Reliability of the sperm chromatin dispersion assay to evaluate sperm deoxyribonucleic acid damage in men with infertility.

OBJECTIVE: To investigate the intraindividual agreement of the sperm chromatin dispersion (SCD) assay results to assess sperm DNA fragmentation (SDF) in men with infertility. DESIGN: Diagnostic test reliability study. SETTING: Andrology laboratories. PATIENT(S): A total of 219 men with infertility. INTERVENTION(S): Sperm DNA fragmentation assessment in two ejaculates of the same subjects within a 3-month interval, using the SCD assay performed and analyzed by the same observers under similar testing conditions. MAIN OUTCOME MEASURE(S): Cohen's κ statistics to assess the degree of agreement between the pairs of results after converting the nominal SCD values into categorical data, that is, normal (<20%), intermediate (21%-29%), and high (≥30%) SDF rates. We also assessed the pairs of results using reliability measures for numerical variables (intraclass correlation coefficient for consistency using the two-way mixed-effects model and Bland-Altman plots). RESULT(S): The degree of agreement in classifying patients according to normal and pathological SDF classes was overall substantial (κ = 0.632; 95% confidence interval [CI], 0.546-0.718). A total of 76.7% of individuals were classified under the same class using paired ejaculates. The agreement rate was highest (approximately 80%) in ejaculates initially classified as either normal or high and lowest (approximately 60%) among those with intermediate SDF levels. The frequency of intermediate SDF ejaculates downgraded to normal or upgrade to high SDF classes in the second test was similar (approximately 20%). The intraclass correlation coefficient was 0.856 (95% CI, 0.812-0.887), and the mean difference between the pairs of observations was 0.80% (95% CI, -0.72 to 2.23), indicating no systematic difference between paired observations. CONCLUSION(S): Our study indicates a substantial intraindividual agreement of paired SCD assay results to classify men with infertility into three SDF categories: normal, intermediate, and high. The reliability of the SCD assay was adequate and exceeded 0.80 using two ejaculates analyzed within a 3-month interval under similar conditions. Although this evidence overall supports a single SCD test for patient classification using predefined SDF thresholds, particularly when the first test shows normal or high SDF levels, one in four men will have discordant values in paired ejaculates. Clinicians should be judicious when using SDF test results in decision-making.

Management of premature ejaculation: a clinical guideline from the Italian Society of Andrology and Sexual Medicine (SIAMS).

Premature ejaculation (PE) is the most prevalent male sexual dysfunction, and the most recently defined. PE is often mistakenly considered a purely psychosexological symptom by patients: the lacking awareness in regards to the pathophysiology and treatments often lead to resignation from the patients' side, making PE the most underdiagnosed sexual complaint. However, an ever-growing body of evidence supporting several organic factors has been developed in the last decades and several definitions have been suggested to encompass all defining features of PE. In the present document by the Italian Society of Andrology and Sexual Medicine (SIAMS), we propose 33 recommendations concerning the definition, pathophysiology, treatment and management of PE aimed to improve patient care. These evidence-based clinical guidelines provide the necessary up-to-date guidance in the context of PE secondary to organic and psychosexological conditions, such as prostate inflammation, endocrine disorders, and other sexual dysfunctions, and suggest how to associate pharmacotherapies and cognitive-behavioral therapy in a couple-centered approach. New therapeutic options, as well as combination and off-label treatments, are also described.

Testosterone therapy: where do the latest guidelines agree and differ?

PURPOSE OF REVIEW: The incidence of testosterone deficiency and number of men on testosterone therapy (TTh) has increased significantly over the past 3 decades. This rise has been accompanied by controversies surrounding the indications and possible adverse effects of therapy. To better inform prescribing habits among providers, many major medical associations have devised guidelines regarding the diagnosis and management of testosterone deficiency. While these guidelines agree in many areas, there are some key differences that should be identified. This review will explore the similarities, differences, and rationale for these guidelines. RECENT FINDINGS: Over the past 7 years, much attention has been devoted to the implications of TTh on cardiac health. All reviewed guidelines include dedicated sections discussing these implications and the society's position on prescribing testosterone considering recent findings, however, differ on specific contraindications to TTh and when to initiate therapy after a cardiovascular event. In addition, the American College of Physicians released its first guideline earlier this year which may impact prescribing habits among primary care physicians. SUMMARY: The differences between testosterone deficiency guidelines may indicate gaps in our knowledge of testosterone deficiency and focuses of future research efforts. Prescribers should be aware of these differences and discuss all treatment options with their patients.

