The GG genotype of rs743572 in CYP17A1 gene regulating the decrease of T/E ratio can be an independent risk factor for MetS-BPH: a retrospective cohort study.

PURPOSE: To confirm if the CYP17A1 gene regulates the ratio of T/E leading to MetS-BPH. METHODS: 824 men, aged 47-88 years, were recruited into this study through consecutive routine physical examination programs and long-term outpatient screening. Several parameters, including SNPs of CYP17A1 gene, total testosterone, estradiol, and the ratio of total testosterone to estradiol (T/E) were obtained for each participant. Based on the diagnosis of BPH, MetS, and MetS-BPH, the participants were divided into BPH and non-BPH groups, MetS and non-MetS groups, and MetS-BPH and non-MetS-BPH groups. Values of the obtained parameters were evaluated using one-way analysis of variance, Student's t-test, Chi-squared test, and logistic regression analysis. RESULTS: SNPs of the CYP17A1 gene, including the rs743572 genotypes (GG, GA, and AA), rs3781287 genotypes (GG, GT, TT), and rs4919686 genotypes (CC, CA, and AA), were present in every group. Only the GG genotype of rs743572 was independently associated with BPH (OR = 5.868, 95% CI: 3.363-7.974, P < 0.001), MetS (OR = 7.228, 95% CI: 3.925-11.331, P < 0.001), and MetS-BPH (OR = 3.417, 95% CI: 1.783-5.266, P < 0.001) after adjusting for age. In the population of genotype GG of rs743572, the decrease in T/E ratio was an independent risk factor for BPH (OR = 839.756, 95% CI: 36.978-1334.263, P = 0.001), MetS (OR = 376.988, 95% CI: 12.980-488.976, P < 0.003), and MetS-BPH (OR = 388.236, 95% CI: 24.869-495.363, P = 0.003). CONCLUSION: The GG genotype of rs743572 in CYP17A1 gene regulating the decrease of T/E ratio can be an independent risk factor for MetS-BPH populations. TRIAL REGISTRATION NUMBER: ChiCTR2200057632 "retrospectively registered". DATE OF REGISTRATION: March 15, 2022 "retrospectively registered".

Cushing's syndrome caused by adrenocortical oncocytoma: A case report.

Adrenal cortical eosinophilic adenoma usually presents as non-functional adrenal tumor but may lead to Cushing's syndrome in patients. The present article reports a patient with Cushing's syndrome caused by right adrenocortical oncocytoma. The patient was treated in Urology Department of Wuchuan People's Hospital (Zunyi, China) in November 2022 because of hirsutism, weight gain and hypertension. A laparoscopic right adrenal tumor resection was performed using an abdominal approach. Following surgery, blood pressure and heart rate of the patient fluctuated within a healthy range and menstruation returned to normal. Laparoscopic adrenalectomy has obvious advantages over open adrenalectomy, such as less trauma, shorter recovery time and fewer complications. Thus, this treatment for this rare disease is safe and feasible.

Studies on improving semen quality and increasing pregnancy chances through the in vitro addition of L-carnitine and coenzyme Q10 to semen in patients with asthenozoospermia.

