{"title":"Risk factors for erectile dysfunction after penile fracture and surgical repair: 12 years of clinical experience.","authors":"Mehmet Ozturk, Muharrem Baturu, Ozlem Basgut, Omer Turgut, Yasin Kurt, Omer Bayrak","doi":"10.4103/aja202519","DOIUrl":"https://doi.org/10.4103/aja202519","url":null,"abstract":"<p><p>Penile fracture is a rare urological emergency that may cause erectile dysfunction (ED). We analyzed the factors affecting erectile function in patients who underwent surgical repair for the management of penile fractures. Eighty-two patients who underwent penile fracture surgery in the Department of Urology, University of Gaziantep (Gaziantep, Türkiye) between January 2012 and January 2023 were evaluated. Age, body mass index, time elapsed from the incident of penile fracture to surgery, size, laterality, level of the defect, causes of fracture, presenting signs and symptoms, and relevant complications were recorded. Erectile function of the patients was evaluated preoperatively and at postoperative 3 rd and 6 th months according to the International Index of Erectile Function-5 (IIEF-5) scoring system. The factors decreasing the erection quality of the patients after surgical repair of penile fractures were investigated using IIEF-5 scoring system. Only age, defect size, and time elapsed from fracture onset to surgery were found to be effective on the occurrence of ED ( P = 0.005, P < 0.001, and P < 0.001, respectively). In the receiver operating characteristic (ROC) analysis, the cut-off values were 12.5 mm for defect size ( P < 0.001), 8.5 h for the time elapsed from fracture onset to surgery ( P = 0.036), and 40.5 years for the age of the patients ( P = 0.005). Delayed surgery, defect size, and advanced age had significant and negative effects on erectile function in cases of penile fracture. Before repair of the defect, patients should be given appropriate counseling about the possibility of ED, and early penile rehabilitation should be initiated.</p>","PeriodicalId":93889,"journal":{"name":"Asian journal of andrology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michele Di Nauta, Ugo Giovanni Falagario, Anna Ricapito, Matteo Rubino, Pasquale Annese, Gian Maria Busetto, Luigi Cormio, Giuseppe Carrieri, Carlo Bettocchi
{"title":"Sexual function recovery following open and robotic radical prostatectomy: results of an academic penile rehabilitation program.","authors":"Michele Di Nauta, Ugo Giovanni Falagario, Anna Ricapito, Matteo Rubino, Pasquale Annese, Gian Maria Busetto, Luigi Cormio, Giuseppe Carrieri, Carlo Bettocchi","doi":"10.4103/aja202525","DOIUrl":"https://doi.org/10.4103/aja202525","url":null,"abstract":"<p><p>Despite surgical advancements, erectile dysfunction (ED) is a common consequence of radical prostatectomy (RP). This study aimed to evaluate the impact of early penile rehabilitation within a dedicated penile rehabilitation program on assisted and unassisted erectile function (EF) recovery. All patients who underwent RP and at least 1 year follow-up at penile rehabilitation program in the Department of Urology, OORR Policlinico Riuniti (Foggia, Italy) were included. Treatment involved phosphodiesterase type 5 inhibitors (PDE5Is; tadalafil 20 mg, 1 tablet every other day), intracavernous injections (Caverject 5 µg, 1 vial per week), and daily use of vacuum erection devices (VEDs). Primary end point was EF recovery defined as International Index of Erectile Function-5 (IIEF-5) ≥21 with or without rehabilitation aids. IIEF-5 and prescribed treatments were prospectively collected at 3 months, 6 months, 9 months, 12 months, and 24 months. Among 570 eligible patients, 397 (69.6%) underwent rehabilitation. Patients who undergoing andro-rehabilitation were younger (65 months v s 70 months; P < 0.0001), had lower prostate-specific antigen (PSA) levels (5.9 ng ml -1vs 6.2 ng ml -1 ; P = 0.04), and lower grade tumors ( P = 0.001) compared to the patients who did not undergo sexual rehabilitation after radical prostatectomy. Two-year EF recovery rates in patients undergoing andro-rehabilitation ranged from 75% (preoperative IIEF-5 >16) to 45% (preoperative IIEF-5 <16) with rehabilitation aids. Combination treatments (PDE5I+VEDs with or without intracavernous injections) showed the highest rates of EF recovery (up to 80% at 2 years). EF recovery without rehabilitation aids was significantly higher for patients with IIEF-5 >21 (IIEF-5 >21 [36%] vs IIEF-5 of 17-21 [18%]; P = 0.01). Subanalysis indicated a moderate benefit of rehabilitation in patients with preoperative IIEF-5 <16 who underwent bilateral nerve-sparing RP. Participation in intensive penile rehabilitation programs improves EF recovery in patients undergoing RP. Preserving the neurovascular bundles may be beneficial for patients with preoperative ED.