The erectile and ejaculatory implications of the surgical management of rectal cancer.

Colorectal cancer is a significant cause of cancer-related deaths worldwide. Although advances in surgical technology and technique have decreased mortality rates, surviving patients often experience sexual dysfunction as a common complication. The development of the lower anterior resection has greatly decreased the use of the radical abdominoperineal resection surgery, but even the less radical surgery can result in sexual dysfunction, including erectile and ejaculatory dysfunction. Improving the knowledge of the underlying causes of sexual dysfunction in this context and developing effective strategies for preventing and treating these adverse effects are essential to improving the quality of life for postoperative rectal cancer patients. This article aims to provide a comprehensive evaluation of erectile and ejaculatory dysfunction in postoperative rectal cancer patients, including their pathophysiology and time course and strategies for prevention and treatment.

Effect of Radiofrequency Electromagnetic Radiation Emitted by Modern Cellphones on Sperm Motility and Viability: An In Vitro Study.

BACKGROUND: Cellphones emit radiofrequency electromagnetic radiation (RF-EMR) for transmission of data for social media communication, web browsing, and music/podcast streaming. Use of Bluetooth ear buds has probably prolonged the time during which cellphones reside in the trouser pockets of men. It has been postulated that RF-EMR increases oxidative stress and induces free radical formation. OBJECTIVE: To investigate the effect of wireless-spectrum (4G, 5G, and WiFi) RF-EMR emitted by modern smartphones on sperm motility and viability and explore whether these effects can be mitigated using a physical barrier or distance. DESIGN, SETTING, AND PARTICIPANTS: Semen samples were obtained from fertile normozoospermic men aged 25-35 yr. A current-generation smartphone in talk mode was used as the RF-EMR source. A WhatsApp voice call was made using either 4G, 5G, or WiFi wireless connectivity. We determined if exposure effects were mitigated by either a cellphone case or greater distance from the semen sample. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The semen samples were analyzed according to 2010 World Health Organization laboratory guidelines. Statistical analysis was performed using SPSS v.28. RESULTS AND LIMITATIONS: We observed decreases in sperm motility and viability with WiFi exposure but not with exposure to 4G or 5G RF-EMR. With large variability among smartphones, continued research on exposure effects is needed. CONCLUSIONS: Our exploratory study revealed that sperm motility and viability are negatively impacted by smartphones that use the WiFi spectrum for data transmission. PATIENT SUMMARY: We looked at the effect of cellphone use on sperm motility and viability. We found that cellphones using WiFi connectivity for data usage have harmful effects on semen quality in men.

Postorgasmic Illness Syndrome: An Update.

Postorgasmic illness syndrome (POIS) is a rare condition affecting men who experience a cluster of flu-like and allergic symptoms after ejaculation. POIS can occur after intercourse, masturbation, or spontaneous ejaculation, and may persist for up to 7 d. Recurrent symptoms often negatively impact quality of life and sexual activity, leaving those affected with mental sequelae, diminished concentration, and mood changes. While it has been shown that various treatment options can alleviate symptoms in the short term, acute management remains controversial. In addition, follow-up data are severely lacking, resulting in the absence of established long-term management options for men suffering from POIS. This review highlights hallmark studies and the current state and promising developments surrounding clinical approaches to POIS. PATIENT SUMMARY: In this review, we discuss what is known about postorgasmic illness syndrome (POIS), a disease that causes flu-like symptoms in some men after ejaculation. Little research has been on POIS, so its causes, diagnosis, and appropriate treatments are poorly understood.

Sexuality, Intimacy, and Reproductive Health after Spinal Cord Injury.

Spinal cord injury (SCI) is a life-altering event often accompanied by a host of anxiety-provoking questions and concerns in the minds of affected individuals. Questions regarding the ability to resume sexual activity, partner's satisfaction as well as the ability to have biological children are just a few of the unknowns facing patients following the devastating reality that is SCI. As a result of advances in SCI research over the last few decades, providers now have the knowledge and tools to address many of these concerns in an evidence-based and patient-centered approach. SCI can impair multiple components involved in sexual function, including libido, achieving and maintaining an erection, ejaculation, and orgasm. Many safe and effective fertility treatments are available to couples affected by SCI. Finally, learning to redefine one's self-image, reinforce confidence and self-esteem, and feel comfortable communicating are equally as important as understanding functionality in regaining quality of life after SCI. Thus, this review aims to highlight the current state of SCI research relating to sexual function, reproductive health, and the search for meaning.

COVID-19 vaccination not associated with increased risk of erectile dysfunction.

Although mRNA COVID-19 vaccines have proven to be safe and effective against SARS-CoV-2, vaccination rates have slowed, with some individuals citing impotence as a concern. Therefore, we conducted a survey of the US males to evaluate the impact of COVID-19 vaccination on erectile function. We hypothesized that vaccinated men would not have a higher risk of ED compared to unvaccinated men. Amazon Mechanical Turk (MTurk) was utilized to survey the US adult male population between August 26 and September 2, 2021. Survey participation was open to 1000 males over the age of 18 and currently living in the United States regardless of vaccination status or the past medical history of COVID-19. Selection criteria included respondents ≥45 years old, no history of physician-diagnosed ED, biologically born, and identify as male. Participants completed an anonymous 16-question survey that included a multidimensional scale used to evaluate ED, the International Index of Erectile Function (IIEF-5). Among vaccinated men, the median IIEF-5 score was 20 [16-24] compared to 22 [17.5-25] in the unvaccinated group (p = 0.195). The multivariable-adjusted analysis demonstrated that vaccination against COVID-19 was not associated with increased risk of ED. Overall, this cross-sectional survey showed that COVID-19 vaccination was not associated with an increased risk of erectile dysfunction in males 45 years and older.

