Association between anti-Müllerian hormone concentrations and sperm retrieval outcomes in patients with idiopathic nonobstructive azoospermia: a systematic review and meta-analysis.

ABSTRACT: Microdissection testicular sperm extraction (mTESE) is commonly performed to retrieve sperm in the testes for assisted reproductive techniques in patients with idiopathic nonobstructive azoospermia (iNOA). However, the success rate of sperm retrieval varies among individuals. We aim to investigate the association between clinical parameters and sperm retrieval outcomes in patients with iNOA. We searched PubMed, EMBASE, and Web of Science from database inception to August 2, 2023. The main measure was whether sperm retrieval was successful in patients with iNOA who underwent mTESE. Pooled estimates of the sperm retrieval rate and weighted mean differences were calculated using random-effects models. The overall sperm retrieval rate was 36.8% (95% confidence interval [CI]: 27.5%-46.0%, I2 = 95.0%) in nine studies comprising 1892 patients with iNOA. No significant differences were found in age, testicular volume, serum total testosterone concentrations, or inhibin B concentrations between positive and negative sperm retrieval outcomes. Lower anti-Müllerian hormone concentrations in patients with iNOA were associated with a positive outcome of mTESE (weighted mean differences: -2.70; 95% CI: -3.94--1.46, I2 = 79.0%). In conclusion, this study shows a significant relationship between anti-Müllerian hormone and sperm retrieval outcomes in patients with iNOA, while age, testicular volume, total testosterone, and inhibin B show no significant association. These findings have important implications for assessing the potential success of sperm retrieval and selecting appropriate treatment strategies in patients with iNOA.

Testicular volume is a noninvasive predictor of sperm retrieval failure in idiopathic nonobstructive azoospermia.

ABSTRACT: We investigated the prognostic importance of noninvasive factors in predicting sperm retrieval failure in idiopathic nonobstructive azoospermia (iNOA). We studied 193 patients with nonobstructive azoospermia who underwent microsurgical testicular sperm extraction. The Chi-square test and Mann-Whitney U tests for clinical parameters and seminiferous tubule distribution were used for between-group comparisons. A logistic regression analysis was conducted to identify predictors of retrieval failure. Area under the receiver operating characteristic curve for each variable was evaluated, and the net clinical benefit was calculated using a clinical decision curve. Patients with iNOA had a lower sperm retrieval rate than those with known causes. Moreover, testicular volume was an independent factor affecting sperm extraction outcomes (odds ratio = 0.79, P < 0.05). The testicular volume cut-off value was 6.5 ml (area under the curve: 0.694). The patients with iNOA were categorized into two groups on the basis of the distribution of seminiferous tubules observed. The sperm retrieval rate and testicular volume were significantly different between the groups with a uniform or heterogeneous tubule distribution. There was also a significant association between a uniform tubule distribution and testicular volume. In conclusion, a testicular volume of more than 6.5 ml effectively predicts microsurgical testicular sperm extraction failure due to a uniform tubule distribution in patients with iNOA.

Efficacy of various surgical approaches in treating hematospermia using transurethral seminal vesiculoscopy.

PURPOSE: To explore the efficacy of different approaches of seminal vesiculoscopy surgery and the predictive factors of good treatment outcome. MATERIALS AND METHODS: A retrospective analysis of 68 patients who underwent seminal vesiculoscopy for hematospermia in our hospital from January 2015 to January 2021. According to different surgical approaches, they were divided into three groups: natural ejaculatory ducts (method A, 45 cases), assisted transurethral resection/incision of ejaculatory ducts (method B, 14 cases), fenestration in prostatic utricle (method C, 9 cases). We analyzed the recurrence rate of the three surgical approaches and the predictive factors of treatment efficacy. RESULTS: The total recurrence rate after the seminal vesiculoscopy for hematospermia in this group was 32.35%. The postoperative recurrence rates of the three methods were 24.44% for method A, 50.00% for method B and 44.44% for method C, and there was no significant difference among the three methods (P > 0.05). The data of five predictors of 45 cases in method A group were included in the Univariate Logistic analysis, the results suggest that whether complicated with seminal tract stones/cysts was an effective predictor (OR 0.250, P = 0.022), which was still an effective predictor in the Multivariate Logistic analysis model (OR 0.244, P = 0.010). CONCLUSIONS: The Transurethral seminal vesiculoscopy technique demonstrates a low postoperative recurrence rate in treating hematospermia. Among the various approaches, the intraoperative use of natural orifices through the ejaculatory duct exhibits the lowest recurrence rate. Additionally, seminal tract stones/cysts effectively predict favorable postoperative outcomes.

