Arab Journal of Urology最新文献

{"title":"Effect of vardenafil in long-standing diabetic patients comparing different doses regarding erectile dysfunction, testosterone level and partner satisfaction.","authors":"Ahmed ElSayed Abdellatif, Ahmed Mahmoud Abdelbary, Ahmed M Ragheb, Ayman S Moussa, Mahmoud K Naguib, Akram A Elmarakbi, Ahmed El Batanouny","doi":"10.1080/20905998.2025.2526978","DOIUrl":"10.1080/20905998.2025.2526978","url":null,"abstract":"<p><strong>Purpose: </strong>Diabetic patients had erectile dysfunction at an earlier age and with greater frequency than nondiabetic males, with prevalence rates ranging from 20% to 75%. The aim of the work is to study the efficacy and safety of different doses of vardenafil in patients with long-standing type II DM on Erectile Dysfunction (ED), testosterone level, and partner satisfaction.</p><p><strong>Methods: </strong>A randomized clinical investigation was undertaken spanning the period from October 2021 to October 2022 on patients with long-standing type II DM who were diagnosed with ED and were randomized into 4 groups to receive vardenafil, 5 mg once, 5 mg twice, 10 mg once, and 10 mg twice, respectively. The International Index of Erectile Function (IIEF) self-completed questionnaire was used to measure erectile dysfunction, the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire was used to measure partner satisfaction, and testosterone levels were taken both before and after vardenafil was administered.</p><p><strong>Results: </strong>Of 102 patients, 26 patients received 5 mg once daily, 25 patients received 5 mg twice daily, 27 patients received 10 mg once daily and 24 patients received 10 mg twice daily. The mean age was 55.45 ± 8.142 years, ranging from 40 to 65 years, HbA1c mean was 8.8%  ± 1.5. There was a statistically significant difference regarding EDITS and IIEF-15 scores among patients who received 10 mg once and 5 mg twice, <i>p</i> = 0.001. Testosterone levels were elevated in all doses, especially for higher doses of vardenafil.</p><p><strong>Conclusion: </strong>Vardenafil with doses of 10 mg once or 5 mg twice is an effective and valid option for long-standing type II diabetic patients with ED.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"24 1","pages":"75-81"},"PeriodicalIF":1.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12777897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145931689","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":"Prevention of parastomal hernia after ileal conduit using prophylactic mesh: A meta-analysis of randomized controlled trials.","authors":"Hamza Elhashamy, Tarek Mohamed, Baha' Aldeen Bani Irshid, Mohammad Ghassab Deameh, Mohamed Ramez","doi":"10.1080/20905998.2025.2526980","DOIUrl":"10.1080/20905998.2025.2526980","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims at assessing the effectiveness of using prophylactic mesh for the prevention of Parastomal hernia (PSH) after cystectomy and ileal conduit.</p><p><strong>Methods: </strong>PRISMA statement guidelines were followed. A comprehensive literature search was conducted across PubMed, MEDLINE, Cochrane Library, and Embase databases. The primary outcomes analyzed were operation time, clinical hernia, radiological hernia, and complications classified as greater than or less than 3 on the Clavien-Dindo scale.</p><p><strong>Results: </strong>Three RCTs with a total number of 782 patients were included. The occurrence of clinical hernia significantly favored the mesh group, with a risk ratio (RR) of 0.50 (<i>p</i> < 0.002). However, the occurrence of radiological hernia showed no significant difference between groups, with an RR of 0.72 (<i>p</i> = 0.10). The analysis of operation time significantly favored the no mesh group, with a mean difference (MD) of -28.56 minutes (<i>p</i> < 0.002), indicating shorter operation times compared to the mesh group. Regarding complications, no significant differences were observed between the mesh and no mesh groups. For Clavien-Dindo Grade ≥3 complications, the RR was 1.11 (<i>p</i> = 0.42), and for Clavien-Dindo Grade <3 complications, the RR was 1.15 (<i>p</i> = 0.36).