</p>","PeriodicalId":93889,"journal":{"name":"Asian journal of andrology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Editorial comment on \"Outcomes and management of Peyronie's disease with combined treatment of collagenase clostridium histolyticum, vacuum erection device, and tadalafil\".","authors":"Martin K Gelbard","doi":"10.4103/aja202533","DOIUrl":"https://doi.org/10.4103/aja202533","url":null,"abstract":"","PeriodicalId":93889,"journal":{"name":"Asian journal of andrology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Biagio Barone, Luigi Napolitano, Dario Del Biondo, Felice Crocetto
{"title":"Commentary on \"Outcomes and management of Peyronie's disease with combined treatment of collagenase clostridium histolyticum, vacuum erection device, and tadalafil\".","authors":"Biagio Barone, Luigi Napolitano, Dario Del Biondo, Felice Crocetto","doi":"10.4103/aja202540","DOIUrl":"https://doi.org/10.4103/aja202540","url":null,"abstract":"","PeriodicalId":93889,"journal":{"name":"Asian journal of andrology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Update on penile prosthesis.","authors":"Mykoniatis Ioannis, Langas Georgios, Tsiakaras Stavros, Anastasiadis Anastasios, Van Renterghem Koenraad","doi":"10.4103/aja2024100","DOIUrl":"https://doi.org/10.4103/aja2024100","url":null,"abstract":"<p><strong>Abstract: </strong>The aim of this narrative review is to provide a comprehensive overview of penile prostheses (PPs) for the treatment of erectile dysfunction (ED), exploring their historical evolution, types, key advancements, clinical outcomes, and future directions. A comprehensive literature search of studies published in English was conducted between January 2000 and April 2024, using databases including PubMed, MEDLINE, Embase, and the Cochrane Library. Search terms included \"penile prosthesis\", \"penile implants\", \"malleable penile implant\", \"inflatable penile prosthesis\", \"two-piece IPP\", \"three-piece IPP\", and \"penile implant advancements\". The included studies focused on the development, effectiveness, and complications of penile prostheses. These studies are clinical trials, randomized controlled trials, observational studies, systematic reviews, and meta-analyses. Data were synthesized qualitatively and quantitatively. Penile prostheses have significantly evolved since their invention, with notable advancements in both malleable and inflatable models. Malleable prostheses, known for their simplicity and reliability, offer a semirigid state that is beneficial for patients with limited hand dexterity or those undergoing salvage procedures. Inflatable penile prostheses (IPPs), particularly the three-piece models, have seen substantial technological improvements, including enhanced mechanical reliability, reduced infection rates due to antibiotic coatings, and better patient satisfaction. Key innovations include the development of hydrophilic coatings, parylene microcoatings, and antibiotic-impregnated implants, which have collectively reduced complications.</p>","PeriodicalId":93889,"journal":{"name":"Asian journal of andrology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Raidh Talib Alzubaidi, Mohamed Abdelkareem, Raed M Al-Zoubi, Ahmad R Al-Qudimat, Aksam Yasin, Hatem Kamkoum, Abdullah A Al-Ansari
{"title":"Outcomes and management of Peyronie's disease with combined treatment of collagenase clostridium histolyticum, vacuum erection device, and tadalafil.","authors":"Raidh Talib Alzubaidi, Mohamed Abdelkareem, Raed M Al-Zoubi, Ahmad R Al-Qudimat, Aksam Yasin, Hatem Kamkoum, Abdullah A Al-Ansari","doi":"10.4103/aja202514","DOIUrl":"https://doi.org/10.4103/aja202514","url":null,"abstract":"<p><strong>Abstract: </strong>Peyronie's disease (PD) is a connective tissue disorder characterized by abnormal collagen deposition in the tunica albuginea, leading to penile curvature, pain, and erectile dysfunction. This study aimed to evaluate the outcomes of a combined treatment protocol incorporating collagenase clostridium histolyticum (CCH), vacuum erection device, and tadalafil. A retrospective analysis