Clinical Practice Guideline Recommendation on the Use of Low Intensity Extracorporeal Shock Wave Therapy and Low Intensity Pulsed Ultrasound Shock Wave Therapy to Treat Erectile Dysfunction: The Asia-Pacific Society for Sexual Medicine Position Statement.

Published literature shows low intensity extracorporeal shock wave therapy (LIESWT) and low intensity pulsed ultrasound (LIPUS) therapy to improve erectile function and penile hemodynamic by inducing neovascularisation and promoting tissue regeneration. Key opinion leaders across the Asia Pacific region attended the recent biennial meeting of the Asia Pacific Society for Sexual Medicine in Australia, and presented the current evidence on LIESWT and LIPUS for erectile dysfunction (ED). The clinical findings were internally discussed, and the quality of evidence was graded based on the Oxford Centre for Evidence-Based Medicine recommendations. Existing literature supports the use of LIESWT and LIPUS in men with ED, with many clinical studies reported encouraging results with improved erectile function, good safety profile and short-term durability. However, controversial exists due to sampling heterogeneity, non-standardised treatment protocol and lack of large multiinstitutional studies. There is a need to better define which subgroup of ED population is best-suited, and specific treatment protocol to optimise shock wave energy delivery. More stringent and larger multi-institutional randomised placebo-controlled trials are warranted before clinical adoption of LIESWT and LIPUS as the new standard of care for men with ED.

Intercellular transfer of P-glycoprotein mediates the formation of stable multi-drug resistance in human bladder cancer BIU-87 cells.

We investigated the biological characteristics of acquired drug-resistant cells (AqMDRs) formed by intercellular P-glycoprotein (P-gp) transfer and whether AqMDRs can form stable drug-resistant strains. Drug-sensitive BIU-87 cells were co-cultured with doxorubicin (DOX)-resistant derivative BIU-87/DOX cells in transwell chambers for up to 96 h. The presence of P-gp in recipient cell membranes (AqMDRs) was detected by confocal microscopy, CCK-8, western blot, and RT-PCR were used to detect resistance index (RI), P-gp expression and MDR1 mRNA expression in AqMDRs after 0, 4, 8, 16, and 20 passages and frozen/resuscitated twentieth generation AqMDRs. There was an increase in P-gp transfer with longer co-culture times of drug-resistant and sensitive strains. Without DOX, although the AqMDR numbers increased with each passage, the RI and P-gp expression decreased gradually, and the expression level of MDR1 mRNA did not change significantly. With DOX, the RI and P-gp expression increased slightly, and the MDR1 mRNA expression level gradually increased to the BIU-87/DOX level. AqMDRs can grow stably at drug concentrations slightly higher than the IC50 of sensitive strains, which sensitive strains cannot survive. P-gp transfer between cells gradually increases with longer co-culturing of drug-resistant and sensitive strains. The drug resistance of AqMDRs decreases without drug intervention, but with drug intervention, cells can maintain resistance and gradually develop into stable drug-resistant cells. This article has an associated First Person interview with the first author of the paper.

[Treatment of erectile dysfunction in patients with spinal cord injury].