New insights to guide patient care: the bidirectional relationship between male infertility and male health.

Male reproduction is a complex process, and numerous medical conditions have the potential to alter spermatogenesis. In addition, male factor infertility may be a biomarker for future health. In the present review, we discuss the current literature regarding the association between systemic diseases and fertility, which may impact clinical outcomes or semen parameters. A number of conditions that have systemic consequences were identified, including genetic (e.g., cystic fibrosis, DNA mismatch repair alterations), obesity, psychological stress, exogenous testosterone, and a variety of common medications. As such, the infertility evaluation may offer an opportunity for health counseling beyond the discussion of reproductive goals. Moreover, male infertility has been suggested as a marker of future health, given that poor semen parameters and a diagnosis of male infertility are associated with an increased risk of hypogonadism, cardiometabolic disease, cancer, and even mortality. Therefore, male fertility requires multidisciplinary expertise for evaluation, treatment, and counseling.

Introduction: Rare and unusual andrologic syndromes that clinicians should be aware of.

There are conditions that are rare and that most providers are unaware of or conditions that consist of a series of symptoms for which there is no agreement that they are even a medical condition. These include painful nocturnal erections, post-orgasmic illness syndrome, body dysmorphic disorder, and post-finasteride syndrome. While some have a psychiatric basis, others clearly have an organic pathophysiology, while for others, there remains much controversy. This month's Views and Reviews will inform the reader of these conditions so they may recognize affected patients and direct them towards appropriate resources for their care.

Rapid sperm capture: high-throughput flagellar waveform analysis.

STUDY QUESTION: Can flagellar analyses be scaled up to provide automated tracking of motile sperm, and does knowledge of the flagellar waveform provide new insight not provided by routine head tracking? SUMMARY ANSWER: High-throughput flagellar waveform tracking and analysis enable measurement of experimentally intractable quantities such as energy dissipation, disturbance of the surrounding medium and viscous stresses, which are not possible by tracking the sperm head alone. WHAT IS KNOWN ALREADY: The clinical gold standard for sperm motility analysis comprises a manual analysis by a trained professional, with existing automated sperm diagnostics [computer-aided sperm analysis (CASA)] relying on tracking the sperm head and extrapolating measures. It is not currently possible with either of these approaches to track the sperm flagellar waveform for large numbers of cells in order to unlock the potential wealth of information enclosed within. STUDY DESIGN, SIZE, DURATION: The software tool in this manuscript has been developed to enable high-throughput, repeatable, accurate and verifiable analysis of the sperm flagellar beat. PARTICIPANTS/MATERIALS, SETTING, METHODS: Using the software tool [Flagellar Analysis and Sperm Tracking (FAST)] described in this manuscript, we have analysed 176 experimental microscopy videos and have tracked the head and flagellum of 205 progressive cells in diluted semen (DSM), 119 progressive cells in a high-viscosity medium (HVM) and 42 stuck cells in a low-viscosity medium. Unscreened donors were recruited at Birmingham Women's and Children's NHS Foundation Trust after giving informed consent. MAIN RESULTS AND THE ROLE OF CHANCE: We describe fully automated tracking and analysis of flagellar movement for large cell numbers. The analysis is demonstrated on freely motile cells in low- and high-viscosity fluids and validated on published data of tethered cells undergoing pharmacological hyperactivation. Direct analysis of the flagellar beat reveals that the CASA measure 'beat cross frequency' does not measure beat frequency; attempting to fit a straight line between the two measures gives ${\mathrm{R}}^2$ values of 0.042 and 0.00054 for cells in DSM and HVM, respectively. A new measurement, track centroid speed, is validated as an accurate differentiator of progressive motility. Coupled with fluid mechanics codes, waveform data enable extraction of experimentally intractable quantities such as energy dissipation, disturbance of the surrounding medium and viscous stresses. We provide a powerful and accessible research tool, enabling connection of the mechanical activity of the sperm to its motility and effect on its environment. LARGE SCALE DATA: The FAST software package and all documentation can be downloaded from www.flagellarCapture.com. LIMITATIONS, REASONS FOR CAUTION: The FAST software package has only been tested for use with negative phase contrast microscopy. Other imaging modalities, with bright cells on a dark background, have not been tested but may work. FAST is not designed to analyse raw semen; it is specifically for precise analysis of flagellar kinematics, as that is the promising area for computer use. Flagellar capture will always require that cells are at a dilution where their paths do not frequently cross. WIDER IMPLICATIONS OF THE FINDINGS: Combining tracked flagella with mathematical modelling has the potential to reveal new mechanistic insight. By providing the capability as a free-to-use software package, we hope that this ability to accurately quantify the flagellar waveform in large populations of motile cells will enable an abundant array of diagnostic, toxicological and therapeutic possibilities, as well as creating new opportunities for assessing and treating male subfertility. STUDY FUNDING/COMPETING INTEREST(S): M.T.G., G.C., J.C.K-B. and D.J.S. gratefully acknowledge funding from the Engineering and Physical Sciences Research Council, Healthcare Technologies Challenge Award (Rapid Sperm Capture EP/N021096/1). J.C.K-B. is funded by a National Institute of Health Research (NIHR) and Health Education England, Senior Clinical Lectureship Grant: The role of the human sperm in healthy live birth (NIHRDH-HCS SCL-2014-05-001). This article presents independent research funded in part by the NIHR and Health Education England. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. The data for experimental set (2) were funded through a Wellcome Trust-University of Birmingham Value in People Fellowship Bridging Award (E.H.O.).The authors declare no competing interests.

