Impact of Spirulina Supplementation on Semen Parameters in Patients with Idiopathic Male Infertility: A Pilot Randomized Trial.

PURPOSE: To evaluate the efficacy of therapy with spirulina supplement on semen parameters in patients with idiopathic male infertility. MATERIALS AND METHODS: A total of 40 men with idiopathic infertility were randomly assigned into two groups. Group A received 2 g spirulina supplement as well as conventional regimen for the treatment of infertility selected by their physician (220 mg/day zinc sulfate, 500mg/day L-carnitine, and 50 mg/day clomiphene) during 12 weeksof the study, while group B received placebo plus conventional therapy during the study period. Semen parameters were analyzed at baseline and at the end of the study as a primary endpoint. The secondary endpoint was the rate of pregnancy occurring in the patients. wives. RESULT: No significant differences in semen parameters were observed between the spirulina and control groups [count (16.43 vs. 46.00, P = .164), motility (51.00 vs. 48.7, P = .008), and morphology (47.50 vs. 15.00, P = NA)]. Our results showed a pregnancy rate of 5% in the spirulina group versus 0% in the control group. CONCLUSION: This pilot randomized trial provides initial evidence on the possible beneficial effects of spirulina mainly in patients with impaired sperm motility or morphology. Due to the limited sample size, further larger randomized trials not only at the level of semen parameters but at the scope of paternity are required to confirmthese potential benefits.

A Randomized Double-blind Placebo-controlled Trial to Assess the Effect of Tamarind seed in Premature Ejaculation.

BACKGROUND: This randomized clinical trial was aimed to evaluate the effect of oral use of tamarind seed powder as an herbal product in patients affected by premature ejaculation (PE). MATERIALS AND METHODS: In this study, 75 patients randomized in tamarind group (25 patients received daily 130 mg tamarind seed powder), paroxetine group (25 patients received daily 20 mg paroxetine), and placebo group (25 patients). Patients received the treatment regimen for 4 weeks. The primary outcome was intravaginal ejaculatory latency time (IELT). The secondary outcomes were PE diagnostic tool score, sexual function using International Index of Erectile Function (IIEF), and complications. Studied sexual functions include erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction. RESULTS: The mean of IELT in tamarind, paroxetine, and placebo groups at baseline was 35.2 ± 26.5, 38 ± 27.6, and 44 ± 34.9 s and at the end of study was 49.5 ± 48.2, 147.4 ± 209.6, and 46.9 ± 37.6 s, respectively, which in paroxetine group significantly increased compared to other groups. IIEF scores for orgasmic function and intercourse satisfaction for paroxetine after treatment significantly increased than that of other groups. The differences between tamarind and placebo groups for studied variables were not statistically significant. The mean of increases in IELT for tamarind, paroxetine, and placebo groups was 14.35 ± 34.3, 109.4 ± 213.4, and 2.9 ± 9.3 s, respectively, which in paroxetine group was significantly higher than other groups and in tamarind group was significantly higher than placebo. CONCLUSIONS: Paroxetine was significantly better than tamarind seed powder and placebo although side effect in paroxetine was more frequent. IELT significantly more increased in tamarind group compared to placebo.

Heat-targeted drug delivery: A promising approach for organsparing treatment of bladder cancer.THERMODOX®. / Administración de medicamentos dirigida por el calor: un enfoque prometedor para el tratamiento órgano conservador del cáncer de vejiga. THERMODOX®.

Disease recurrence and progression remain as significant challenges for the management of non-muscle invasive bladder cancer (NMIBC). In recent years, novel drugs and delivery systems have been investigated as strategies to reduce recurrence, progression and mortality. In this review, we focus on the role of intravesical hyperthermic chemotherapy and discuss a novel approach involving a heat-activated drug delivery system (ThermoDox®) that enables local accumulation of systemic chemotherapy.

Effect of Preoperative Finasteride on the Volume or Length Density of Prostate Vessels, Intraoperative, Postoperative Blood Loss during and after Monopolar Transurethral Resection of Prostate: A Dose Escalation Randomized Clinical Trial Using Stereolog Methods.

