milieu.</p>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Normozoospermic men in infertile couples: Potential benefit of early medical diagnostic procedures.","authors":"Simone Bier, Anton Wolff, Michael Zitzmann, Sabine Kliesch","doi":"10.1111/andr.70035","DOIUrl":"https://doi.org/10.1111/andr.70035","url":null,"abstract":"<p><strong>Introduction: </strong>Infertility, defined as the inability to achieve pregnancy despite regular, unprotected sexual intercourse for 1 year, affects approximately 15% of couples. Male factors contribute to 50% of these cases. The necessity of andrological evaluations for male partners of infertile couples with normozoospermia is currently under consideration.</p><p><strong>Methods: </strong>From 2010 to 2020, our center evaluated 997 patients presenting with infertility and normozoospermia. All patients underwent comprehensive assessments, including physical examinations, testicular sonography, blood tests, follice-stimulating hormone beta (FSHB) c.-211 variants, and semen analyses. For comparative purposes, we established two control groups: one comprising healthy men participating in the FAMe study (n = 201) and another consisting of men seeking fertility restoration following vasectomy (n = 75). Within the infertile male group, we further stratified patients into those with primary or secondary infertility.</p><p><strong>Results: </strong>Analysis of patient histories revealed a significantly elevated prevalence of genital malformations (e.g., hypospadias (p = 0.024) and undescended testes during childhood (p < 0.001) in our infertile group relative to the control group. By anamnesis we could find significant more patients with erectile dysfunction (p < 0.001) in our infertile men. The physical examination showed significant more patients with obesity in our infertility group (p < 0.001). Regarding hormonal profiles, a notably higher proportion of patients in the infertility group exhibited hypogonadism (p < 0.001), while compensated hypogonadism was more common in the control group. Reduced serum follicle-stimulating hormone (FSH) concentrations in men with the FSHB c.-211 GT/TT polymorphism versus the GG wildtype were only present in the infertile but not the fertile cohort (p < 0.001). Evaluation of ejaculate samples indicated a significant increase in round cells (p < 0.001) and leukocytes (p = 0.013) in our infertile patients compared to the healthy subjects.</p><p><strong>Discussion: </strong>The assessment of men presenting with infertility and normozoospermia unveiled a marked prevalence of physical and genetic findings. This underscores the critical need for andrological evaluations to prevent potential long-term consequences.</p><p><strong>Conclusion: </strong>The andrological examination of normozoospermic and infertile men promises better health outcomes for the patients as well as it aids in refining fertility treatment options for their female counterparts.</p>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of glucagon-like peptide 1 receptor agonists on testicular dysfunction: A systematic review and meta-analysis.","authors":"Gianmaria Salvio, Alessandro Ciarloni, Nicola Ambo, Monia Bordoni, Michele Perrone, Silvia Rossi, Giancarlo Balercia","doi":"10.1111/andr.70022","DOIUrl":"https://doi.org/10.1111/andr.70022","url":null,"abstract":"<p><strong>Background: </strong>Hypogonadism and infertility are two conditions that are heavily affected by overweight and obesity in the male patient. Glucagon-like peptide 1 agonists (GLP-1RAs) are a recently introduced class of antidiabetic drugs with powerful weight-loss effect; this may induce an indirect positive effect on the testicular function. Nevertheless, recent evidence also suggests a potential direct influence of these molecules on the gonadal function.</p><p><strong>Objectives: </strong>Our study aims at evaluating the effects of GLP-1RAs on hormone secretion in male patients and comparing their impact on the testicular function with other antidiabetic agents or weight-lowering drugs.</p><p><strong>Materials and methods: </strong>A literature search was conducted using PubMed, EMBASE, and Scopus database to assess the effects of GLP-1RAs on hormone levels, sperm parameters, and erectile function in overweight and obese men. Before-after analysis and comparison between therapy with GLP-1RAs and other treatment regimens were performed.