Sexual, physical, and overall adverse effects in patients treated with 5α-reductase inhibitors: a systematic review and meta-analysis.

Postfinasteride syndrome (PFS) is a term coined to characterize a constellation of reported undesirable sexual, physical, and neuropsychiatric side effects. In the present study, we conducted the meta-analysis to demonstrate whether the use of 5α-reductase inhibitors (5ARIs) increases the risk of PFS-like adverse effects. A search of studies published until May 10, 2020, was performed using PubMed, EMBASE, and the Cochrane Library. We included randomized controlled trials with at least one comparison between male patients receiving 5ARIs versus placebo for the treatment of benign prostatic hyperplasia (BPH) or androgenetic alopecia (AGA), and identified 34 studies from 28 articles that met our eligibility criteria. In the random-effects model, the overall use of 5ARIs exhibited a 1.87-fold risk of PFS-like adverse effects during the trial (95% confidence interval [CI]: 1.64-2.14). Regarding specific types of adverse effects, the use of 5ARIs had a 1.89-fold risk of sexual adverse effects (95% CI: 1.74-2.05) and was associated with an increased risk of physical adverse effects (relative risk [RR]: 1.31, 95% CI: 0.80-2.15), albeit without statistical significance. This meta-analysis helped to better define the adverse effects caused by 5ARIs. We concluded that the overall use of 5ARIs significantly increased the risk of PFS-like adverse effects in men with AGA or BPH during treatment. Enhanced awareness of and education on the PFS-like adverse effects are necessary for clinicians.

[Urethral dilatation with the renal sheath dilator under the ureteroscope to treat male urethrostenosis].

OBJECTIVE: To explore the efficacy of urethral dilatation with the renal sheath dilator under the ureteroscope in the treatment of male patients with urethrostenosis. METHODS: Eighteen male patients with urethrostenosis underwent urethral dilatation with the renal sheath dilator. Under the ureteroscope, a zebra-guide wire was inserted through the stenosed urethra into the bladder and the stenosis was gradually dilated with the renal sheath dilator, followed by placing a Foley catheter of proper size for 1-4 weeks. For children, the renal sheath dilator was selected according to their age, while for adults, metal dilators (> or = F20) were used following dilatation with the F18 renal sheath dilator. All the patients were followed up for 6-24 months. RESULTS: The operation was successfully performed in all the 18 cases, with no urethral false passage, urethral perforation or urethra tearing. Sixteen of the patients were cured, and the other 2 received urethroplasty for stenosis recurrence. The maximum flow rate was increased to 13.6-30.2 (18.1 +/- 3.5) mL/s after the operation. CONCLUSION: Urethral dilatation with the renal sheath dilator under the ureteroscope is a simple, safe and effective method for the treatment of urethrostenosis.

[Molecular cloning of a novel human testis-specific gene TDRG1].

OBJECTIVE: To clone a novel human testis-specific gene TDRG1. METHODS: A new contig of expression sequence tags (ESTs) Hs.180197 was identified from the testis libraries using digital differential display (DDD) to screen the novel human testis-specific gene. To validate the use of bioinformatics approaches in gene discovery, the ESTs Hs.180197, which was predicted to be testis specific, was chosen for further study. Reverse transcriptase-polymerase chain reaction (RT-PCR) was performed on different normal tissues to identify the expression of Hs.180197 in human testis. Using bioinformatics methods and IMAGE cloning of this contig, the full-length cDNA sequence of the noval human gene was cloned. RESULTS: This novel gene was 1197 bp in length, located in chromosome 6p21.1-p21.2. The sequence of the open reading frame was 504-806 bp, as confirmed by RT-PCR and sequencing in human testis. The cDNA encodes a novel protein of 100 amino acids with a theoretical molecular weight of 10 000 and isoelectric point of 6.81. The sequence shares no significant homology with any known protein in the databases. Semi-quantitative RT-PCR analysis of multiple tissues further showed that the novel gene was expressed specifically in adult human testis. Considering a possible relation of this novel gene with the function of human testis, we named this new gene TDRG1 (testis development related gene 1, GenBank accession number: DQ168992). CONCLUSION: DDD combined with laboratory validation is an efficient method for identifying new human functional genes.