PURPOSE: To evaluate the effects of two preoperative treatment courses with Finasteride on intraoperative and postoperative bleeding complications and prostate blood vessel characteristics in men who underwent transurethral resection of prostate (TURP) using monopolar energy. MATERIALS AND METHODS: Men scheduled for TURP were randomized into group 1 (control n = 25, no medication), group 2 and 3 (n = 20 in each, 5 mg Finasteride daily for 2 and 4 weeks before TURP; respectively). Hematocrit level in the irrigation fluid, weight of the resected prostate chips, decreases in blood hemoglobin (Hb) level 6 and 24 hours after the operation together with volume and length density of prostate vessels using stereological methods were compared. RESULTS: The three groups were matched regarding preoperative demographic data, resection time and weight of the resected tissue. Men who received preoperative Finasteride (groups 2 and 3) had significantly lower hematocrit levels in irrigation fluid than control group (control, 0.59 ± 0.85, group 2, 0.25 ± 0.4, group 3, 0.175 ± 0.16; P = .028; Power = .80). However, no statistically significant difference was found in hematocrit level in irrigation fluid between groups 2 and 3 (0.25 ± 0.4 vs. 0.175 ± 0.16, 95% confidence interval (CI) = -0.28-0.42; P = .68). These values were independent of the weight of the resected tissue and resection time. There were no significant differences between the three groups in the decrease in Hb 6 hours (P = .58) and 24 hours after TURP (P = .65). The stereological and histological characteristics of blood vessels in suburethral prostate tissue were similar in all three groups. CONCLUSION: A 2-week preoperative course of daily Finasteride seems sufficient to significantly reduce intraoperative blood loss; this effect was independent of the weight of the resected tissue and resection time. Neither the 2-week nor the 4-week presurgical Finasteride regimen could significantly decrease postoperative blood loss, and neither regimen induced significant changes in characteristics of prostate tissue blood vessels.

Superselective α-adrenergic blockers versus transurethral resection of the prostate: a prospective comparison of health-related quality of life outcome after treating patients with benign prostatic hyperplasia.

PURPOSE: We prospectively evaluated the impact of transurethral resection of the prostate (TURP) versus superselective α-adrenergic blocker treatment on health-related quality of life (HRQOL) in men with clinically diagnosed benign prostatic hyperplasia (BPH). PATIENTS AND METHODS: A total of 219 patients with lower urinary tract symptoms (LUTS) caused by BPH were recruited in this study. Treatment modalities consisted of standard TURP (n = 104) and tamsulosin medical treatment (n = 115). HRQOL was assessed by SF-36-Item Health Survey 1.0. LUTS were estimated by The International Prostate Symptom Score. Patients' outcome 4 weeks after treatment was compared to pre-treatment status and to that of the other group. Statistically significant changes in each HRQOL scale from baseline to follow-up period were investigated. RESULTS: Baseline characteristics were similar in both groups except for the duration of disease before treatment that was longer in TURP group. Both treatments resulted in statistically significant improvements from pre-treatment in all scales of QOL after 4 weeks, with no significant differences observed between the two groups. In medical treatment group, there was a significant association between higher educational level and better QOL in all 8 scales. Our outcomes revealed a significant decrease in the IPSS in both groups but this improvement was more evident in TURP group. CONCLUSION: All scales concerning HRQOL were favorably improved 4 weeks after both surgical and medical treatment, and no significant differences were observed between these two treatment modalities for patients with symptomatic BPH. This information may aid patients when deciding which treatment option to take.

Epidemiologic status of bladder cancer in Shiraz, southern Iran.

BACKGROUND: Bladder cancer is the second most common malignancy of the genitourinary tract worldwide after prostate cancer. However, in Iran it is the most common cancer of the genitourinary system and the third most common cancer in males. The increasing trend in bladder cancer incidence in recent decades, along with the lack of research on this malignancy in Iran, make epidemiologic research important in light of its preventability through early recognition and limiting exposure to risk factors. The present study aimed to assess the epidemiology of bladder cancer in Shiraz, a large city in southern Iran, during a 2-year period. METHODS: The data for this study were obtained from the population-based cancer registry of the Vice-Chancellery for Health Affairs of Shiraz University of Medical Sciences and Shiraz hospitals between March 1, 2007 and March 1, 2009. Demographic, clinical and pathological aspects of 216 patients with bladder cancer were investigated through careful review of their medical records. Statistical analyses were performed with SPSS software. P values less than 0.05 were considered statistically significant. RESULTS: We analyzed data for 179 (82.9%) men and 37 (17.1%) women (mean age of 65.1∓12.7 years). Tobacco and opium use were found in 109 (65.3%) and 44 (34.1%) patients, respectively. Cigarette smokers and water pipe smokers were mostly men (P=0.001 and P=0.04, respectively). The most common type of tumor was transitional cell carcinoma (95.7%) and most tumors were of low malignant potential grade (39.7%). Nearly half of the patients suffered recurrence. CONCLUSION: Comparisons with previous studies showed that bladder cancer tends to appear slightly more often in the elderly and that the tumors tend to have a higher grade of malignancy in our region. There is a need for more epidemiologic studies on the trends in the incidence and other epidemiologic indices.