</p><p><strong>Conclusion: </strong>Prophylactic mesh significantly reduces the incidence of PSH following ileal conduit. However, it does not significantly affect radiological hernia rates or complication rates. Despite longer operation times, its use offers a clear benefit in preventing PSH without substantially increasing complications.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"24 1","pages":"82-89"},"PeriodicalIF":1.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12777752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145931946","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":"Efficacy and safety of low-intensity shockwave therapy on lower urinary tract symptoms in non-prostatic condition: A systematic review and meta-analysis.","authors":"Holy Sarah Gita Sinaga, Helda, Harrina Erlianti Rahardjo, Gideon Hot Partogi Sinaga","doi":"10.1080/20905998.2025.2528171","DOIUrl":"10.1080/20905998.2025.2528171","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy and safety of low-intensity shockwave therapy (LiSWT) for non-prostatic storage lower urinary tract symptoms (LUTS), including overactive bladder (OAB), stress urinary incontinence (SUI), and interstitial cystitis/bladder pain syndrome (IC/BPS).</p><p><strong>Methods: </strong>A systematic search of MEDLINE, Embase, CENTRAL, and ClinicalTrials.gov was conducted up to September 2024. Randomized controlled trials (RCTs), prospective studies, and single-arm studies evaluating LiSWT for non-prostatic LUTS in adults were included. Outcomes assessed included urinary frequency, urgency, nocturia, pain for IC/BPS, pad-test for SUI, uroflowmetry parameters, and questionnaire-based symptom scores. Risk of bias was assessed using Cochrane Risk of Bias 2.0 and ROBINS-I. Random-effects meta-analysis was performed.</p><p><strong>Results: </strong>Twelve studies (six RCTs, six observational) involving 624 participants were included. LiSWT significantly reduced urinary frequency in OAB and IC/BPS patients, with SUI improvements emerging at 12 weeks. Compared to sham treatment, only the OAB group showed significant reductions at 4 weeks. Urgency symptoms improved in OAB and SUI, but differences from sham were not significant. Nocturia improved in OAB and IC/BPS but was not significantly different from sham. Overall pain reduction was significant for IC/BPS (MD -1.61 (95%CI -2.21 to -1.02)). In SUI, most participants had >50% improvement in pad-test weight, but the mean difference compared to sham was not significant. Significant improvements in uroflowmetry also observed in OAB and SUI groups, while IC/BPS showed non-significant changes. Compared to sham, LiSWT did not significantly improve uroflowmetry parameters at 4 weeks. OAB and IC/BPS questionnaire-symptom scores significantly improved, but quality-of-life data was limited.</p><p><strong>Limitations: </strong>Heterogeneity in treatment protocols, short follow-ups, and high risk of bias in some studies limited generalizability.</p><p><strong>Conclusions: </strong>LiSWT may present a novel non-invasive treatment modality for non-prostate LUTS etiology. While it demonstrates some subjective symptom improvements, its overall clinical utility remains uncertain due to methodological limitations, heterogeneity, and high bias risk in current studies. Larger, high-quality RCTs are urgently needed to establish standardized treatment protocols and long-term safety profiles.Registration: PROSPERO (CRD42024590708).</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"24 1","pages":"42-56"},"PeriodicalIF":1.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12777881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145931879","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":"Efficacy of alpha-blockers in medical expulsive therapy for ureteral stones: A systematic review and meta-analysis of randomized controlled trials between 2010 and 2025.","authors":"Mohammed Marzouq Almaghthawi, Eman Abdullah Alotaibi, Mohammed Saad Alotaibi, Renad Wesam Alomari, Yazeed Dakhel Alsulami, Manar Ali Alahamdi, Salem Ibrahim S Aljaddua, Wijdan Ateeq Allah Alruhaili, Eyad Mohammed Hijazi, Abdullah Sulaiman Alkharboosh, Oroub Abdulaziz Almurshed, Adel H Alshammari","doi":"10.1080/20905998.2025.2532196","DOIUrl":"10.1080/20905998.2025.2532196","url":null,"abstract":"<p><strong>Introduction: </strong>Alpha-blockers are widely used in medical expulsive therapy (MET) for ureteral stones; however, the current evidence regarding their comparative effectiveness remains inconsistent. We aimed to evaluate the efficacy and safety of different alpha-blockers in facilitating ureteral stone passage and identify factors influencing treatment outcomes.