Can ChatGPT help patients understand their andrological diseases?

We aimed to assess the reliability of Chat Generative Pre-training Transformer (ChatGPT)'s andrology information and its suitability for informing patients and medical students accurately about andrology topics. We presented a series of systematically organized frequently asked questions on andrology topics and sentences containing strong recommendations from the European Association of Urology (EAU) Guideline to ChatGPT-3.5 and 4.0 as questions. These questions encompassed Male Hypogonadism, Erectile Dysfunction and Sexual Desire Disorder, Disorders of Ejaculation, Penile Curvature and Penile Size Abnormalities, Priapism, and Male Infertility. Two expert urologists independently evaluated and assigned scores ranging from 1 to 4 to each response based on its accuracy, with the following ratings: (1) Completely true, (2) Accurate but insufficient, (3) A mixture of accurate and misleading information, and (4) Completely false. A total of 120 questions were included in the study. Among these questions, 50.0% received a grade of 1 (completely correct) (55.4% for 4.0 version). The combined rate of correct answers (grades 1 and 2) was 85.2% for frequently asked questions (88.8% for 4.0 version) and 81.5% for questions obtained from the guideline. The rate of completely incorrect answers (grade 4) was 1.8% for frequently asked questions (0% for 4.0 version) and 5.2% for questions based on strong recommendations. The response rate of version 4.0 to questions created from sentences containing strong recommendations from the EAU guideline was the same as version 3.5. ChatGPT provided satisfactory answers to the questions asked, although some responses lacked completeness. It may be beneficial to utilize ChatGPT under the guidance of a urologist to enhance patients' comprehension of their andrology issues.

[Connotation and extension of andrology of traditional Chinese medicine].

This paper discusses the study contents, theoretical basis, treatment methods and research tasks of andrology of traditional Chinese medicine (ATCM). It clarifies the connotation, explores the extension and reflects on the direction and content of disciplinary construction of ATCM, aiming to contribute to the development of ATCM in the new era and further improvement of male health.

Dynamism of andrological surgery in France: Evolution of procedures over 10 years.

INTRODUCTION: Andrology and urogenital reconstruction are emerging disciplines in French urology. The aim of our study was to evaluate the evolution of andrological surgical procedures over the period 2013-2022 using national data. MATERIALS AND METHODS: We collected national common classification of medical acts (CCAM) coding data for all procedures involving andrological surgery from the Scansanté internet platform set up by the Technical Agency for Information on Hospitalisation, which collects prospectively from healthcare structures all procedures coded according to CCAM coding. All surgical procedures in andrology were selected. The inclusion period extended from 2013 to 2022. RESULTS: In 10 years, the number of vasectomies has increased tenfold, with 29,890 cases in 2022. Vaso-vasostomies remain marginal, with 80 cases per year. Trans-identity surgeries are rising sharply. Vaginoplasties have multiplied by 4 (333 in 2022) and masculinising surgeries have multiplied by 10 (234 in 2022). Penile prosthesis surgery has increased slightly over 10 years. The number of testicular biopsies has remained stable over time, as has the number of surgeries for curvature of the penis. CONCLUSION: Two andrological surgeries are showing very strong growth: vasectomy and transgender surgery. The emergence of these 2 activities is linked to societal aspirations. Urologists need to be trained to meet this demand. NIVEAU DE PREUVE: Grade 4.

Chatbots vs andrologists: Testing 25 clinical cases.

OBJECTIVE: AI-derived language models are booming, and their place in medicine is undefined. The aim of our study is to compare responses to andrology clinical cases, between chatbots and andrologists, to assess the reliability of these technologies. MATERIAL AND METHOD: We analyzed the responses of 32 experts, 18 residents and three chatbots (ChatGPT v3.5, v4 and Bard) to 25 andrology clinical cases. Responses were assessed on a Likert scale ranging from 0 to 2 for each question (0-false response or no response; 1-partially correct response, 2- correct response), on the basis of the latest national or, in the absence of such, international recommendations. We compared the averages obtained for all cases by the different groups. RESULTS: Experts obtained a higher mean score (m=11/12.4 σ=1.4) than ChatGPT v4 (m=10.7/12.4 σ=2.2, p=0.6475), ChatGPT v3.5 (m=9.5/12.4 σ=2.1, p=0.0062) and Bard (m=7.2/12.4 σ=3.3, p<0.0001). Residents obtained a mean score (m=9.4/12.4 σ=1.7) higher than Bard (m=7.2/12.4 σ=3.3, p=0.0053) but lower than ChatGPT v3.5 (m=9.5/12.4 σ=2.1, p=0.8393) and v4 (m=10.7/12.4 σ=2.2, p=0.0183) and experts (m=11.0/12.4 σ=1.4,p=0.0009). ChatGPT v4 performance (m=10.7 σ=2.2) was better than ChatGPT v3.5 (m=9.5, σ=2.1, p=0.0476) and Bard performance (m=7.2 σ=3.3, p<0.0001). CONCLUSION: The use of chatbots in medicine could be relevant. More studies are needed to integrate them into clinical practice.

Fertility preservation in patients undergoing gonadotoxic treatments: a Canadian Fertility and Andrology Society clinical practice guideline.