BACKGROUND: At present, L-carnitine (LC) and coenzyme Q10 (CoQ10), as used clinically to treat male infertility caused by asthenozoospermia (ASZ) is still mainly administered orally, but some patients with ASZ still show no significant improvement in sperm motility and spouse pregnancy rate. Prodom is a device used to assist reproduction, which is temporarily fitted onto the penis to facilitate conception by helping the wife inject a certain drug into the vagina. This study used Prodom-assisted LC/CoQ10 in the treatment of patients with ASZ and evaluated the effect of this method on sperm motility and clinical pregnancy, with the goal of finding a comfortable, low-cost, effective method. RESULTS: During the trial period, 232 cases completed the trial, while 25 cases did not. During in vitro testing, the progressive sperm motility in the LC group, CoQ10 group, LC combined with CoQ10 group, and the semen blank control group was 24.3 ± 4.6% and 38.1 ± 5.1%, 23.0 ± 4.8% and 36.9 ± 4.4%, 28.4 ± 5.0% and 43.8 ± 5.4%, 19.7 ± 4.4% and 26.0 ± 4.9%, respectively. There were statistically significant differences in progressive sperm motility among the groups (all P values < 0.05). The pregnancy rates of the Prodom-assisted LC treatment group, Prodom-assisted CoQ10 treatment group, Prodom-assisted LC combined with CoQ10 treatment group, and oral LC combined with CoQ10 treatment group in the clinical treatment stage were 38.2, 35.4, 57.1, and 30.3%, respectively; the time to conception was 6.1 ± 1.8, 6.2 ± 1.8, 3.4 ± 0.9, and 7.9 ± 2.0, months respectively; and the treatment costs were $2350 ± 457, $2455 ± 434, $1348 ± 411, and $2684 ± 334, respectively. The differences in pregnancy rate, time to conception, and treatment costs among the groups were statistically significant (all P values < 0.05). CONCLUSIONS: The supplementation of in vitro semen with LC/CoQ10 can improve sperm motility. LC/CoQ10 injected into the spouse's vagina with the assistance of a Prodom can increase the pregnancy rate, shorten the time to conception, and reduce the cost of treatment in patients with ASZ. TRIAL REGISTRATION: ChiCTR2000040349 (registry: http://www.chictr.org.cn/ ). Date of registration: November 28, 2020.

RéSUMé: CONTEXTE: À l'heure actuelle, la L-carnitine (LC) et le coenzyme Q10 (CoQ10), tels qu'utilisés en clinique pour traiter l'infertilité masculine due à une asthénozoospermie (AZS), sont encore principalement administrés par voie orale, mais certains patients atteints d'AZS ne montrent pas toujours d'amélioration significative de la motilité des spermatozoïdes, ni de grossesse chez la conjointe. Prodom™ est. un dispositif utilisé pour aider à la reproduction, qui est. temporairement installé sur le pénis pour faciliter la conception en aidant la femme à injecter certains médicaments dans le vagin. Cette étude a utilisé une association CL + CoQ10 assistée par Prodom™ pour traiter des patients atteints d'AZS et a évalué l'effet de cette méthode sur la mobilité des spermatozoïdes et la grossesse clinique, dans le but de trouver une méthode confortable, peu coûteuse et efficace. RéSULTATS: Au cours de cet essai thérapeutique, 232 cas sont allés au bout de l'étude, alors que 25 se sont arrêtés. Au cours des tests in vitro, la mobilité progressive des spermatozoïdes dans le groupe LC, le groupe CoQ10, le groupe CL + CoQ10 et dans le groupe témoin de sperme, était respectivement de 24,3 ± 4,6% et 38,1 ± 5,1%, de 23,0 ± 4,8% et 36,9 ± 4,4%, de 28,4 ± 5,0% et 43,8 ± 5,4%, et de 19,7 ± 4,4% et 26,0 ± 4,9%. La mobilité progressive des spermatozoïdes était significativement différentes entre les groupes (toutes les valeurs de P < 0,05). Les taux de grossesse dans le groupe traité par LC assistée par Prodom™, dans le groupe traité par CoQ10 assisté par Prodom™, dans le groupe traité par une association CL + CoQ10 assistée par Prodom™, et dans le groupe traité cliniquement par CL par voie orale associée au CoQ10, étaient respectivement de 38,2%, 35,4%, 57,1% et 30,3%; le délai de conception était respectivement de 6,1 ± 1,8, 6,2 ± 1,8, 3,4 ± 0,9 et 7,9 ± 2,0, mois; et les coûts de traitement étaient respectivement de 2350 ± 457 $, 2455 ± 434 $, 1348 ± 411 $ et 2684 ± 334 $. Les différences dans le taux de grossesse, le délai de conception et les coûts de traitement entre les groupes étaient statistiquement significatives (toutes les valeurs de P < 0,05). CONCLUSIONS: La supplémentation en LC/CoQ10 du sperme in vitro peut améliorer la mobilité des spermatozoïdes. L'association LC + CoQ10 injectée dans le vagin de la conjointe avec l'aide d'un Prodom™ peut augmenter le taux de grossesse, raccourcir le délai de conception et réduire le coût du traitement chez les patientes atteints d'AZS. Numéro d'enregistrement de l'essai ChiCTR2000040349 (registre: http://www.chictr.org.cn/ ). Date d'enregistrement: 28 novembre 2020.

