Combination of Korean Red Ginseng Extract and Hydrogen-Rich Water Improves Spermatogenesis and Sperm Motility in Male Mice / 中国结合医学杂志

OBJECTIVE@#To investigate the effect of hydrogen-rich Korean Red Ginseng (KRG) water (HRGW) mixture on the spermatogenesis and sperm motility of mice of different ages.@*METHODS@#Eighty young (3 month-old) and aged (12 month-old) male mice were randomly assigned to 4 groups (n =10 per group) including control group, hydrogen-rich water (HRW) group (10 mL/kg daily), KRG group (50 mg/kg daily) and HRGW group (10 mL/kg and 50 mg/kg daily) by an oral zoned needle for 4 weeks. Sperm count and motility were measured using sperm suspension released from cauda epididymis. Serum follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone, and reactive oxygen species (ROS) in serum have also been estimated. Tubular changes were examined through histological hematoxylin and eosin staining. Expression of antioxidation (PPx3, PPx4, GSTm5 and GPx4), spermatogenesis (inhibin-a, neptin-2 and CREM), antiaging (SIRT1 and SIRT2), and angiogenesis [visfatin and vascular endothelial growth factor (VEGF)] related genes were examined through real-time polymerase chain reaction.@*RESULTS@#HRW and KRG treatment stimulated spermatogenesis followed by increasing sperm production and sperm motility (P <0.05). These effects were strengthened synergistically by a HRGW mixture (P <0.05 or P <0.01). HRGW greatly increased the expressions of antioxidation, antiaging, spermatogenesis related genes and VEGF especially in aged mice (P <0.05). Serum testosterone and FSH levels also increased, while serum ROS level decreased (all P <0.05).@*CONCLUSION@#HRGW increases sperm production and motility by enhancing antioxidation and stimulating spermatogenesis and sex hormone production, particularly in aged mice.

Efficacy and Safety of a Mixed Extract of Trigonella foenum-graecum Seed and Lespedeza cuneata in the Treatment of Testosterone Deficiency Syndrome: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial

PURPOSE: The aim of this study was to investigate the efficacy and safety of a mixed extract of Trigonella foenum-graecum seed and Lespedeza cuneata (TFGL) for the treatment of testosterone deficiency syndrome (TDS). MATERIALS AND METHODS: Patients were instructed to take a placebo or 200 mg TFGL capsule twice per day for 8 weeks. The primary efficacy variable was the change from baseline in the Aging Males' Symptoms scale (AMS), as well as levels of serum total and free testosterone. Secondary efficacy measurements included changes from baseline in the number of ‘yes’ answers on the Androgen Deficiency in the Aging Male (ADAM) questionnaire, levels of serum total cholesterol, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglyceride, all domain scores of the International Index of Erectile Function (IIEF), perceived stress scale-10 (PSS-10), as well as changes in body composition. RESULTS: The TFGL group exhibited a significant improvement in the AMS scores at 8 weeks, total testosterone at 8 weeks, and free testosterone at 4 and 8 weeks. At 4 weeks, 25% of the TFGL group changed to negative in terms of ADAM scores and 34.1% of the TFGL group had negative scores at the end of the study. The TFGL group exhibited a significant improvement in total cholesterol, HDL-C, LDL-C, triglyceride, IIEF scores, and PSS-10 scores at 8 weeks. CONCLUSIONS: The mixed extract of TFGL resulted in significant improvements in symptoms of TDS, as measured by the AMS, ADAM, PSS-10 and testosterone levels.

Restoration of Spermatogenesis Using a New Combined Herbal Formula of Epimedium koreanum Nakai and Angelica gigas Nakai in an Luteinizing Hormone-Releasing Hormone Agonist-Induced Rat Model of Male Infertility

PURPOSE: We investigated the protective effect of a mixture of 2 herbal extracts, KH-465, which consisted of Epimedium koreanum Nakai and Angelica gigas Nakai, on spermatogenesis in a luteinizing hormone-releasing hormone (LHRH) agonist-induced rat model of male infertility. MATERIALS AND METHODS: Seventy-five 12-week-old male Sprague-Dawley rats were randomly divided into 5 groups, containing 15 rats each: a normal control group that received no treatment and 4 experimental groups (I, II, III, and IV) in which an LHRH agonist was administered for 4 weeks to induce spermatogenic failure. Group I received distilled water, and groups II, III, and IV received 200 mg/kg/day of KH-465, 400 mg/kg/day KH-465, and depo-testosterone for 4 weeks, respectively. Weight changes of the testis and epididymis, sperm count motility, and levels of testosterone (T), free T, follicle-stimulating hormone (FSH), luteinizing hormone (LH), superoxide dismutase (SOD), and 8-hydroxy-2′-deoxyguanosine (8-OHdG) were estimated. RESULTS: Body, testis, and epididymis weight showed no significant differences among the control and experimental groups. Treatment with KH-465 increased the sperm count and motility. Serum hormone levels of T, free T, and FSH were not significantly different in the experimental groups, while the LH level was higher than in the LHRH agonist-induced control group, but not to a significant extent. Levels of SOD were higher and 8-OHdG were lower in the groups that received KH-465 than in the LHRH agonist-induced control group. CONCLUSIONS: Our results suggest that KH-465 increased sperm production via reducing oxidative stress and had a positive effect in a male infertility model.

