Arab Journal of Urology最新文献

{"title":"'Controversies on risk factors, diagnosis and treatment of male infertility: Is there an end?'","authors":"Ramadan Saleh, Taymour Mostafa, Selahittin Çayan, Rupin Shah, Ashok Agarwal","doi":"10.1080/20905998.2025.2515742","DOIUrl":"https://doi.org/10.1080/20905998.2025.2515742","url":null,"abstract":"","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"23 3","pages":"167-168"},"PeriodicalIF":1.2,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12308884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144758978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pandemic of testosterone abuse: Considerations for male fertility.","authors":"Naveen Kumar, Shitangsu Kakoti, Eric Chung","doi":"10.1080/20905998.2025.2509456","DOIUrl":"10.1080/20905998.2025.2509456","url":null,"abstract":"<p><p>Testosterone is the primary male hormone, which is essential for sexual differentiation, spermatogenesis, and the development of male sexual characteristics. It has been recommended for therapeutic use for symptomatic hypogonadism as androgen replacement therapy. However, the misuse and abuse of testosterone and other anabolic androgenic steroids (AAS) are detrimental to cardiovascular and psychological health, with a serious risk to male reproductive health. Testosterone abuse adversely impacts male fertility by suppressing the hypothalamic-pituitary-gonadal axis, leading to reduced intratesticular testosterone levels, impaired spermatogenesis, testicular atrophy and azoospermia. Additionally, chronic testosterone abuse induces oxidative stress and DNA damage in sperm cells, and may lead to sexual dysfunction. Recovery for fertility parameters after cessation of abuse is often prolonged and may be incomplete in many cases. Diagnostic approaches include clinical profile, hormonal assessment, semen analysis, genetic testing, and imaging techniques. Management involves cessation of AAS use, pharmacological interventions such as human chorionic gonadotropin and selective estrogen receptor modulators, lifestyle modifications, and assisted reproductive techniques for refractory infertility. Prevention measures focus on public awareness campaigns targeting athletes and young individuals to raise awareness about the adverse effects of testosterone abuse on fertility as well as overall health. This article discusses the physiological functions of testosterone and its therapeutic applications. Also, the article explains the mechanisms through which testosterone abuse exerts its negative effect on reproductive and general health. Additionally, the article explores the effects of the current pandemic of testosterone on male fertility. Further, the latest advancements and future directions to tackle this menace of testosterone abuse and minimise its effects on spermatogenesis have been deliberated.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"23 3","pages":"183-189"},"PeriodicalIF":1.2,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12308887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144758983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"3D-bioprinted urethral grafts: Revolutionizing urethral stricture treatment.","authors":"Kirolos Eskandar","doi":"10.1080/20905998.2025.2504797","DOIUrl":"10.1080/20905998.2025.2504797","url":null,"abstract":"<p><p>Urethral stricture disease remains a significant clinical challenge, often requiring complex surgical interventions with variable long-term success rates. Traditional approaches, including urethral dilation, endoscopic treatments, and urethroplasty using autologous grafts such as buccal mucosa, are limited by donor site morbidity, graft contraction, and suboptimal integration. Recent advancements in 3D-bioprinting have introduced a transformative alternative - bioengineered urethral grafts designed to replicate native tissue architecture and promote cellular integration. However, while these constructs aim to enhance long-term functionality, robust evidence confirming their dynamic and functional equivalence to native tissue remains limited. This review explores the latest developments in 3D-bioprinted urethral grafts, detailing bioink formulations, scaffold designs, and bioprinting techniques. Comparative analysis of conventional urethral reconstruction methods versus bioengineered grafts highlights the potential benefits of patient-specific, regenerative solutions. Additionally, we discuss preclinical and clinical progress, challenges in clinical translation, and future directions for optimizing bioprinted urethral constructs. By bridging regenerative medicine with urologic surgery, 3D-bioprinting holds the promise of revolutionizing urethral stricture treatment and improving patient outcomes.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"23 4","pages":"330-340"},"PeriodicalIF":1.2,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety & efficacy of thulium laser endoscopic en bloc resection versus conventional trans urethral resection of bladder tumors, for treatment of non muscle invasive bladder tumors: A prospective randomized trial.","authors":"Mahmoud Abd El Hamid, Ahmed Abd Allah, Ahmed Assem, Mohamed Abd El Wahed, Hossam Hassan, Amr Lotfi, Ayman Kassem","doi":"10.1080/20905998.2025.2501888","DOIUrl":"10.1080/20905998.2025.2501888","url":null,"abstract":"<p><strong>Introduction: </strong>Non-muscle invasive bladder cancers (NMIBCs) are managed with endoscopic resection and intravesical therapy. Lasers, particularly thulium and holmium, are now central to bladder tumor management. This study assesses the safety and efficacy of thulium laser enucleation of bladder tumors (Tm-LRBT).