Changes in practice patterns in male infertility cases in the United States: the trend toward subspecialization.

OBJECTIVE: To assess changes in the practice patterns of urologists performing male infertility procedures (vasal reconstruction, sperm retrieval, varicocelectomy) from 2004 to 2015 in the United States. DESIGN: Examination of self-reported procedural volumes from urologists undergoing certification and recertification using case log data provided by the American Board of Urology. The study period was stratified into early (2004-2007) and recent (2012-2015) time periods. SETTING: Not applicable. PATIENT(S): None. INTERVENTION(S): None. MAIN OUTCOMES MEASURE(S): Temporal variations in male infertility practice patterns among different urologic subspecialties between the early and recent time periods. RESULT(S): The overall proportion of total male infertility procedures performed by andrologists significantly increased between the early and recent groups (23% to 26%). This growth was driven by a significant increase in the proportion of varicocele repairs being performed by andrologists between the early and recent periods (19% to 25%). Most notably, an assessment of total number of male infertility procedures performed by newly certifying urologists showed that there was a significant increase in the overall proportion of all male infertility procedures being performed by recently trained andrologists (24% to 35%). This significant increase was seen individually among all three types of male infertility procedures. CONCLUSION(S): With the increased trend in urologists obtaining fellowship training, male infertility surgical volume is beginning to shift from general urologists to subspecialized andrologists.

European Academy of Andrology guideline Management of oligo­astheno­teratozoospermia

Oligo­astheno­teratozoospermia is frequently reported in men from infertile couples. Its etiology remains, in the majority of cases, unknown with a variety of factors to contribute to its pathogenesis. The aim of this European Academy of Andrology guideline was to provide an overview of these factors and to discuss available management options.

Determinantes psicossociais do funcionamento sexual e bem-estar sexual subjetivo em homens adultos portugueses / Psychosocial determinants of sexual functioning and subjective sexual well-being in portuguese adult men

Introdução. O funcionamento sexual e o bem-estar sexual subjetivo são dimensões humanas muito importantes que contribuem para a qualidade de vida dos homens; no entanto, não existe nenhum estudo que informe acerca de medidas normativas junto de homens portugueses. Objetivos. Avaliar os níveis de funcionamento sexual e bem-estar sexual subjetivo numa amostra de homens adultos portugueses, comparar diferenças entre grupos e determinar o grau de associação entre as 2 variáveis. Material e método. Participaram no estudo 603 homens adultos (média de idades=42,05 anos; desvio padrão=13,93) que preencheram um questionário sociodemográfico, o questionário de mudanças no funcionamento sexual e o questionário de avaliação do bem-estar sexual subjetivo, medidas estas que foram disseminadas através da internet. Resultados. Os resultados obtidos permitiram produzir uma tabela de dados normativos para o funcionamento sexual e bem-estar sexual subjetivo, tendo sido encontradas diferenças estatisticamente significativas na comparação entre grupos em função da idade, escolaridade, local de residência, existência de filhos, estado civil e ocupação profissional. Verificou-se também uma forte correlação entre as 2 dimensões. Discussão e conclusões. Esta investigação permite evidenciar a importância dos determinantes psicossociais na expressão da funcionalidade sexual e bem-estar sexual subjetivo, na medida em que os técnicos que trabalhem com homens nesta área deverão estar atentos ao modo como os contextos psicossociais interferem na expressão sexual (AU)