The majority of men with spinal cord injury (SCI) suffer from different types and degrees of erectile dysfunction (ED). The impact of SCL on erectile function depends on the severity and location of the injury. Some patients can restore the residual sexual potential in the period of SCI recovery. Treatments of ED in men with SCI include psychotherapy, medication of oral PDE5 inhibitors, intracavernous injection of vasoactive drugs, transurethral medication, application of the vacuum erectile device and penile ring, penile prostheses, sacral neuromodulation, etc., among which PDE5 inhibitors remain the first option and usually give good clinical results for those with higher SCI. However, intracavernous injection of vasoactive drugs and combined treatment are preferable for those with lower SCI.

[Expressions of interleukin-17 and interleukin-8 in the prostatic tissue of the patients with BPH or BPH with inflammation].

OBJECTIVE: To investigate the expressions of interleukin-17 (IL-17) and interleukin-8 (IL-8) in benign prostatic hyperplasia (BPH) and BPH complicated with histological inflammation and their significance. METHODS: According to the results of HE staining, we divided 60 cases of BPH treated by transurethral resection of the prostate (TURP) into a BPH group (n = 23) and a BPH with inflammation group (n = 37). We analyzed the clinical data of the patients and determined the mRNA and protein expressions of IL-17 and IL-8 by immunohistochemistry, real-time fluorescence quantitative PCR, and Western blot, respectively. RESULTS: Compared with the BPH patients complicated with inflammation, the BPH group showed significantly lower International Prostate Symptom Score (IPSS) (29.1 ± 6.2 vs 21.6 ± 3.7), quality of life score (QoL) (5.4 ± 1.3 vs 4.4 ± 1.6), postvoid residual urine volume (RUV) (ï¼»198.6 ± 15.5ï¼½ vs ï¼»98.2 ± 19.3ï¼½ ml), prostate volume (ï¼»69.2 ± 24.1ï¼½ vs ï¼»49.8 ± 16.5ï¼½ ml), PSA level (ï¼»7.4 ± 1.9ï¼½ vs ï¼»2.8 ± 0.8ï¼½ µg/L) and serum c-reactive protein content (CRP) (ï¼»5.1±2.0ï¼½ vs ï¼»1.5±0.6ï¼½ mg/L), but a higher maximum urine flow rate (Qmax) (ï¼»4.7 ± 2.1ï¼½ vs ï¼»8.2 ± 1.8ï¼½ ml/s) (all P<0.05). The former group had a significantly higher incidence rate of urinary retention than the latter (32.4% ï¼»12/37ï¼½ vs 8.69% ï¼»2/23ï¼½), mRNA expressions of IL-17 (0.303 ± 0.076 vs 0.042 ± 0.019) and IL-8 (0.536 ± 0.059 vs 0.108 ± 0.025), and protein expressions of IL-17 (0.88 ± 0.10 vs 0.34 ± 0.05) and IL-8 (1.07 ± 0.08 vs 0.43 ± 0.04) (all P<0.05). CONCLUSIONS: The expressions of IL-17 and IL-8 are upregulated in the prostatic tissue of the BPH patients with inflammation, which may play a significant role in the development and progression of BPH.

The role of TSG-6 and uroplakin III in bladder pain syndrome/ interstitial cystitis in rats and humans.

OBJECTIVES: We investigated the relationship between the expression of tumor necrosis factor-inducible gene 6 (TSG-6) with inflammation and integrity of the bladder epithelium in the bladder tissues of patients with bladder pain syndrome/interstitial cystitis (BPS/IC) and the mechanism of action using a rat model of BPS/IC. MATERIALS AND METHODS: Expression of TSG-6 and uroplakin III was determined by immuno- histochemistry of bladder biopsy samples from control human subjects and patients with verified BPS/IC. Our rat model of BPS/IC was employed to measure the perfusion of bladders with hyaluronidase, and assessment of the effect of TSG-6 administration on disease progression. Treatment effects were assessed by measurement of metabolic characteristics, RT-PCR of TGR-6 and interleukin-6, bladder histomorphology, and immunohistochemistry of TGR-6 and uroplakin III. RESULTS: The bladders of patients with BPS/IC had lower expression of uroplakin III and higher expression of TSG-6 than controls. Rats treated with hyaluronidase for 1 week developed the typical signs and symptoms of BPS/IC, and rats treated with hyaluronidase for 4 weeks had more serious disease. Administration of TSG-6 reversed the effects of hyaluronidase and protected against disease progression. CONCLUSION: Our results indicate that TSG-6 plays an important role in maintaining the integrity of the bladder epithelial barrier.