Impact of Low-Dose Melatonin Supplementation on Testosterone Levels in U.S. Adult Males.

OBJECTIVE: Amidst the rapid rise in melatonin supplementation, decreased testosterone levels amongst males in recent decades, and the unclear association between melatonin and the hypogonadal-pituitary-gland (HPG) axis, this study aimed to further examine the association between melatonin use and testosterone levels among men in a nationally representative sample. METHODS: U.S. men over the age of 18 surveyed from 2011-2016 via the National Health and Nutrition Examination Survey (NHANES) without missing demographic or pertinent health information were included in the analysis. A total testosterone (TT) level of less than 300 ng/dL was considered low. An average daily dose (ADD) was calculated to quantify participants' exposure to melatonin supplementation in the past 30 days. RESULTS: Analysis included 7,656 participants after selection criteria. The median age of participants was 47 [31-63] years old; the median TT level was 389.9 [289 - 513.9] ng/dL. Melatonin intake was reported in 51 (0.7%) individuals with an ADD of 1 [0.4 - 3] mg/day. We found no association between melatonin intake in the past 30 days and low TT levels (OR = 0.958, 95% CI: 0.496 -1.850; P=0.898). As expected, increasing BMI (OR = 1.133, 95% CI: 1.122 - 1.144; P < 0.001) and older age (OR = 1.019, 95% CI: 1.016 - 1.022; P < 0.001) were associated with low TT levels. CONCLUSION: Predominantly low-dose melatonin supplementation was not associated with low TT levels. Future studies are needed to better quantify the relationship between melatonin intake and low TT levels, especially in the setting of supratherapeutic doses and prolonged periods of exposure.

Future of Male Infertility Evaluation and Treatment: Brief Review of Emerging Technology.

Over the past few decades, there have been significant advances in male infertility, particularly in the development of novel diagnostic tools. Unfortunately, there remains a substantial number of patients that remain infertile despite these improvements. In this review, we take heed of the emerging technologies that will shape the future of male infertility diagnosis, evaluation, and treatment. Improvement in computer-assisted semen analyses and portability allow males to obtain basic semen parameters from the comfort of their home. Additionally, breakthrough ultrasound technology allows for preoperative prediction of potential areas of spermatogenesis within the testes, high-resolution optics permits better visualization during microdissection testicular sperm extraction (mTESE), and artificial intelligence improves sperm selection and identification.

Fear about adverse effect on fertility is a major cause of COVID-19 vaccine hesitancy in the United States.

Although COVID-19 vaccine access has increased nationwide, vaccination rates have been slow-moving, with many studies showing significant vaccine hesitancy in the U.S. We conducted an online survey using Amazon Mechanical Turk (MTurk) to identify reasons for vaccine hesitancy among unvaccinated adults between June 30 and July 1, 2021. We found that 58% of unvaccinated respondents were worried about unknown long-term adverse effects. Of these, 41% believed that the COVID-19 vaccines can negatively impact reproductive health and or fertility, and 38% were unsure of the effects on fertility. Our study demonstrates that fear regarding COVID-19 vaccine adverse effects and belief that they can negatively impact fertility is a major cause of vaccine hesitancy in the United States. We identified that urban residents, married individuals, those born outside the U.S., those with health insurance, and people with higher education and income greater than $100,000 felt that the vaccine would affect fertility more than their counterparts did. Finally, we found that 48% of unvaccinated respondents cited 'more information and research conducted on the COVID-19 vaccines' as the action that would most encourage vaccine uptake.

Muscle Atrophy Classification: The Need for a Pathway-Driven Approach.

It is well known that muscles can waste away (atrophy) due to a lack of physical activity. Muscle wasting commonly presents with reduced muscle strength and an impaired ability to perform daily tasks. Several studies have attempted to categorize muscle atrophy into three main subgroups: physiologic, pathologic, and neurogenic atrophy. Physiologic atrophy is caused by the general underuse of skeletal muscle (e.g., bedridden). Pathologic atrophy is characterized as the loss of stimulus to a specific region (e.g., aging). Neurogenic atrophy results from damage to the nerve innervating a muscle (e.g., SMA, GBS). Mechanisms have been elucidated for many of these pathways (e.g., ubiquitin-proteasome system, NF-κB, etc.). However, many causes of muscle atrophy (e.g., burns, arthritis, etc.) operate through unelucidated signaling cascades. Therefore, this review highlights the underlying mechanisms of each subtype of muscle atrophy while emphasizing the need for additional research in properly classifying and identifying muscle atrophy.

The Missing Link in the Covid-19 Vaccine Race.

Operation Warp Speed and global vaccine research efforts have succeeded in rapidly launching three vaccine candidates for coronavirus disease 2019 (COVID-19) into Phase III clinical trials. A recent letter from Centers for Disease Control and Prevention (CDC) Director Redfield underscored the possibility of "large-scale" distribution of a coronavirus vaccine as early as November 1, 2020. However, recent polling reveals that the majority of Americans remain skeptical of both the safety and efficacy of a potential Covid-19 vaccine. Even more troublesome is the fact that a comprehensive, collaborative vaccine marketing campaign has not been initiated to educate the U.S. public on and encourage widespread Covid-19 vaccination. Accordingly, this article lays out a plan of action, utilizing proven immunization marketing strategies and novel approaches, that could be used to combat vaccine hesitancy toward Covid-19. A vaccine may indeed be our ticket out of this pandemic, but targeted marketing is needed to increase public optimism toward that fact.