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) published between 2010 and 2025. We searched multiple databases for studies comparing alpha-blockers with control interventions or other alpha-blockers for ureteral stones ≤10 mm. Primary outcome was stone expulsion rate; secondary outcomes included time to expulsion, pain episodes, analgesic use, and adverse events. We performed subgroup analyses by alpha-blocker type, stone size, location, and treatment duration. Network meta-analysis assessed comparative effectiveness between agents.</p><p><strong>Results: </strong>Twenty-nine RCTs with a total of 4,256 patients were included. Alpha-blockers significantly increased stone expulsion rates compared to controls (70.9% vs. 56.5%; RR 1.25, 95% CI 1.20-1.32; Number Needed to Treat (NNT) = 7) and reduced expulsion time by approximately three-days. Efficacy was greatest for distal ureteral stones (RR 1.52; Number Needed to Treat (NNT) = 4) and stones 5-10 mm (RR 1.35; NNT = 6). Network meta-analysis revealed efficacy ranking favoring at first terazosin, followed by doxazosin then, silodosin then, tamsulosin then, alfuzosin and last the least effective was naftopidil. Alpha-blockers significantly reduced pain episodes and analgesic requirements. Adverse events were infrequent (Number Needed to Harm (NNH) = 38), with retrograde ejaculation being most common with silodosin.</p><p><strong>Conclusion: </strong>Alpha-blockers significantly improve the stone expulsion rates and reduce expulsion time, especially for distal ureteral stones 5-10 mm in size. While tamsulosin remains the most studied agent, our network meta-analysis suggests terazosin and doxazosin may offer superior efficacy. The favorable risk-benefit profile supports routine use of alpha-blockers for appropriately selected patients with ureteral stones.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"24 1","pages":"1-14"},"PeriodicalIF":1.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12777816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145931895","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":"'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":"Retrograde intra renal surgery (RIRS) versus percutaneous nephrolithotomy (PNL) as a primary treatment for large renal stones: A prospective randomized controlled trial.","authors":"Ayman Kassem, Hesham Torad, Ahmed Essam, Mahmoud Abdel Hamid, Sameih Zamel, Amr Elkady","doi":"10.1080/20905998.2025.2515354","DOIUrl":"10.1080/20905998.2025.2515354","url":null,"abstract":"<p><strong>Background: </strong>Despite the high efficacy of percutaneous nephrolithotomy (PNL), it has more morbidity and a difficult learning curve. Retrograde intra renal surgery (RIRS) was introduced as a minimally invasive procedure for treatment of renal stones.</p><p><strong>Objective: </strong>To compare RIRS versus PNL in the management of renal stones sized 2-3 cm.</p><p><strong>Patient and methods: </strong>In this prospective randomized controlled trial, 122 patients with renal stones 2-3 cm were included and divided into two equal groups. Group A underwent RIRS. Group B underwent PNL. Patients with bleeding disorders, pregnancy, active UTI were excluded. Laboratory investigations, Ultrasound, CTUT were done preoperatively. Perioperative outcome (operative time, complications, hospital stay and pain score) was recorded. SFR (stone free rate) was assessed by CTUT after one month.</p><p><strong>Results: </strong>The mean stone size for group A and B were 2.11 ± 0.21 and 2.12 ± 0.23, respectively. The Stone free rate was 70.5% in RIRS and 73.8% in PNL (<i>p</i> = 0.840). lithotripsy time was significantly longer in the RIRS group (84.75 vs 72.95 minutes) (<i>p</i> = 0.019). PNL group showed significant post-operative hemoglobin drop but with no need for blood transfusion. High-grade fever was slightly higher in the RIRS group (8.2% vs 6.5%) (<i>p</i> = 0.557). Sepsis developed in 4.9% of RIRS group and 1.6% of the PNL group (<i>p</i> = 0.362). One case of mortality was reported in the PNL group. The hospital stay was significantly longer in the PNL group. The mean pain score was significantly lower in the RIRS.