was conducted on 99 male patients with PD treated at the Department of Urology, Hamad Medical Corporation (Doha, Qatar) between January 2018 and January 2020. Patients received 4-8 CCH injections alongside vacuum therapy and daily tadalafil (5 mg). The baseline mean penile curvature of 49.0° improved by an average of 21.4% post-treatment. Erectile function scores also increased significantly, with a mean improvement of 2.3 points on the International Index of Erectile Function. Minor complications were observed in 15 patients, while 13 were dissatisfied with treatment, with six opting for surgery. The modified protocol demonstrated significant improvements in penile curvature and erectile function with minimal complications, offering a safe, cost-effective alternative to traditional intensive treatments.</p>","PeriodicalId":93889,"journal":{"name":"Asian journal of andrology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bi-Ran Ye, Hui Wang, Yong-Qing Zhang, Guo-Wen Lin, Hua Xu, Zhe Hong, Bo Dai, Fang-Ning Wan
{"title":"A propensity score-matched analysis on biopsy methods: enhanced detection rates of prostate cancer with combined cognitive fusion-targeted biopsy.","authors":"Bi-Ran Ye, Hui Wang, Yong-Qing Zhang, Guo-Wen Lin, Hua Xu, Zhe Hong, Bo Dai, Fang-Ning Wan","doi":"10.4103/aja202515","DOIUrl":"https://doi.org/10.4103/aja202515","url":null,"abstract":"<p><p>The choice of biopsy method is critical in diagnosing prostate cancer (PCa). This retrospective cohort study compared systematic biopsy (SB) or cognitive fusion-targeted biopsy combined with SB (CB) in detecting PCa and clinically significant prostate cancer (csPCa). Data from 2572 men who underwent either SB or CB in Fudan University Shanghai Cancer Center (Shanghai, China) between January 2019 and December 2023 were analyzed. Propensity score matching (PSM) was used to balance baseline characteristics, and detection rates were compared before and after PSM. Subgroup analyses based on prostate-specific antigen (PSA) levels and Prostate Imaging-Reporting and Data System (PI-RADS) scores were performed. Primary and secondary outcomes were the detection rates of PCa and csPCa, respectively. Of 2572 men, 1778 were included in the PSM analysis. Before PSM, CB had higher detection rates for both PCa (62.9% vs 52.4%, odds ratio [OR]: 1.54, P < 0.001) and csPCa (54.9% vs 43.3%, OR: 1.60, P < 0.001) compared to SB. After PSM, CB remained superior in detecting PCa (63.1% vs 47.9%, OR: 1.86, P < 0.001) and csPCa (55.0% vs 38.2%, OR: 1.98, P < 0.001). In patients with PSA 4-12 ng ml-1 (>4 ng ml-1 and ≤12 ng ml-1, which is also applicable to the following text), CB detected more PCa (59.8% vs 40.7%, OR: 2.17, P < 0.001) and csPCa (48.1% vs 27.7%, OR: 2.42, P < 0.001). CB also showed superior csPCa detection in those with PI-RADS 3 lesions (32.1% vs 18.0%, OR: 2.15, P = 0.038). Overall, CB significantly improves PCa and csPCa detection, especially in patients with PSA 4-12 ng ml-1 or PI-RADS 3 lesions.</p>","PeriodicalId":93889,"journal":{"name":"Asian journal of andrology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Liu Liu, Yi-Ling Zhou, Wei-Dong Tian, Feng Jiang, Jia-Xiong Wang, Feng Zhang, Chun-Yu Liu, Hong Zhu
{"title":"Novel biallelic HFM1 variants cause severe oligozoospermia with favorable intracytoplasmic sperm injection outcome.","authors":"Liu Liu, Yi-Ling Zhou, Wei-Dong Tian, Feng Jiang, Jia-Xiong Wang, Feng Zhang, Chun-Yu Liu, Hong Zhu","doi":"10.4103/aja20259","DOIUrl":"https://doi.org/10.4103/aja20259","url":null,"abstract":"<p><p>Male factors contribute to 50% of infertility cases, with 20%-30% of cases being solely attributed to male infertility. Helicase for meiosis 1 (HFM1) plays a crucial role in ensuring proper crossover formation and synapsis of homologous chromosomes during meiosis, an essential process in gametogenesis. HFM1 gene mutations are associated with male infertility, particularly in cases of non-obstructive azoospermia and severe oligozoospermia. However, the effects of intracytoplasmic sperm injection (ICSI) in HFM1-related infertility cases remain inadequately explored. This study identified novel biallelic HFM1 variants through whole-exome sequencing (WES) in a Chinese patient with severe oligozoospermia, which was confirmed by Sanger sequencing. The pathogenicity of these variants was assessed using real-time quantitative polymerase chain reaction (RT-qPCR) and immunoblotting, which revealed a significant reduction in HFM1 mRNA and protein levels in spermatozoa compared to those in a healthy control. Transmission electron microscopy revealed morphological abnormalities in sperm cells, including defects in the head and flagellum. Despite these abnormalities, ICSI treatment resulted in a favorable fertility outcome for the patient, indicating that assisted reproductive techniques (ART) can be effective in managing HFM1-related male infertility. These findings offer valuable insights into the management of such cases.