Intercellular transfer of P-glycoprotein from the drug resistant human bladder cancer cell line BIU-87 does not require cell-to-cell contact.

PURPOSE: The efflux activity of transmembrane P-glycoprotein prevents various therapeutic drugs from reaching lethal concentrations in cancer cells, resulting in multidrug resistance. We investigated whether drug resistant bladder cancer cells could transfer functional P-glycoprotein to sensitive parental cells. MATERIALS AND METHODS: Drug sensitive BIU-87 bladder cancer cells were co-cultured for 48 hours with BIU-87/ADM, a doxorubicin resistant derivative of the same cell line, in a Transwell® system that prevented cell-to-cell contact. The presence of P-glycoprotein in recipient cell membranes was established using fluorescein isothiocyanate, laser scanning confocal microscopy and Western blot. P-glycoprotein mRNA levels were compared between cell types. Rhodamine 123 efflux assay was done to confirm that P-glycoprotein was biologically active. RESULTS: The amount of P-glycoprotein protein in BIU-87 cells co-cultured with BIU-87/ADM was significantly higher than in BIU-87 cells (0.44 vs 0.25) and BIU-87/H33342 cells (0.44 vs 0.26, each p <0.001), indicating P-glycoprotein transfer. P-glycoprotein mRNA expression was significantly higher in BIU-87/ADM cells than in co-cultured BIU-87 cells (1.28 vs 0.30), BIU-87/H33342 (0.28) and BIU-87 cells (0.25, each p <0.001), ruling out a genetic mechanism. After 30 minutes of efflux, rhodamine 123 fluorescence intensity was significantly lower in BIU-87/ADM cells (5.55 vs 51.45, p = 0.004) and co-cultured BIU-87 cells than in BIU-87 cells (14.22 vs 51.45, p <0.001), indicating that P-glycoprotein was functional. CONCLUSIONS: Bladder cancer cells can acquire functional P-glycoprotein through a nongenetic mechanism that does not require direct cell contact. This mechanism is consistent with a microparticle mediated process.

N-[4-(Dimethyl-amino)-benzyl-idene]-4H-1,2,4-triazol-4-amine.

The title compound, C(11)H(13)N(5), is a Schiff base synthesized by the reaction of 4-amino-4H-1,2,4-triazole and 4-(dimethyl-amino)-benzaldehyde. The dihedral angle between the benzene and triazole rings is 43.09 (11)°. The crystal structure displays weak C-H⋯N inter-actions.

Intravesical hyaluronic acid and alkalinized lidocaine for the treatment of severe painful bladder syndrome/interstitial cystitis.

INTRODUCTION AND HYPOTHESIS: Intravesical instillation of hyaluronic acid (HA) may restore the integrity of glycosaminoglycan layer in patients with painful bladder syndrome/interstitial cystitis (PBS/IC), and the benefit may be improved with addition of alkalinized lidocaine (AL). METHODS: 48 women with severe PBS/IC who failed oral medications were enrolled and divided into one trial and two control groups. The trial group received intravesical 40 mg HA, 10 ml of 2 % lidocaine and 5 ml of 8.4 % sodium bicarbonate on a weekly basis for 8 weeks and then monthly for 4 months with a subsequent follow-up of 24 weeks, while the two control groups received 40 mg HA and mixture of 10 ml of 2 % lidocaine and 5 ml of 8.4%sodium bicarbonate respectively following the same procedure. Response to therapy was evaluated by Global Response Assessment, voids per day, Visual Analogue Scale for pain, frequency and urgency, O'leary-Sant Interstitial Cystitis Symptom Index and Problem Index, cystoscopy and bladder capacity. RESULTS: Overall 45 patients finished this study protocol. The HA + AL group and the AL group showed significant improvement at week 2 (P < 0.01), while the HA group began to show effect at week 4 (P < 0.01). There was no improvement in the AL group at week 24 and these patients quitted the study without follow up. Contrarily, the HA + AL and HA group kept on improving till the end of the study without significant difference between the two groups. CONCLUSIONS: Intravesical instillation of HA and AL may provide both immediate and sustained relief of symptoms in severe PBS/IC in this preliminary study.