Effects of unilateral/bilateral amputation of the ischiocavernosus muscle in male rats on erectile function and conception.

BACKGROUND: The ischiocavernosus muscle (ICM) encompasses a pair of short pinnate muscles attached to the pelvic ring. The ICM begins at the ischial tuberosity and ends at the crus of the penis while covering the surface of the crus. According to the traditional view, the contraction of the ICM plays an auxiliary role in penile erection. However, we have previously shown that the ICM plays an important role in penile erection through an indirect method of diagnosing erectile dysfunction (ED) caused by ICM injury by observing the infertility of paired female rats. Since intracavernosal pressure (ICP) is the current gold standard for diagnosing ED, this study aimed to amputate unilaterally/bilaterally the ICM to establish an ED model by detecting the ICP, recording the infertility of matching female rats, and comparing the two methods. RESULTS: Forty sexually mature adult male rats were selected and randomly divided into the following groups: the control group (n = 10), sham operation group (n = 10), unilateral ischiocavernosus muscle (Uni-ICM) amputation group (n = 10), and bilateral ischiocavernosus muscle (Bi-ICM) amputation group (n = 10). Eighty female reproductive rats were randomly assigned to the above groups at a ratio of 2:1. We evaluated the time to conception for the paired female rats and the effects of unilateral/bilateral severing of the ICM on erectile function. The results showed that the baseline and maximum intracavernosal pressure (ICP) in the control group, sham operation group, Uni-ICM amputation group, and Bi-ICM amputation group were 17.44±2.50 mmHg and 93.51±10.78 mmHg, 17.81±2.81 mmHg and 95.07±10.40 mmHg, 16.73±2.11 mmHg and 83.49±12.38 mmHg, and 14.78±2.78 mmHg and 33.57±6.72 mmHg, respectively, immediately postsurgery. The max ICP in the Bi-ICM amputation group was lower than that in the remaining three groups (all P<0.05). The pregnancy rates were 100, 100, 90, and 0% in the control group, sham operation group, Uni-ICM amputation group, and the Bi-ICM amputation group, respectively. The pregnancy rate in the Bi-ICM amputation group was significantly lower than that in the remaining groups (all P<0.05). The time to conception was approximately 7-10 days later in the Uni-ICM amputation group than in the control and sham groups (all P<0.05). CONCLUSIONS: Male rats undergoing Bi-ICM amputation may develop permanent ED, which affects their fertility. In contrast, rats undergoing Uni-ICM amputation may experience transient ED.