</p><p><strong>Results: </strong>Seven studies (n = 680) were included in the quantitative analysis. Treatment with GLP-1RAs produced a significant increase in total serum testosterone (TT), with a standardized mean difference of 1.39 ng/mL (95% confidence interval: 0.70, 2.09; p < 0.0001). Free serum testosterone (FT), sex hormone-binding globulin (SHBG), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) showed similar increase, while weight, body mass index (BMI), waist circumference (WC), and glycated hemoglobin (HbA1c) decreased. Meta-regression showed a significant negative correlation between standardized mean difference in TT levels before-after treatment and percentage change in weight and BMI. When compared with other treatment options, GLP-1RAs showed a comparable effect on serum androgens, but greater BMI reduction and increase in serum gonadotropins and indexes of the erectile function.</p><p><strong>Conclusion: </strong>Our systematic review and meta-analysis suggest a possible role for GLP-1RAs in the therapy of functional hypogonadism related to overweight and obesity, while also promoting weight loss. The limitations of the current literature do not allow to demonstrate a direct action of GLP-1RAs on the testicular function.</p>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lost to follow up: Semen analysis compliance following potential vasectomy failure.","authors":"Max D Sandler, Laura Angulo-Llanos, Rohan Dureja, Faaris Khan, Adriana Sandino, Veronica Junco, Dan V Tran, Julio Yanes, Adam D Williams, Thomas A Masterson","doi":"10.1111/andr.70027","DOIUrl":"https://doi.org/10.1111/andr.70027","url":null,"abstract":"<p><strong>Background: </strong>Many patients do not follow up for repeat semen analysis after potential vasectomy failure, indicating a need for strategies to enhance compliance and maximize outcomes.</p><p><strong>Objective: </strong>To evaluate the rate of men who do not return for repeat semen analysis after suspected or confirmed vasectomy failure, defined as presence of motile or >100,000 non-motile sperm on post-vasectomy semen analysis, and investigate subsequent management.</p><p><strong>Materials and methods: </strong>We conducted a retrospective chart review of males aged ≥18 years old who underwent vasectomy for the first time between January 2004 and January 2024. We examined adherence to and timing of follow-up semen analyses and subsequent vasectomy outcomes, rates of non-compliance with follow-up, management strategies.</p><p><strong>Results: </strong>Of 2567 patients, 42.1% did not follow up at any time point post-vasectomy. Of those with spermatozoa on initial semen analysis < 3 months post-vasectomy, 43.3% failed to return for repeat testing. Nearly, 47% percent of those with spermatozoa present on first post-vasectomy semen analysis at or after 3 months also failed to follow up to re-evaluate sterility. Management of patients who did follow up often included repeat semen analyses at 6-week intervals until a negative result was produced or repeat vasectomy.</p><p><strong>Conclusion: </strong>Alarmingly, many patients who could not be cleared to resume sexual activity after vasectomy did not follow up for repeat semen analyses. This highlights a significant deficit in compliance, which may benefit from interventions such as improved counseling and reminder systems. Future research should explore the impact of these interventions on compliance rates and explore rates of unintended pregnancy associated with loss to follow up.</p>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of topical and intraurethral alprostadil on erectile function: A systematic review and meta-analysis.","authors":"Iason Papadopoulos, Maksim Tishukov, Ioannis Sokolakis, Ioannis Katafigiotis, Ioannis Leotsakos, Markos Karavitakis, Julian Marcon, Christian G Stief, Nikolaos Pyrgidis","doi":"10.1111/andr.70025","DOIUrl":"https://doi.org/10.1111/andr.70025","url":null,"abstract":"<p><strong>Background: </strong>Erectile dysfunction (ED) affects up to 50% of men over 40. While phosphodiesterase-5 inhibitors (PDE5i) are the first line of medical treatment, they are not always effective. Alprostadil, available in injectable, topical, and intraurethral forms, offers an alternative treatment modality.</p><p><strong>Objectives: </strong>This systematic review and meta-analysis aim to evaluate the efficacy and safety of topical and intraurethral forms of alprostadil.