Introduction. Sexual functioning and subjective sexual well-being are very important human dimensions that contribute to the quality of life of men; however, there are no studies to report about normative measures for the Portuguese male population. Purpose. To assess the levels of sexual functioning and subjective well-being in a sample of Portuguese adult men comparing differences between groups and determine the degree of association between the two variables. Materials and Methods. Participants in the study were 603 adult men (mean age=42.05 years, standard deviation=13.93) who completed a sociodemographic questionnaire, the changes in sexual functioning questionnaire and the subjective sexual well-being questionnaire. These measures disseminated over the internet. Results. The results obtained allowed us to produce a table of normative data for sexual functioning and subjective sexual well-being, and statistically significant differences were found when comparing groups according to age, education, place of residence, number of children, marital status and their occupation. There was also a strong correlation between the two dimensions. Discussion and Conclusions. This research allows us to highlight the importance of psychosocial determinants in the expression of sexual function and subjective sexual well-being, to the extent that the health professionals who work with men in this area should be aware of how psychosocial contexts interfere with their sexual expression (AU)

Escalas de Valoración de Excitación Sexual y Valoración de Sensaciones Genitales: propiedades psicométricas en muestras españolas / Ratings of sexual arousal and ratings of genital sensations: psychometric properties in spanish sample

Objetivo. La excitación sexual subjetiva es la percepción de excitación a nivel psicológico, siendo el Multiple Indicators of Subjective Sexual Arousal (MISSA) uno de los escasos instrumentos para evaluarla de manera situacional. El objetivo es adaptar a población española y examinar las propiedades psicométricas de dos de las escalas del MISSA: Valoración de Excitación Sexual (VES) y Valoración de Sensaciones Genitales (VSG). Material y método. Se emplearon dos muestras independientes formadas por jóvenes heterosexuales de 18-30 años de edad. En la primera muestra (n=122) se examinó la estructura factorial de la escala VES, la cual se puso a prueba en una segunda muestra (n=336) en la que se examinó la invarianza por sexo. Además, en esta segunda muestra se buscaron evidencias de validez de ambas escalas. Los participantes de ambos estudios (N=458) contestaron las escalas VES y VSG en una situación experimental de laboratorio en la que eran expuestos a films de contenido neutro y contenido sexual explícito. Resultados. La versión española de la escala VES presenta una estructura unidimensional con una adecuada fiabilidad de consistencia interna (α=0,90). Dicha estructura es invariante en cuanto al sexo, no encontrándose diferencias entre hombres y mujeres. Tanto las puntuaciones de la escala VES como de la VSG correlacionaron con la predisposición a excitarse y con la erotofilia. Conclusiones. Las escalas VES y VSG son fiables y válidas para evaluar la excitación sexual subjetiva ante estímulos sexuales, constituyendo instrumentos adecuados para su uso, tanto en el ámbito clínico como en el de la investigación (AU)

Objective. Subjective sexual arousal is the psychological perception of arousal. The Multiple Indicators of Subjective Sexual Arousal (MISSA) is one of the limited self-reported measures to evaluate it in a specific situation. The aim is to adapt and examine the psychometric properties of two scales from the MISSA: Ratings of Sexual Arousal (RSA) and Ratings of Genital Sensations (RGS) in a Spanish sample. Material and method. The measures were administered to two independent samples composed by heterosexual young individuals aged from 18 to 30 years old. In the first sample (n=122) the factorial structure of the RSA was examined, which was later confirmed in a second sample (n=336) where invariance analysis by sex and validity evidences were also analyzed. Both, the RSA and the RGS, together with other scales measuring similar constructs, were answered by participants from both studies (N=458) in a laboratory setting in which individuals were exposed to films with neutral content and explicit sexual content. Results. The Spanish version of the RSA shows a unidimensional structure with adequate reliability (α=.90). This structure showed to be invariant by sex, thus no significant differences were found between men and women. Scores from both, the RSA and the RGS correlated with higher predisposition to get excited and erotophilia. Conclusions. The RSA and RGS are reliable and valid measures to evaluate subjective sexual arousal towards sexual stimuli. Therefore, their use is suitable for both clinical and research areas (AU)

The great opportunity of the andrological patient: cardiovascular and metabolic risk assessment and prevention.