N-(2-Amino-4,6-dihydroxypyrimidin-5-yl)acetamide dihydrate.

The title compound, C(6)H(8)N(4)O(3)·2H(2)O, which crystallized as a dihydrate, has two almost planar segments viz. the pyrimidine ring and the C-N-C(=O)-C group [maxmum deviations of 0.020 (2) and 0.014 (2) Å, respectively], with a dihedral angle of 87.45°. In the crystal, the components are linked by O-H⋯O and N-H⋯O hydrogen bonds.

[Significance of nerve growth factor expression in the prostate tissue of spontaneously hypertensive rats].

OBJECTIVE: To investigate the changes of the expressions of the nerve growth factor (NGF) and its mRNA in the prostate tissues of spontaneously hypertensive rats (SHR) of different ages and their significance. METHODS: SHRs and normotensive Wistar Kyoto (WKY) rats were killed at 1 month (young), 6 months (adult) and 12 months (aging), respectively, 5 in each group. Their prostate indexes were calculated, and the expressions of NGF and its mRNA in the ventral prostate tissue were detected by immunohistochemistry and RT-PCR. RESULTS: The prostate indexes of the SHR and WKY groups were 1.16 +/- 0.06 and 1.03 +/- 0.09 at 1 month, 1.12 +/- 0.14 and 0.93 +/- 0.07 at 6 months, and 1.11 +/- 0.05 and 0.96 +/- 0.09 at 12 months, significantly higher in the former group than in the latter either at 6 or at 12 months (P < 0.05), but with no obvious difference at 1 month (P > 0.05). The expressions of NGF and its mRNA in the ventral prostate tissue were detected in all groups, and elevated gradually with the increase of age (P < 0.05). Among those of the same age, the expression levels were markedly higher in the SHR than in the WKY group (P < 0.05). CONCLUSION: In SHRs with benign prostate hyperplasia (BPH), the enhanced excitation of the sympathetic nervous system may be a common mechanism underlying BPH and hypertension, and NGF plays an important role in it.

2-Meth-oxy-4-[(4-methyl-piperazin-1-yl)imino-meth-yl]phenol.

The title compound, C(13)H(19)N(3)O(2), was obtained by the direct solvent-free reaction of 4-hy-droxy-3-meth-oxy-benzaldehyde with 1-amino-4-methyl-piperazine. The piperazine ring adopts a chair conformation. In the crystal, strong inter-molecular O-H⋯N and weak inter-molecular C-H⋯O and C-H⋯N hydrogen bonds help to establish the packing.

[Expression of COX-2 and VEGF and their correlation with angiogenesis in human clear cell renal cell carcinoma].