</p><p><strong>Patients & methods: </strong>A prospective randomized clinical study was conducted from June 2022 to December 2023, involving 100 patients. Group A was treated with TmLRBT and Group B with conventional monopolar TURBT. Informed consent was obtained from all participants. Inclusion criteria were NMIBC, tumor size < 5 cm, and fewer than three tumors. Exclusion criteria included tumors > 5 cm, more than three tumors, invasive/upper tract cancers, hydronephrosis, metastases, and history of TURBT.</p><p><strong>Results: </strong>The mean tumor diameter in Group A was 2.3 ± 0.74 cm. The mean operative time was 45.4 ± 13.48 minutes. Re-resection within 90 days was negative for bladder cancer in all Group A patients; three patients in Group B had persistent disease. Seven Group B cases lacked muscle in the specimen compared to three in Group A. Significant intraoperative bleeding occurred in four cases in Group A and five in Group B. Tumor recurrence was 42% in Group A and 44% in Group B at 12-month follow-up. .</p><p><strong>Conclusion: </strong>TmLRBT is a potential alternative to TURBT, providing accurate reporting of neoplastic depth invasion. It is advantageous, particularly for tumors in the lateral wall, bladder dome, or perimeatal zone.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"23 4","pages":"315-323"},"PeriodicalIF":1.2,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to Editor: Mental health after orchiectomy: Systematic review and strategic management.","authors":"Hery Sumasto, Sari Luthfiyah, Triwiyanto Triwiyanto, Nurwening Tyas Wisnu","doi":"10.1080/20905998.2025.2494179","DOIUrl":"10.1080/20905998.2025.2494179","url":null,"abstract":"<p><p>This letter to the editor addresses the article 'Mental Health After Orchiectomy: Systematic Review and Strategic Management' by Shokaier et al, which reviews the psychological impacts of orchiectomy, including depression, anxiety, and reduced quality of life. The letter acknowledges the importance of the review but highlights gaps in the study, such as the lack of exploration into how cultural and socioeconomic factors influence mental health outcomes. It also points out the variability introduced by different psychological assessment tools used in the studies, which may limit the robustness of the conclusions. The letter suggests integrating artificial intelligence (AI) to analyze large datasets on post-orchiectomy mental health, proposing that AI-driven models could identify risk factors more precisely and offer personalized interventions. Additionally, the letter calls for expanding research to include a longitudinal perspective to understand the long-term psychological effects of orchiectomy. The author commends the original work while urging further studies to address these gaps, thereby advancing the understanding and management of post-orchiectomy mental health.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"23 4","pages":"253-254"},"PeriodicalIF":1.2,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is varicocele repair justified in infertile men with clinical varicocele, normal conventional semen parameters and elevated sperm DNA fragmentation (SDF)?","authors":"Khaled Almekaty, Ahmed Ghaith, Maged Ragab, Haitham Elbardisi","doi":"10.1080/20905998.2025.2494180","DOIUrl":"10.1080/20905998.2025.2494180","url":null,"abstract":"<p><p>Varicocele is a prevalent cause of male infertility, with sperm DNA fragmentation (SDF) identified as a key factor. Although varicocele repair (VR) has been associated with improved fertility outcomes, its effectiveness in men who have a palpable varicocele, normal conventional semen analysis, and high SDF levels is still not fully understood. This review summarizes existing evidence regarding the connection between varicocele and SDF, the effect of VR on both SDF and fertility outcomes and focuses on infertile men experiencing these specific conditions. Current literature indicates that VR can significantly improve SDF and reproductive success following surgery, independent of the surgical approach, SDF testing method, or preoperative SDF levels. Nonetheless, additional research is necessary to validate these results and to establish the best management strategies for these individuals. We recommend that organizations engaged in the area of male infertility take into account the significance of SDF testing in the decision-making process concerning VR, particularly for men who present with a palpable varicocele and demonstrate normal findings in conventional semen analysis.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"23 3","pages":"230-236"},"PeriodicalIF":1.2,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12308864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144758980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To sheath or not to sheath in flexible ureteroscopy: A randomized controlled trial.","authors":"A M Tawfeek, Mohamed Mostafa Elsayed Osman, M Sherif Mourad, Mohammed Metwally Sadeq","doi":"10.1080/20905998.2025.2480540","DOIUrl":"10.1080/20905998.2025.2480540","url":null,"abstract":"<p><strong>Objective: </strong>To assess the effect of employing UAS compared to not using UAS in FURS concerning stone-free rate, operative duration, and intraoperative and postoperative complications.</p><p><strong>Methods: </strong>A total of 120 patients presenting with symptomatic upper ureteric and renal stones were recruited and allocated into two equal groups. Group A underwent flexible ureteroscopy (FURS) without using ureteral access sheaths (UAS), while Group B underwent FURS with UAS.</p><p><strong>Results: </strong>There were no statistically significant differences among the groups for the Stone-free rate, operative duration, length of hospital stay, and postoperative pain, with p-values of 0.543, 0.122, 0.639, and 0.083, respectively. However, group A experienced a significantly higher occurrence of postoperative complications, affecting 14 patients (23.3%), compared to five patients (8.3%) in group B, with a p-value of less than 0.05. These complications mainly presented as postoperative fever and urosepsis.