Andrologists, cardiologists and diabetologists (and general practitioners) have the great opportunity to collaborate and find shared clinical workup for the benefit of a large number of men. Several evidence established a link between erectile dysfunction (ED), cardiovascular disease (CVD), diabetes, and metabolic syndrome. Not only these conditions share many risk factors and pathophysiological mechanisms but also an emerging paradigm indicates that ED is, in fact, an independent marker of cardiovascular disease risk, CV events and CV mortality. However, there is no consensus on the best cardiologic investigation in men with ED with no known CVD and, on the contrary, on what is the clinical and prognostic role of detecting ED during cardiovascular investigation and CVD risk assessment. Only vasculogenic ED, which represents the most common type of organic ED, indeed represents a harbinger of CVD, especially for younger patients, and might be diagnosed by dynamic penile color doppler ultrasonography, which represents a real cardiovascular imaging technique that give evidence on the presence of systemic endothelial dysfunction and atherosclerosis. Furthermore, assessment of glucose and lipid metabolism is warranted as first step workup in all ED patients, and diabetologists should ask their patients for erectile function, address ED patients to andrologists, and consider vasculogenic ED in the context of the cardiovascular and metabolic workup and in the context of diabetic complications. Sexual symptoms (and testosterone levels) should sound as harbinger for cardiovascular and metabolic investigation and cardiologists and diabetologists have the opportunity to have a symptom (erectile dysfunction) and a vascular test (penile color doppler) that help them in better management of patients, their comorbidities and complications.

[Disease-syndrome combination in integrated traditional Chinese and Western medicine in andrology: Confusions and countermeasures in studies].

Researches on the mechanisms underlying the therapeutic effects of the disease-syndrome combination approach in integrated traditional Chinese and Western medicine are becoming a hot spot in andrology, but many recent studies of this kind have failed to explain the connotation of integrated traditional Chinese and Western medicine in andrology. Related existing problems include repeated researches into the same indexes of action mechanisms of different therapeutic principles of traditional Chinese medicine (TCM), Chinese herbal compound and special prescriptions, studies focusing on individual diseases but ignoring symptoms, immature syndrome models for studies of mechanisms, and too much attention to uncertain or immature target mechanisms. The stress should be placed on the action mechanisms of Chinese herbal compound and special prescriptions on male diseases and, what is more important, on the clarification of the essential principles of differentiation and treatment of TCM syndromes. In the recent years, proteomics, genomics, transcriptomics and metabolomics have shed some light upon researches into the mechanisms underlying the therapeutic effects of the disease-syndrome combination approach in integrated traditional Chinese and Western medicine in andrology. An insight into the TCM syndrome, a macroscopic inductive analysis, and a comprehension of such microcosmic aspects as the gene, protein, metabolism and metagenome may contribute to some breakthroughs and new ideas in the studies of disease-syndrome combination in integrated traditional Chinese and Western medicine in andrology.

Rasgos psicopatológicos en personas con disforia de género / Psychopathological traits in people with gender dysphoria

Objetivos. En primer lugar, el objetivo es evaluar los rasgos psicopatológicos en personas con disforia de género y, en segundo lugar, establecer si existen diferencias entre los grupos de hombre a mujer y de mujer a hombre. Participantes y método. Se aplicó el Inventario clínico multiaxial de Millon (MCMI-II) a 32 sujetos con disforia de género, de los cuales 20 pertenecen al grupo de hombre a mujer y 12 al de mujer a hombre. Los participantes fueron seleccionados de forma intencional. Resultados. No se encuentran alteraciones psicopatológicas significativas. Las puntuaciones más elevadas se obtuvieron en los rasgos esquizoide, paranoide y delirante. Hay diferencias estadísticamente significativas entre los grupos de hombre a mujer y de mujer a hombre en los patrones clínicos de la personalidad esquizoide (p = 0,012), compulsiva (p = 0,047) y autodestructiva (p = 0,040) y en el síndrome clínico de gravedad moderada abuso de alcohol (p = 0,000). Conclusiones. Las personas con disforia de género no se caracterizan por alteraciones psicopatológicas. Los rasgos con puntuaciones más elevadas se corresponden con los señalados en estudios anteriores. Se aprecian diferencias por grupos, aunque solo en determinadas escalas (AU)