</p><p><strong>Conclusion: </strong>RIRS can be used as an alternative to PNL for the management of renal stones sized 2-3 cm, with comparable stone free rates, less hospital stays, less pain score, less hemoglobin drops. but longer lithotripsy time.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"24 1","pages":"21-27"},"PeriodicalIF":1.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12777879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145931864","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":"Infection rates of trans-perineal versus trans-rectal prostate biopsy: A Middle Eastern tertiary center experience-Time for a change?","authors":"Oussama G Nasrallah, Maya T Herrera, Mohammad W Fawaz, Mohamad Watfa, Mohammad El Mir, Muhammad A Bulbul, Albert El Hajj, Raja B Khauli, Bassel G Bachir, Wassim Wazzan, Hisham Mukaddem, Riad Khouzami, Rami W Nasr","doi":"10.1080/20905998.2025.2510123","DOIUrl":"10.1080/20905998.2025.2510123","url":null,"abstract":"<p><strong>Introduction: </strong>Prostate cancer is the most diagnosed cancer in men, with transrectal ultrasound-guided (TRUS) biopsy being the most frequently used method of tissue diagnosis in the past. With the introduction of the new modality of trans-perineal (TP) ultrasound-guided prostate biopsy, urologists and radiologists adopted this new technique for the decreased rate of complications such as urinary tract infections, bacteremia, sepsis and the avoidance of antimicrobial prophylaxis. We aim to compare the infectious rates of TRUS versus TP biopsy from our Middle Eastern tertiary care center.</p><p><strong>Methods: </strong>Retrospective data was collected on patients from our medical records from May 2019 till December 2023 at our institution. The data included adult male patients aged 18 years and above undergoing TP or TRUS prostate biopsy. Patients with positive urine culture before biopsy were excluded. Electronic medical records, pathology and laboratory reports were reviewed to collect patient-related data including age, BMI, smoking, alcohol consumption, medical history and comorbidities. In addition, variables related to the procedure type, the target lesion location, antibiotic prophylaxis, bowl preparation, number of cores taken, and laterality of the tumor were included.</p><p><strong>Results: </strong>A total of 745 patients underwent an ultrasound guided prostate biopsy performed by 6 attending urologists at our institution. Among them, 157 (21.1%) patients underwent TRUS biopsy, while 588 (78.9%) underwent TP biopsy. Within one month of the biopsy, 13 patients (1.7%) developed UTI. 6 of them had TRUS (4.1%), and 7 had TP (1.2%) with <i>p</i> = 0.03. Four patients required hospital admission for fever and bacteremia, all of which had undergone TRUS biopsy with hospital stay from 2-5 days receiving meropenem, ciprofloxacin, cefixime or Bactrim.</p><p><strong>Conclusion: </strong>TP prostate biopsy carries a lower risk of infectious complications and requires no antibiotic prophylaxis compared to TRUS biopsy of the prostate. These results advocate the superiority of the use of TP biopsy over TRUS biopsy.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"24 1","pages":"57-65"},"PeriodicalIF":1.2,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12777834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145931892","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":"Evaluation of monotherapy of Coenzyme Q10, L-carnitine or combined therapy on semen parameters in idiopathic male infertility: A placebo-controlled double blind randomized clinical trial.","authors":"Ahmed Higazy, Waleed Mohammed, M Esmat, Mohamed Samir","doi":"10.1080/20905998.2025.2509424","DOIUrl":"10.1080/20905998.2025.2509424","url":null,"abstract":"<p><strong>Introduction: </strong>Antioxidant therapy has been proposed to improve the semen parameters in idiopathic male infertility with no clear consensus on the proper way of management. Our study aimed to evaluate the monotherapy of Coenzyme Q10 (CoQ10), L-Carnitine, or combined therapy on semen parameters in idiopathic male infertility presented with oligoasthenoteratozoospermia (OAT).