OBJECTIVE: To investigate the expression of COX-2 and VEGF in clear cell renal cell carcinoma (CCRCC) and their correlation with tumor angiogenesis. METHODS: Envision immunohistochemistry was used to determine the expression of COX-2 and VEGF, and microvessel density (MVD) was marked by CD34 in 80 CCRCC tissues and 20 normal kidney tissues. The relationship between the above mentioned markers were analyzed. RESULTS: Expressions of COX-2 and VEGF were noted in both CCRCC and normal kidney tissues. The positive rates of COX-2 and VEGF were significantly higher in CCRCC than in normal kidney (P < 0.05); The expression of COX-2 was correlated with TNM stage (P < 0.05), histological grade (P < 0.05) and lymph node metastasis (P < 0.05) in CCRCC, but not with age (P = 0.663) and diameter of tumor (P = 0.528). Both COX-2 expression (r = 0.851, P < 0.01) and VEGF expression (r = 0.736, P < 0.01) were significantly associated with MVD in CCRCC. There was a positive correlation between expression of cox-2 and that of VEGF in CCRCC. CONCLUSION: COX-2 expression is correlated with tumor angiogenesis in CCRCC. It is likely that VEGF is one of the most important mediators in the COX-2 angiogenic pathway.

[Synthesis and spectra of transition metals complexes RE3L6(NO3)6(H2O)2].

Schiff base 4-(p-dimethylaminobenzaldehydeamino)-4H-1,2,4-triazole(L) was synthesized from 4-amino-1,2,4-triazole and p-dimethylaminobenzaldehyde using acetic acid as the catalyst. The solid complexes RE3L6(NO3)6(H2O)2 (RE = Cu, Co, Zn, Cd; x = 3-6) were synthesized with 4-(p-dimethylaminobenzaldehydeamino)-4H-1,2,4-triazole and nitrate of transition metals in ethanol and characterized by elemental analysis, infrared spectroscopy, UV spectrum, and fluorescence spectrum. Experimental results showed that the free ligand is a thermally stable material, and its ethanol solution emitted intense blue fluorescence at the peak wavelength of 416 nm. The absorption band at about 406 nm can be assigned to the intrinsic absorption of C==N. Compared with the fluorescence emission of free ligand in ethanol solution, the emission of the complex of RE3L6 (NO3)6(H2O)2 was red-shifted to 445 nm and narrow in solution. RE(II) was coordinated with N atomy of triazole in 4-(p-dimethylaminobenzaldehydeamino)-4H-1,2,4-triazole.

[Synthesis, characterization and fluorescence of Zn3 (NCS)6 (L1)6 (NO3)2 and Ni3(NCS)6(L2)6(NO3)2].

The complexes of Zn2+, Ni2+ with 4-amino-3,5-dimethyl-1,2,4-triazole and 4-amino-1,2,4-triazole were synthesized in water, respectively. By elemental analysis, coordination titration and molar conductivities studies, the compositions of the complexes were suggested as Zn3 (NCS)6 (L1)6 (NO3)2 and Ni3 (NCS)6 (L2)6 (NO3)2 respectively. The ligands and coordination compounds were studied by means of IR spectra, UV and fluorescence excitation and emission spectra. The IR spectra studies indicate that triazolate was bonded with RE (II) through nitrogen atoms in the heterocyclic ring. The fluorescence spectra showed that the fluorescence emission intensity of Ni3 (NCS)6 (L2)6 (NO3)2 was stronger than that of Zn3 (NCS)6 (L1)6 (NO3)2.

[Synthesis and fluorescence property of new La3+ complex].

The solid complex of lanthanum nitrate hydrate with 4-(p-dimethylaminobenzaldehydeamino)-4H-1,2,4-triazole (L) LaL3 (NO3)3 x (H2O)2 x (C2 H5 OH)2 was synthesized in dry N2 atmosphere and absolute alcohol. The composition of the complex was determined by chemical and elemental analyses. The crystal structure showed that La3+ was coordinated by ten oxygen atoms with three nitrate, two water and two alcohol molecules. Characterized by elemental analysis, infrared spectroscopy, and solid fluorescence, the experimental results showed that the free ligand is a thermally stable material, and emitted intensive blue fluorescence at the peak wavelength of 451 nm. Compared with the fluorescence emission of free ligand in solid-state, the emission of complex of LaL3 (NO3)3 x (H2O)2 x (C2H5 OH)2 red-shifted to 464 nm and exhibited stronger blue fluorescence.