RéSUMé: INTRODUCTION: Le muscle Ischiocavernosus (MIC) est une paire de muscles courts attachés à l'anneau pelvien. Elle commence à la tubérosité ischiale et se termine au crus du pénis tout en couvrant la surface de ce dernier. Selon la vision traditionnelle, la contraction du MIC joue un rôle auxiliaire dans l'érection pénienne. Cependant, nos travaux précédents ont montré qu'il joue un rôle important dans l'érection pénienne par une méthode indirecte de diagnostic de la dysfonction érectile (DE) induite par une blessure du MIC en observant l'infertilité des rats femelles appariés. Comme la pression intracaverneuse (PIC) est actuellement l'étalon de référence pour le diagnostic, cette étude visait à amputer unilatéralement/bilatéralement l'ICM pour établir un modèle de DE par détection de l'ICP, par détection de l'infertilité de rats femelles appariés, et par comparaison des deux méthodes. RéSULTATS: Quarante rats mâles adultes sexuellement matures ont été sélectionnés et répartis aléatoirement dansquatre groupes groupe témoin (n = 10), groupe d'opération simulée (n = 10), groupe d'amputation unilatérale du MIC (Uni-MIC) (n = 10), et groupe d'amputation bilatérale du MIC (Bi-MIC) (n = 10). Quatre-vingts rats femelles en période de reproduction ont été réparties de façon aléatoire dans chacun des groupes mentionnés ci-dessus, selon un rapport de 2:1. Nous avons évalué le temps avant la conception des rats femelles appariés et les effets de l'amputation Uni /Bi-MIC sur la fonction érectile. Les résultats ont montré que la pression de base et la PIC maximale dans le groupe témoin, le groupe d'opération simulée, le groupe Uni-MIC et le groupe Bi-MIC étaient respectivement de 17.44 ± 2.50 mmHg et 93.51 ± 10.78 mmHg, 17.81 ± 2.81 mmHg et 95.07 ± 10.40 mmHg, 16.73 ± 2.11 mmHg et 83.49 ± 12.38 mmHg, et 14.78 ± 2.78 mmHg et 33.57 ± 6.72 mmHg, immédiatement après l'opération. La PIC maximale dans le groupe Bi-MIC était inférieure à celles des trois autres groupes (tous P < 0.05). Les taux de grossesse étaient de 90% dans le groupe Uni-MIC et de 0% dans le groupe Bi-MIC. Le taux de grossesse dans le groupe Bi-MIC était significativement plus faible que dans les autres groupes (tous P < 0.05). Le temps de conception a été d'environ 7 à 10 jours plus tard dans le groupe Uni-MIC que dans le groupe témoin et le groupe d'opération simulée (tous P < 0.05). CONCLUSIONS: Les rats mâles subissant une amputation Bi-MIC peuvent développer une DE permanente qui affecte leur fertilité. En revanche, ceux qui subissent une amputation Uni-MIC peuvent connaître des troubles érectiles transitoires.

Clinical Efficacy of Prodom-Assisted Urokinase in the Treatment of Male Infertility Caused by Impaired Semen Liquefaction.

PURPOSE: To evaluate the clinical efficacy of prodom in the administration of urokinase in the vagina in couples with impaired semen liquefaction. MATERIALS AND METHODS: Overall, 261 patients with impaired semen liquefaction were randomly divided into prodom-assisted urokinase treatment (PAUT) group (n = 91), syringe-assisted urokinase treatment (SAUT) group (n = 86), and traditional treatment (TT) group (n = 84) in the first stage. If the first stage of treatment failed, other treatment methods were initiated instead and the patients were grouped according to the newer treatment method in the second stage. The pregnancy rate, time-to-conception, and treatment costs were evaluated in each group. RESULTS: In the first stage, the pregnancy rate in the PAUT, SAUT, and TT groups was 69.23%, 29.07%, and 22.62%, respectively; the time-to-conception was 2.66 ± 1.44, 3.69 ± 2.61, and 3.86 ± 3.00 months, respectively; the treatment costs were 658.18 ± 398.40, 666.67 ± 507.50, and 680.56 ± 480.94 $, respectively. The pregnancy rate and time-to-conception were different in the PAUT group compared with those in SAUT and TT groups (all P < 0.05). However, the difference in treatment costs was not significant (P = 0.717). In the second stage, 154 nonpregnant patients were divided into nine treatment groups, and the effects of changing TT to PAUT on the pregnancy rate, time-to-conception, and treatment costs were observed to be different from those of other treatments (all P < 0.05). CONCLUSION: Prodom-assisted urokinase can effectively treat male infertility secondary to impaired semen liquefaction.