Objectives. Firstly, the aim is to evaluate psychopathological traits in people with gender dysphoria, and secondly, to establish if there are differences between groups of male to female and female to male. Participants and method. The Millon clinical multiaxial inventory (MCMI-II) was applied to 32 subjects with gender dysphoria, of which 20 belong to the group of male to female and 12 to the group female to male. Participants were selected intentionally. Results. No significant psychopathological alterations are found. The highest scores were obtained in the schizoid, paranoid and delusional traits. There are statistically significant differences between the male to female and female to male in clinical patterns of schizoid (P=.012), compulsive (P=.047) and self-destructive personality (P=.040), and in moderate clinical syndrome, abuse of alcohol (P=.000). Conclusions. People with gender dysphoria are not characterized by psychopathological alterations. The traits with higher scores correspond with those pointed out in previous studies. Differences were appreciated between groups, but only in certain scales (AU)

Prevalencia de microdeleciones del cromosoma Y en hombres chilenos infértiles / Y chromosome microdeletion prevalence in infertile Chilean men

Objetivo. El objetivo de este estudio es determinar la prevalencia de microdeleciones del cromosomaY en hombres chilenos infértiles. Material y métodos. Se incluyeron 102 hombres con diagnóstico de azoospermia u oligozoospermia severa que consultaron en la Unidad de Andrología por infertilidad. Se llevó a cabo análisis de microdeleciones de la región del factor de azoospermia (AZF) del cromosomaY a través de reacción en cadena de la polimerasa, utilizando ADN genómico extraído de leucocitos de sangre periférica. Cada paciente fue analizado utilizando sequence tagged sites para las regiones AZFa, AZFb y AZFc. Resultados. Sesenta y siete pacientes presentaron azoospermia y 35 oligozoospermia severa. Se encontraron microdeleciones del cromosomaY en el 9,8% de los pacientes. La mutación más prevalente fue AZFc, afectando al 3,9% de la muestra, seguida por AZFbc (2,9%), AZFa (2,0%) y AZFb (1,0%). Solo los hombres azoospérmicos presentaron las mutaciones. Conclusiones. La prevalencia de microdeleciones del cromosomaY en hombres chilenos infértiles es similar a la presentada en estudios internacionales. Estas mutaciones deben ser buscadas cuando se enfrenta a un paciente infértil con alteraciones cuantitativas severas del seminograma, ya que AZFa y AZFb están asociados con ausencia completa de gametos viables, y la portación de AZFc tiene importantes consecuencias en el potencial de fertilidad de la descendencia masculina (AU)

Objective. The aim of this study is to determine the prevalence of Ychromosome microdeletions in infertile Chilean men. Material and methods. A group of 102 infertile men with azoospermia or severe oligozoospermia were screened while attending a fertility clinic for microdeletions in the azoospermia factor (AZF) region of Ychromosome by multiplex polymerase chain reaction. Genomic DNA was extracted from peripheral blood samples. Each patient was analysed for the presence of sequence tagged sites in the AZFa, AZFb, and AZFc regions. Results. Azoospermia and severe oligozoospermia was found in 67 and 35 patients, respectively. Microdeletions were found in 9.8% of patients. The most prevalent mutation was AZFc, affecting 3.9% of the sample. This was followed by AZFbc with 2.9%, AZFa with 2.0%, and AZFb with 1.0%. Only azoospermic men were found to have these genetic alterations. Conclusions. Prevalence of Ychromosome microdeletions in infertile Chilean men is similar to the prevalence presented in international studies. As AZFa and AZFb mutations are associated with complete absence of viable gametes, and AZFc has important consequences in the fertility potential of the offspring, these mutations have to be searched when presented with an infertile patient with severe sperm alterations (AU)

Presencia o ausencia de espermatozoides en el líquido preeyaculatorio / Presence or absence of sperm in the pre ejaculatory fluid