</p><p><strong>Materials and methods: </strong>The objectives and methods of this systematic review and meta-analysis were predefined in a protocol registered on PROSPERO (CRD42021260894). We systematically searched PubMed, EMBASE, and the Cochrane Library up to April 2024. Using a random-effects model, we compared the efficacy of topical and intraurethral forms of alprostadil against placebo. Additionally, we performed a qualitative assessment of the studies using RoB-2 and ROBINS-I tools.</p><p><strong>Results: </strong>The analysis included 11 randomized controlled trials and 4 non-randomized studies, encompassing 5869 patients with a mean age of 60 ± 9.4 years. The meta-analysis showed a statistically significant improvement in the IIEF score by 4.7 points (95% CI: 2.4-7.1, I² = 97%) in patients using the topical form of alprostadil compared to placebo. There was also a statistically significant improvement of ED in patients using intraurethral alprostadil compared to placebo, with a pooled odds ratio of 0.08 (95% CI: 0.04-0.16, I² = 54%). The most common adverse events reported were penile pain and erythema.</p><p><strong>Discussion: </strong>These results are limited by the variability in study designs and the relatively small number of included studies in the meta-analysis. Moreover, the low methodological quality of the included studies further limits the strength of the conclusions.</p><p><strong>Conclusions: </strong>Topical and intraurethral alprostadil significantly improve ED symptoms compared to placebo and are generally safe, with no serious adverse events. Further trials are necessary to confirm and expand on these findings.</p>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is 'living apart together' a real advantage for patients consulting for sexual dysfunction? A cohort study.","authors":"Clotilde Sparano, Giovanni Corona, Giulia Rastrelli, Linda Vignozzi, Daniele Vignoli, Mario Maggi","doi":"10.1111/andr.70023","DOIUrl":"https://doi.org/10.1111/andr.70023","url":null,"abstract":"<p><strong>Background: </strong>Quantitative research on families has introduced a new category of relationship called living apart together, that is, when a couple in a committed relationship live in separate homes. This study aimed to confirm whether living apart together improves sexual relationships in those suffering from sexual dysfunction.</p><p><strong>Methods: </strong>This study comprised cross-sectional (N = 4852) and longitudinal (N = 1402) analyses. The former explored psychobiological, hormonal and relational correlates using the Structured Interview on Erectile Dysfunction scale. The latter assessed the occurrence of major adverse cardiovascular events in a subset of patients followed for 4.3 ± 2.59 years.</p><p><strong>Results: </strong>Compared to cohabiting couples, patients in living apart together relationships were younger and characterised by higher education levels, healthier lifestyles and lower comorbidity burdens (all p < 0.001). After adjusting for those confounders, the living apart together group reported better sexual functioning, more frequent sexual intercourse, and higher total testosterone levels (p < 0.001), and the relationship was often a source of conflicts within the familial context and of shorter duration (all p < 0.05). When total testosterone was included in a fully adjusted analysis of covariance, the difference in obtaining a full erection between cohabiting and living apart together relationships became non-significant (p = 0.086), suggesting a hormonal influence on erectile dysfunction. In the longitudinal analysis, Cox models adjusted for the aforementioned confounders showed that living apart together relationships are associated with a twofold greater risk of major adverse cardiovascular events than cohabiting relationships, independent of other risk factors, including total testosterone levels, waist circumference and pathological penile blood flow.</p><p><strong>Discussion: </strong>This study illustrates that partnership arrangements can shape sexual interest and complaints, as reported by the participants. While men involved in living apart together relationships show an ostensibly healthier phenotype, they experienced more often major adverse cardiovascular events. Therefore, co-residential relationship appears to provide more effective protection against future major adverse cardiovascular events for the male partner than a living apart together relationship.</p>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}