Phoenix dactylifera L. pollen versus pentoxifylline on improvement of sperm parameters in idiopathic male infertility: A randomized clinical trial.

ETHNOPHARMACOLOGICAL RELEVANCE: Phoenix dactylifera L. pollen is the male reproductive dust of palm flowers known as a natural product that is considered a strong stimulant of sexual potency and fertility in Iranian traditional medicine (ITM). In this regard, no evidence-based medications are empirically prescribed to treat IMI. However, applying traditional medicine for the treatment of male infertility has attracted more attention in recent years. AIM OF THE STUDY: Phoenix dactylifera L. pollen was compared with pentoxifylline (PTX) to evaluate its efficacy on sperm parameters. MATERIALS AND METHODS: During this parallel randomized controlled trial, 80 adult men with asthenozoospermia, oligozoospermia, or teratozoospermia (age 20-35 years) were enrolled. In two separate groups of participants with a 1:1 ratio, participants received either 6 g of Phoenix dactylifera L. pollen powder daily or 400 mg of PTX tablets daily for 90 days. We measured the sperm parameters as well as the serum sex hormones in the sample. ANCOVA and t-tests were used to compare groups. RESULTS: There was no significant difference between the study groups in terms of baseline characteristics or demographic characteristics. According to the results, participants who took Phoenix dactylifera L. pollen powder had significantly improved sperm concentration (p = 0.016), morphology (p = 0.029), sperm counts (p = 0.012), progressive motility (p = 0.016), total motility (p = 0.018), and reduced immotile sperms (p = 0.014) compared to those who took PTX. CONCLUSIONS: In light of these results, Phoenix dactylifera L. pollen is recommended as a treatment factor for ameliorating IMI by enhancing sperm functional capacity and semen parameters.

Concomitant Transurethral and Transvaginal-Periurethral Injection of Autologous Adipose Derived Stem Cells for Treatment of Female Stress Urinary Incontinence: A Phase One Clinical Trial.

Stress urinary incontinence is a common medical problem among women. The urethral closure complex and/or the supportive mechanisms are responsible for incontinence in the majority of patients. Several surgical procedures with different degrees of invasiveness and outcomes have been reported to treat the problem. Although most of these procedures are reasonably effective, a general trend towards the study of natural and biocompatible tissues is emerging over popular synthetic materials. Here we report our experience of autologous adipose-derived stem cells transplantation into the periurethral region as a new method of stress urinary incontinence treatment. Ten women with symptoms of stress urinary incontinence were treated by injections of autologous adipose-derived stem cells into the periurethral region via transurethral and transvaginal approach under urethroscopic observation. This report presents the short-term outcome of the patients. The outcome measured by pad test results, ICIQ-SF scores, and Qmax. The mean age of the participants was 45.8±8.7 years. Urinary incontinence significantly decreased through the first two, 6 and 24 weeks after the injection therapy. The difference was significant in pad test results (P<0.001) and ICIQ-SF scores (P<0.001), especially comparing results between 2 and 6 weeks and among 6 and 24 weeks, but not for 2 and 6 weeks compared to each other. Surprisingly, Qmax showed improvement after the study period (means 32.6 vs. 35.7; P=0.002). This study showed that injection of the autologous adipose-derived stem cells to the periurethral region is a safe, yet short-term effective treatment option for stress urinary incontinence. Further studies with longer follow up are needed to confirm its long term efficacy.

Correlation of Preoperative and Radical Prostatectomy Gleason Score: Examining the Predictors of Upgrade and Downgrade Results.