</p>","PeriodicalId":93889,"journal":{"name":"Asian journal of andrology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A review of testicular histopathology in nonobstructive azoospermia.","authors":"Taymour Mostafa, Kadir Bocu, Vineet Malhotra","doi":"10.4103/aja202454","DOIUrl":"10.4103/aja202454","url":null,"abstract":"<p><strong>Abstract: </strong>One major challenge in male factor infertility is nonobstructive azoospermia (NOA), which is characterized by spermatozoa-deficient semen without physical duct blockage. This review offers a thorough overview of the histopathology of the testes in NOA cases, clarifying its complex etiology and emphasizing the possible value of histopathology inspection for both diagnosis and treatment. Variable histopathological findings have been linked to NOA, such as tubular hyalinization, Sertoli cell-only syndrome, hypospermatogenesis, and germ cell arrest. Understanding the pathophysiology and forecasting the effectiveness of treatment are further enhanced by both morphometric and ultrastructural analyses. The potential significance of testicular biopsy in forecasting reproductive outcomes is assessed, especially concerning assisted reproductive technologies like intracytoplasmic sperm injection (ICSI). Besides, testicular microlithiasis, serum hormone profiles, and testicular size are investigated concerning NOA histopathology. It is concluded that understanding the histopathological patterns in NOA is crucial for its accurate diagnosis and appropriate management. Further research is still warranted to improve understanding of the complex pathophysiology underlying NOA.</p>","PeriodicalId":93889,"journal":{"name":"Asian journal of andrology","volume":" ","pages":"370-374"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876949","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}
Krishna Chaitanya Mantravadi, Christina Anagnostopoulou, Firuza R Parikh
{"title":"Andrology laboratory techniques for micro-TESE/IVF/ICSI: a narrative review.","authors":"Krishna Chaitanya Mantravadi, Christina Anagnostopoulou, Firuza R Parikh","doi":"10.4103/aja2024122","DOIUrl":"10.4103/aja2024122","url":null,"abstract":"<p><strong>Abstract: </strong>Since the early days of assisted reproductive technology (ART), the importance of sperm processing, employed to separate the motile, morphologically normal sperm from the semen, has been shown to be beneficial. The aim of the semen processing technique has been to remove seminal plasma and facilitate capacitation. Additionally, the presence of leukocytes, bacteria, and dead spermatozoa has been shown to be detrimental as it may cause oxidative stress that has an adverse effect on oocyte fertilization and embryo development. Hence, removal of leukocytes, bacteria, and dead spermatozoa is an important step of sperm processing for assisted reproduction. Currently, several sperm processing techniques have been evolved and optimized in the field of assisted reproduction. The requirements for in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), and testicular sperm extraction (TESE) are different than those of intrauterine insemination (IUI). The yield of as many motile, morphologically normal sperm as possible is a prerequisite for the success of IVF insemination procedure. In ICSI, where injection of a single spermatozoon into the oocyte is performed by the embryologist, sperm selection techniques play a crucial role in the ICSI procedure. Finally, sperm retrieval in TESE samples with very low number of sperm may be challenging and requires extra care during sample processing. Additionally, sperm cryopreservation is necessary in TESE cases in order to avoid multiple biopsies.</p>","PeriodicalId":93889,"journal":{"name":"Asian journal of andrology","volume":" ","pages":"383-391"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660066","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}