</p><p><strong>Materials and methods: </strong>Two hundred patients presented with OAT were randomly allocated into four equal groups representing CoQ10, L-Carnitine, or combined therapy of both versus placebo. Our primary outcome was to monitor the improvement in semen parameters. The secondary outcomes were to evaluate the impact on the sperm DNA fragmentation (SDF) index and hormonal profile.</p><p><strong>Results: </strong>After 3 months of medical therapy, 174 patients completed the follow-up period. A highly statistically significant difference was monitored in the monotherapy and combination therapy in all semen parameters and SDF index compared to the baseline, while the placebo group failed to show any improvement. A rise in testosterone level and a decrease in luteinizing hormone were seen in the monotherapy and combination therapy, while no change was noted in the placebo group. Prolactin levels showed no change in all groups.</p><p><strong>Conclusion: </strong>Antioxidant therapy improves semen parameters in patients with OAT. A combination therapy of CoQ10 and L-carnitine results in a superior improvement in semen parameters compared to monotherapy in men with idiopathic OAT.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"24 1","pages":"68-74"},"PeriodicalIF":1.2,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12777869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145931882","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":"Thulium YAG laser versus bipolar enucleation for management of benign prostate obstruction secondary to large prostates (>80 gm): A multicenter prospective randomized study.","authors":"H Shaker, A Yehia, M El Adawy, Mohamed Abd El Ghani, A Kassem, M Abd El Hamid","doi":"10.1080/20905998.2025.2509042","DOIUrl":"10.1080/20905998.2025.2509042","url":null,"abstract":"<p><strong>Objectives: </strong>Endoscopic enucleation of the prostate (EEP) was introduced to treat patients with large prostate. The study compared the perioperative and post-operative outcomes of bipolar current and Thulium-YAG in endoscopic enucleation of large prostates above 80 gm.</p><p><strong>Patients and methods: </strong>This is a prospective study conducted on 120 male patients. The patients were randomized into two equal groups; Group A Thulium laser enucleation of the prostate (THuLEP) and Group B bipolar enucleation of the prostate (BEEP). All patients were preoperatively evaluated as regards operative time, hemoglobin drop, intraoperative and early postoperative complications, hospital stay, and time of catheter removal. Patients were then followed up at 1, 3, 6, and 12 months to detect urinary and sexual functional outcome and any postoperative complications.</p><p><strong>Results: </strong>The preoperative characteristics of both groups were comparable. The mean prostate volume was 122.33 ± 24.34 (84-180 gms) and 120.88 ± 25.66 (85-180gms) (<i>p</i> value: 0.751) in THuLEP and bipolar groups, respectively. Significant comparable improvement in IPSS score, Q max, and PVR postoperatively was found in both groups at all follow up points. Follow up after 1 month revealed urgency urinary incontinence in 34 (56.7%) cases in THuLEP and 14 (23.3%) cases in bipolar enucleation group (<i>p</i> value 0.001), and stress urinary incontinence was detected in 44 (73.3%) cases in THuLEP and 26 (43.3%) cases in bipolar enucleation group, respectively (<i>p</i> value 0.001). Both types of incontinence improved after 3 months in both groups, three cases in the THuLEP group had persistent stress incontinence after 1 year.</p><p><strong>Conclusion: </strong>ThuLEP and bipolar enucleation are comparable treatment modalities for patients with large prostate (>80 ml).</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"24 1","pages":"33-41"},"PeriodicalIF":1.2,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12777908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145931909","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}