Preoperative Gleason score (GS) obtained from Trans Rectal Ultra Sonography (TRUS) is the most common grading system to evaluate the appropriate treatment for patients with clinically localized prostate cancer. But this method showed upgraded and downgraded results in comparison to Gleason score obtained from radical prostatectomy. The current study aimed to determine clinical or pathological variables to reduce the differences between biopsy and radical prostatectomy Gleason scores.Through retrospective review of 52 patients with radical prostatectomy, this study examined the correlations of preoperative Gleason score with age, prostate volume, PSA level, PSA density, digital rectal exam findings and percentage of positive core needle biopsies across two groups, including patients with preoperative GS≤6 (i.e. group one) and patients with preoperative GS≥7 (group two). The discordance between biopsy GS and radical prostatectomy GS was observed to be 52% in the current study. Among patients with preoperative GS≤6, prostate volume (P=0.026), PSA density (P=0.032) and percentage of positive core needle biopsies (P=0.042) were found to be significant predictors for upgrade. There was no significant predictor for downgrade in patients with preoperative GS≥7. Findings of this study revealed that in patients with preoperative GS≤6, smaller prostate volume, higher prostate density and higher positive results of core needle biopsies were associated with theupgrade of GS. Therefore, it should be considered when selecting treatment modalities among these patients.

EPCA2.22: A Silver Lining for Early Diagnosis of Prostate Cancer.

PURPOSE: To investigate whether EPCA-2 (a prostate matrix nuclear protein) can be a more helpful marker in prostate cancer diagnosis. MATERIALS AND METHODS: 176 patients enrolled in this study had abnormal prostate specific antigen (PSA) or digital rectal examination and were candidates for prostate needle biopsy. Blood samples were obtained from each patient prior to biopsy and the samples were frozen for EPCA-2 measurement. Patients diagnosed with cancer were assigned to the case group and those with benign prostate hyperplasia (BPH) were included in the control group. Univariate and multivariable analyses were done to assess the relationship between different independent variables with cancer diagnosis. The diagnostic power of EPCA-2 for cancer was estimated at different levels of PSA according to the ROC curve. RESULTS: The mean(± SD) age of cancer cases was 70.33(± 9.02) years while it was 63.34(± 9.47) years for BPH cases (P < .01). EPCA-2 and PSA were also significantly different between cancer and BPH cases (P < .001). The multivariable logistic regression showed that EPCA-2 has a significant relationship with cancer diagnosis (OR=1.009, P = .021). After controlling other variables following stratification for PSA, it was shown that EPCA-2 and cancer were correlated just when PSA was >10 (P < .001). AUC was 0.694 for cancer prediction by EPCA-2 when PSA was >10 ng/mL. CONCLUSION: EPCA-2 has the power of differentiating BPH from cancer in prostate cancer suspects. This suggests that EPCA-2 can be helpful in diagnosing prostate cancer and can be a preventive test to avoid unnecessary biopsies considering PSA and age of the patient. .

Genetic Polymorphism of MMP2 Gene and Susceptibility to Prostate Cancer.

BACKGROUND AND AIMS: The polymorphic genetic variants of matrix metalloproteinase (MMPs) can play critical roles in development and progression of cancer. The purpose of this study was to investigate if any association exists between MMP2 -1306/T and risk of prostate cancer (PCa). METHODS: This case-control study comprised a total number of 241 subjects, including 102 patients with PCa and 139 controls with benign prostatic hyperplasia (BPH). MMP2 genotypes were detected by RFLP. RESULTS: There is no significant difference between different genotypes of MMP2 polymorphism and risk of developing PCa (p = 0.08). Although these genotypes increased the risk of developing PCa 79% (CT vs. CC) and 54% (TT vs. CC), none had a significant effect (p = 0.09 and p = 1 respectively). There were no significant differences in genotype frequencies between patients with low and high degrees of PCa (p = 0.4). Therefore, this polymorphism cannot be considered as a protective factor for PCa metastasis. It seems that MMP2 polymorphism has no protective effect on the grading of the tumor (p = 0.8). Our results indicated that MMP2 polymorphism had no role in the vascular invasion of PCa. CONCLUSION: We found no association between MMP2 polymorphism and cancer risk, overall or by grade, stage or age of diagnosis. Finally, there was no association between the different genotypes and PSA plasma levels among cases or controls. Further evaluations with larger samples from our population may illuminate the effects of polymorphisms on PCa risk and thus help early diagnosis, follow-up and prognostic determinations for PCa patients.