Effects of Korean red ginseng on semen parameters in male infertility patients: A randomized, placebo-controlled, double-blind clinical study / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the effects of Korean red ginseng (KRG) on semen parameters in male infertility patients in a randomized, double-blind, placebo-controlled study.</p><p><b>METHODS</b>A total of 80 male infertility patients with varicocele were recruited from April 2011 to February 2012. The subjects were then divided into the following four groups: non-varicocelectomy (V)+placebo (P) group, V+P group, non-V+KRG group (1.5-g KRG daily), and V+KGR group (1.5-g KRG daily). Semen analysis was performed and hormonal levels were measured in each treatment arm after 12 weeks.</p><p><b>RESULTS</b>All groups but not the non-V+P group, showed significant improvements in sperm concentrations, motility, morphology, and viability at the end of the study. However, there were no significant differences in serum follicle-stimulating hormone, luteinizing hormone, and testosterone among groups. The incidence of adverse events was low, and all events were assumed to be unrelated to the treatments administered.</p><p><b>CONCLUSIONS</b>Although the exact mechanism by which KRG improves spermatogenesis remains unclear, KRG may be a useful agent for the treatment of male infertility. Nevertheless, additional studies to evaluate the optimal dose and duration of treatment are needed.</p>

Urinary Tract Symptoms (LUTS) Secondary to Benign Prostatic Hyperplasia (BPH) and LUTS/BPH with Erectile Dysfunction in Asian Men: A Systematic Review Focusing on Tadalafil

This review assesses lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) with or without erectile dysfunction (ED) and related therapies focusing on tadalafil. A literature search was obtained and reviewed for the epidemiology, treatment therapies, pathophysiology, and efficacy and safety of phosphodiesterase type 5 inhibitor (PDE5i) tadalafil in patients with LUTS/BPH. Approximately 42% of men aged 51 to 60 years have BPH. Approximately 90% of men aged 45 to 80 years have LUTS. Occurrence of LUTS increases with age for almost all racial/ethnic groups (range, 32% to 56%) with prevalence of LUTS highest among Hispanic men, then Blacks, Caucasians, and Asians. There is an independent relationship with LUTS/BPH and ED, with approximately 70% of men with LUTS/BPH having ED with severity of one disease often correlating with the other. The European Urological Association guidelines include the use of the PDE5i tadalafil. Tadalafil is the only therapy recommended for treatment of co-existing BPH and ED, while other therapies have unwanted ED side effects. The mode of action of tadalafil may involve different areas of the lower urinary tract such as smooth muscle cell relaxation in the bladder neck, prostate, and urethra, but there may also be resulting modulation of the afferent nerve activity. Tadalafil (5 mg) in Asian men with LUTS/BPH, similar to global studies, is efficacious and safe. Tadalafil (5 mg) improves co-existing LUTS/BPH and ED, independently. Men with LUTS/BPH likely also have ED. Asian men with LUTS/BPH have similar incidence rates, co-existing ED, comorbid diseases, and risks as non-Asian men. Tadalafil can improve co-existing LUTS/BPH and ED.

The Effect of 5-alpha Reductase Inhibitors on the Efficacy of Photoselective Vaporization of the Prostate with 120 W GreenLight HPS Laser / 대한남성과학회지

PURPOSE: To evaluate the effect of preoperative 5-alpha reductase inhibitor (ARI) administration on the operative results of photoselective vaporization of prostate with 120W GreenLight HPS laser. MATERIALS AND METHODS: Data were collected from 98 benign prostatic hyperplasia (BPH) patients who underwent transurethral electrovaporization of prostate by 120W Greenlight HPS laser between Jan. 2010 and Dec. 2010. We compared the time of operation, the energy required in lasering, postoperative maximum uroflow velocity, change in residual urine volume and complications between 5-ARI administrating group and control group. RESULTS: 56 patients administrated 5-ARI at least 3 months before surgery. 30 and 26 patients administrated finasteride and dutasteride, respectively. Mean follow up period was 4.1+/-1.8 months. Mean age of the subjects and mean prostate volume were not different. Mean change of postoperative hemoglobin, lasing time and energy required in lasering were greater in 5-ARI administrating group. There were 3 and 1 cases of acute urinary retension in 5-ARI administrating group and control group, respectively. CONCLUSIONS: The mean change of hemoglobin and mean energy required in lasering were greater and mean lasing time was longer in the patients who administrated 5-ARI before photoselective vaporization of prostate by 120W Greenlight HPS laser. Further investigation and extensive study will be needed to confirm these results.