The management of young patients with cancer presents several unique challenges. In general, these patients are ill prepared for the diagnosis and the impact on their fertility. With the improved survival for all tumour types and stages, the need for adequate fertility counselling and a multidisciplinary approach in the reproductive care of these patients is paramount. Recent advances in cryopreservation techniques allow for the banking of spermatozoa, oocytes, embryos and ovarian tissue without compromising survival. This Canadian Fertility and Andrology Society (CFAS) guideline outlines the current understanding of social and medical issues associated with oncofertility, and the medical and surgical technologies available to optimize future fertility.

Empowering tomorrow's leaders: the impact of the 15th Network of Young Researchers in Andrology (NYRA) meeting on male reproductive health and interdisciplinary collaboration.

The 15th Network of Young Researchers in Andrology (NYRA) meeting, held at the Palace de Caux, Switzerland, served as a valuable platform to disseminate cutting-edge research and facilitate interactions among early-career researchers and trainees in andrology from around the world. Preceding the 22nd European Testis Workshop, the 2-day event brought together participants from a variety of countries to discuss a range of topics pertaining to men's reproductive health and biology. Specific focuses included piRNAs in mammalian reproduction, biomolecules enhancing sperm physiology, advances in in vitro spermatogenesis, reproductive strategies across species, and career development. A dedicated 'scientific speed-dating' social event also stood out, encouraging cross-disciplinary collaborations and strengthening ties within the scientific community. The high participation rate of the meeting highlighted its value in connecting the andrology community. Finally, the announcement of NYRA's merger with the European Academy of Andrology (EAA) marked a pivotal moment, enabling NYRA to support young researchers while collaborating with the EAA to advance andrology research. The 15th NYRA meeting played a crucial role in enhancing knowledge dissemination and andrology research, empowering young researchers, and addressing key challenges in male infertility.

EAA/EMQN best practice guidelines for molecular diagnosis of Y-chromosomal microdeletions: State of the art 2023.

Testing for AZoospermia Factor (AZF) deletions of the Y chromosome is a key component of the diagnostic workup of azoospermic and severely oligozoospermic men. This revision of the 2013 European Academy of Andrology (EAA) and EMQN CIC (previously known as the European Molecular Genetics Quality Network) laboratory guidelines summarizes recent clinically relevant advances and provides an update on the results of the external quality assessment program jointly offered by both organizations. A basic multiplex PCR reaction followed by a deletion extension analysis remains the gold-standard methodology to detect and correctly interpret AZF deletions. Recent data have led to an update of the sY84 reverse primer sequence, as well as to a refinement of what were previously considered as interchangeable border markers for AZFa and AZFb deletion breakpoints. More specifically, sY83 and sY143 are no longer recommended for the deletion extension analysis, leaving sY1064 and sY1192, respectively, as first-choice markers. Despite the transition, currently underway in several countries, toward a diagnosis based on certified kits, it should be noted that many of these commercial products are not recommended due to an unnecessarily high number of tested markers, and none of those currently available are, to the best of our knowledge, in accordance with the new first-choice markers for the deletion extension analysis. The gr/gr partial AZFc deletion remains a population-specific risk factor for impaired sperm production and a predisposing factor for testicular germ cell tumors. Testing for this deletion type is, as before, left at the discretion of the diagnostic labs and referring clinicians. Annual participation in an external quality control program is strongly encouraged, as the 22-year experience of the EMQN/EAA scheme clearly demonstrates a steep decline in diagnostic errors and an improvement in reporting practice.

[Possibilities and limitations of national guidelines based on the example of pediatric urology guidelines from the Pediatric Urology Working Group of the Austrian Society for Urology and Andrology (ÖGU)]. / Chancen und Grenzen nationaler Leitlinien am Beispiel der "Leitlinien Kinderurologie" des Arbeitskreises für Kinderurologie der österreichischen Gesellschaft für Urologie (ÖGU).

BACKGROUND: Medical guidelines are defined as practical orientation and decision-making aids; they are legally defined as noncommittal recommendations. International guidelines are written in very general terms, especially in the case of heterogeneous clinical pictures (e.g., vesicoureteral reflux). OBJECTIVE: Could national guidelines based on international recommendations become authoritative as specific treatment recommendations for the various specialist groups? MATERIALS AND METHODS: The value of international and national guidelines was assessed using the example case history of a child affected with vesicoureteral reflux. RESULTS: Due to the various therapeutic possibilities according to various guidelines, the child received unfavorable, incongruent, delayed, and repeated unsuccessful attempts with different treatment regimes CONCLUSION: Due to the nonbinding nature of general guidelines, there is a risk of suboptimal therapy. National guidelines aimed at individualized treatment recommendations should aim for higher medical and legal status.

Improving standard practices in studies using results from basic human semen examination.

The purpose of this article is to provide an explanation of the background behind a checklist that declares the laboratory methods used in a scientific study. It focuses primarily on implementing laboratory procedures to yield reliable results in basic semen examinations. While the World Health Organization (WHO) and international standards provide recommendations for basic semen examination, manuscripts submitted to Andrology frequently lack transparency regarding the specific techniques used. In addition, the terminology used for semen examination results often fails to provide a clear definition of the groups under study. Furthermore, the WHO's reference limits are often misinterpreted as strict boundaries between fertility and infertility. It is important to note that valid clinical andrological diagnoses and treatments cannot rely solely on semen examination results; they require proper laboratory procedures as a foundation for diagnosing and treating male patients. Therefore, scientific journals should promote the adoption of robust laboratory practices and an accurate definition of patient groups. A checklist can facilitate the design of high-quality studies and the creation of informative publications. Further, it can help journals assess submitted manuscripts and improve the overall quality of their publications.