Objetivo. Determinar la presencia o ausencia de espermatozoides en el líquido preeyaculatorio. Material y métodos. Estudio descriptivo, transversal, realizado en 25 varones universitarios, voluntarios, entre 18-25 años en Barranquilla, Colombia. A cada sujeto se le entregaron 2 portaobjetos para la toma del líquido preeyaculatorio y un recipiente para la toma de muestra del líquido seminal; se tomó primero y por autoestímulo la muestra preeyaculatoria y posteriormente la muestra para el espermiograma; la búsqueda de espermatozoides en el líquido preeyaculatorio se realizó en al menos 10 campos a un aumento de ×20 y en los 2 portaobjetos. El líquido seminal se procesó según normas de la OMS. Resultados. Los líquidos preeyaculatorios examinados no tenían espermatozoides. Todos los sujetos del estudio tenían espermiogramas con recuento total de espermatozoides superiores a 100 millones de espermatozoides, una movilidad superior al 50%; el pH promedio fue de 8,2±0,5. Conclusiones. El líquido preeyaculatorio secretado por las glándulas de Cowper y Littre durante la estimulación sexual no contiene espermatozoides, siempre que haya al menos 2 días de abstinencia eyaculatoria previa y, por lo tanto, no puede ser responsable de los embarazos ocurridos en la práctica del contacto sexual del pene sobre los genitales externos femeninos ni en la práctica del coito interrumpido como método anticonceptivo (AU)

Objective. To determine the presence or absence of sperm in pre ejaculate fluid. Material and methods. A descriptive, cross-sectional study in 25 college male volunteers, aged between 18 and 25 in Barranquilla (Colombia). Each subject was given two slides for making pre-ejaculatory fluid and a container for sampling of seminal fluid; pre-ejaculatory sample was taken first by self-stimulation, and subsequently the sample for semen analysis was collected. Search for sperm in pre-ejaculatory liquid was held in at least 10 fields at ×20 magnification and the two slides. The seminal fluid was processed according to WHO standards. Results. None of the pre-ejaculatory fluids examined had sperm. All study subjects had spermiograms with total count in excess of 100 million sperm mobility greater than 50%; the average pH was 8.2±0.5. Conclusions. Pre-ejaculatory fluid secreted by the glands of Cowper and Littre during sexual stimulation, does not contain sperm and therefore cannot be responsible for pregnancies occurring in the practice of sexual intercourse where the penis is in contact with the external female genitalia or in practice of withdrawal as a contraceptive method (AU)

Estudio caso-control en hombres con liquen escleroso y atrófico genital / Case control study in men with sclerosus and atrophic genital lichen

Objetivo. Comparar los datos epidemiológicos de una muestra de pacientes con liquen escleroso genital versus un grupo control sin liquen escleroso genital. Material y métodos. Estudio caso-control que incluye 50 pacientes divididos en 2 grupos; grupo 1: 30 pacientes con liquen escleroatrófico genital y grupo 2: 20 pacientes sin liquen escleroatrófico. Se han estudiado variables clínicas, analíticas, antecedentes personales y hábitos de vida. El análisis estadístico se ha llevado a cabo mediante el programa SPSS 20.0, siendo la significación estadística p≤0,05. Resultados. La edad media de los pacientes del grupo 1 fue de 54,7años versus 52,5años en el grupo 2, sin que se observaran diferencias estadísticamente significativas. La principal diferencia observada entre los pacientes del grupo 1 y los del grupo 2 fue el índice de masa corporal, que fue más elevado en el grupo 1, 28,4kg/m2, con respecto al grupo 2, 23,4kg/m2 (p=0,0001), y el estado civil. No se observó una mayor prevalencia significativa en enfermedades autoinmunes en el grupo 1 respecto al grupo 2. Conclusión. Los pacientes con liquen escleroatrófico genital parecen tener mayor índice de masa corporal que los pacientes sin liquen, sin que exista una clara asociación con enfermedades autoinmunes, según los resultados de nuestro estudio (AU)

Objective. To compare epidemiologic dates in patients with sclerosus genital lichen versus control group without sclerosus genital lichen. Material and methods. Case-control study including 50 patients divided into 2 groups: Group 1: 30 patients with sclerosus and atrophic genital lichen and group 2: 20 patients without lichen sclerosus. Study of clinical variables, laboratory, medical history and lifestyle. Statistical analysis with SPSS 20.0 software and statistical significance P≤.05. Results. The mean age of patients in group 1 was 54.7 years versus 52.5 years in group 2, no statistically significant differences were observed. The main difference observed between patients in group 1 and group 2 was the BMI, which was higher in group 1, 28.4kg/m2, compared to group 2, 23.4kg/m2 (P=.0001) and marital status. It has not been observed significantly higher prevalence in autoimmune diseases in group 1 compared with group 2. Conclusion. Patients with genital sclerosus and atrophic lichen seem to be more body mass index than patients without lichen, without a clear association with autoimmune diseases according to the results of our study (AU)