</p><p><strong>Conclusion: </strong>Utilizing UAS alongside Flexible ureteroscopy had no impact on stone-free rate, operative time, hospital stay, or intraoperative complications. However, it notably lowered postoperative infective complications.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"23 4","pages":"324-329"},"PeriodicalIF":1.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental health after orchiectomy: Systematic review and strategic management.","authors":"G Shokaier, M Gross, M Cohen, A Hussein","doi":"10.1080/20905998.2025.2478771","DOIUrl":"10.1080/20905998.2025.2478771","url":null,"abstract":"<p><p>Orchiectomy, the surgical removal of one or both testicles, is often a life-changing procedure. While it is a critical treatment step for conditions such as testicular cancer, advanced prostate cancer, severe unresolving infection, trauma and gender dysphoria, the associated psychological challenges remain underexplored. Depression, anxiety, body image concerns, and diminished quality of life are prevalent but insufficiently addressed. This review synthesizes available literature to quantify these psychological impacts, explore cultural and demographic influences, and present evidence-based management strategies. The review highlights the importance of pre-operative counselling, testosterone replacement therapy (TRT), cognitive behavioural therapy (CBT), and social support networks. Future research should focus on longitudinal assessments to better understand long-term mental health outcomes post-orchiectomy.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"23 4","pages":"245-252"},"PeriodicalIF":1.2,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity and male infertility - a tenuous relationship: Facts discerned for the busy clinicians.","authors":"Lucia Rocco, Ramadan Saleh, Asli Metin Mahmutoglu, Rupin Shah, Ashok Agarwal","doi":"10.1080/20905998.2025.2473219","DOIUrl":"10.1080/20905998.2025.2473219","url":null,"abstract":"<p><p>Obesity is a common health problem affecting over a third of the population worldwide. Obesity has been correlated with many diseases, including cardiovascular disorders, diabetes, cancer, brain degeneration, and premature aging. In men, obesity can also cause issues like erectile dysfunction, poor sperm quality, and prostate problems. Factors like high insulin levels, chronic inflammation, and oxidative stress may play a role in how obesity affects male fertility. Obesity can disrupt the male reproductive system by changing hormone levels, affecting sperm production, and causing problems with metabolism. This can result in a reduction of sperm count, motility, and normal forms. Obesity can also cause sperm DNA fragmentation, increase cell death, and impact the genetic information that can be passed on to future generations. This narrative review explores how obesity impacts male reproductive health and fertility, as well as possible treatment options like weight management, lifestyle changes, medications, and alternative therapies.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"23 3","pages":"169-176"},"PeriodicalIF":1.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12308875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144758982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial differences in male fertility parameters in 2,996 men examined for infertility in a single center.","authors":"Ralf Henkel, Haitham Elbardisi, Ahmad Majzoub, Mohamed Arafa","doi":"10.1080/20905998.2025.2470045","DOIUrl":"10.1080/20905998.2025.2470045","url":null,"abstract":"<p><strong>Objectives: </strong>Several studies have demonstrated racial variations in various diagnostic clinical parameters in different fields of medicine including andrology. Yet, clinical andrological diagnostic is following the lower reference values recommended by the World Health Organization irrespective of the racial descent of men. Therefore, this study aimed to investigate racial differences in hormonal and semen parameters including sperm DNA fragmentation (SDF) and seminal oxidative stress in a large group of patients from Sub-Saharan, Caucasian, Central/South Asian, Middle Eastern, North African, and Southeast Asian descent.</p><p><strong>Methods: </strong>In a total of 2,996 infertile men, testis volume, sperm concentration, total sperm count, total and progressive motility, normal morphology, sperm vitality, SDF, oxidation-reduction potential (ORP), and standard hormones were determined and compared.</p><p><strong>Results: </strong>Significant racial differences for various parameters including the incidence of normal ranges values in the racial groups were found. The highest mean sperm concentration had men of Central/South Asian descent (median: 38.0 × 10⁶/mL) while Southeast Asian men had the lowest (median: 22.0 × 10⁶/mL; <i>p</i> < 0.0001). The highest total sperm motility (median: 55.0%) was observed in Caucasian, Central/South Asian, and Southeast Asian men, while Sub-Saharan African men had the lowest (median: 45.0%; <i>p</i> < 0.0001). For SDF, Caucasian men had the lowest sperm DNA fragmentation (median: 16.0%) and ORP values (median: 1.3 mV/10⁶ sperm/mL) as compared to Central/South Asian men (median: 28.0%; <i>p</i> = 0.0263) and Southeast Asian men (median: 2.4 mV/10⁶ sperm/mL; <i>p</i> = 0.0045), respectively.</p><p><strong>Conclusions: </strong>Our results show not only significant racial differences for many of the parameters investigated but also for the incidence of normal values. Therefore, it might be prudent to revisit the concept of globally standardized reference values for all men. Yet, as a limitation, the small number (53) of Caucasian men needs to be mentioned. Larger studies that include functional sperm parameters need to be conducted.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"23 4","pages":"255-265"},"PeriodicalIF":1.2,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}