The Use of Phytotherapy in Male Patients with a Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: Single Center Study / 대한남성과학회지

PURPOSE: Recently, the use of complementary and alternative medicine (CAM) is increasing among patients with low urinary tract symtoms (LUTS) caused by benign prostate hyperplasia (BPH). We assessed current usage and awareness of phytotherapy, the most ubiquitous CAM, in BPH/LUTS patients. MATERIALS AND METHODS: A total of 204 patients with BPH who completed a questionnaire between January 2009 and December 2010 were enrolled. The questionnaire was composed of questions about age, education level, accompanying disease, type of phytotherapy, route of purchase, reason of taking medicine and whether the patient is using phytotherapy in combination with conventional medicine. RESULTS: The mean age was 55.5+/-8.7 years. 56 of the total patients (27.5%) were using phytotherapy. The patients who were accompanied with erectile dysfunction used phytotherapy the most. The most commonly used phytotherapy for prescription and health functional food was Saw palmetto. The most common route of purchase was by clinician's prescription (46.4%). Most patients answered the dissatisfaction of present treatment's effect as the main reason for using phytotherapy. The number of patients who were taking combination therapy of BPH medication and phytotherapy was much more than using phytotherapy alone. CONCLUSIONS: 27.5% of patients who had BPH/LUTS were using phytotherapy. This is the point of time for many urologists to acquire the knowledge of studies and latest research of phytotherapy and use it in treating patients with BPH/LUTS.

Adenomatoid Tumor of the Epididymis / 대한남성과학회지

Adenomatoid tumor is an uncommon neoplasm found mainly near or in the epididymis in the male and the fallopian tubes and ovary in the female. We observed a case of adenomatoid tumor of the epididymis, which was found incidentally 20 years ago by patient self examination. A rubbery, non-tender, 2 X 1-cm mass was found in the tail portion of the right epididymis. Scrotal ultrasonography showed a 2.1 X 1.1 X 1.2-cm hypoechoic solitary mass. Mass excisional biopsy with partial epididymectomy was done under local anesthesia. Pathologic examination showed an adenomatoid tumor.

The Clinical Efficacy of Topical Agents for Premature Ejaculation / 대한남성과학회지

PURPOSE: The penile hypersensitivity is one of the complicated causes of premature ejaculation so that it has been applied to the local anesthesia or the penile dorsal neurectomy in the cases of treatment. The authors had compared the clinical efficacy of various kinds of OTC topical agents which were designed for premature ejaculation and were approved of selling in Korean market. MATERIALS AND METHODS: 10 normal adult male with ages from 29 to 24 years (ave. 33.4) were enrolled in this study. 8 topical agents of cream-type such as SS-cream(R), gel-type such as Power gel(R), B.M. gel(R), BIGTO gel(R) and Control gel(R), solution-type such as E.L.T soln(R), and spray type such as Sanova(R), Tstone(R) were applicated. With exception of SS-cream(R) which was natural medicine, the rest of them were made from lidocane 9.6%. We evaluated characteristics, efficacy, satisfaction and adverse reactions in treatment of premature ejaculation with 8 topical agents. RESULTS: In concerning of their odor, SS-sream(R) was the strongest (p<0.05). The viscosity was the highest in cream-type agent as SS-cream(R). However washing after sexual intercourse is relatively easy in every cases with the lowest necessity of washing in solution-type E.L.T soln(R) (p<0.05). The main causes of feeling the usage of drugs by partners were delay of ejaculation time, feeling of foreign bodies in genital organ, and the odor of drugs itself. Except SS-cream(R) with 60 minutes, the interval time of drug effect was about 15 to 20 minutes in every cases without any significant difference as well as adequate duration of drug efficacy. The times of usage per one pack was more in both E.L.T(R). soln which was make-up compact-type, and Sanova(R), Tstone(R) which was spray-type than the rest of drugs which were contained in disposal pack or tube. Also E.L.T soln(R), Sanova(R) and Tstone(R) had showed the convenience of usage (p<0.05). With overall satisfaction, there was excellent convenience of usage in E.L.T. soln which was packed in make-up compact (p<0.05). CONCLUSIONS: Topical anesthetic agents designed for premature ejaculation are safe and effective medical treatment with no significant difference in their characteristics, efficacy, and occurrence of adverse reaction among the various topical agents. Therefore, we suggest that the most important factors which influence the satisfaction and selectivity to topical anesthetic agents for premature ejaculations are the preserving container and method of application.