Patient Perspectives on Benign Prostatic Hyperplasia Surgery: A Focus on Sexual Health

BackgroundIn the last decade, many novel minimally invasive surgical techniques within benign prostatic hyperplasia (BPH) surgery were developed to reduce postoperative complications that often discourage patients from pursuing BPH surgery.AimTo assess perspective of future and past international BPH surgery patients regarding their postoperative complications, namely erectile and ejaculatory function.MethodsA survey was distributed randomly to 2 groups of BPH patients: one with 149 patients having undergone surgery in the last 2 years (group A), and the other cohort of 151 men seriously considering BPH surgery in the next year (group B). This survey consisted of 20 questions that assessed patients' motivating factors for undergoing elective BPH surgery and their perspectives regarding the potential postoperative complications attributed to BPH surgery.OutcomesThe perspective of future and past international BPH surgical patients towards the preservation of their erectile and ejaculatory functions was assessed with the help of a survey.ResultsResults indicated that in general BPH surgery patients considered the maintenance of erectile (95%, n = 284) and ejaculatory function (92%, n = 276) to be important preoperative considerations, regardless of their age. Patients aged 50–59 years were most concerned with the permanent impact on sexual function and patients aged >60 years were most concerned with urinary incontinence. In patients aged >70 years, 66% (n = 43) and 62% (n = 40) of the respondents indicated that maintaining erectile and ejaculatory function was important, respectively.Clinical ImplicationsPatient-centered care needs to be implemented in order to address the importance that past and future BPH surgery patients hold toward the maintenance of their postoperative sexual function.Strengths & LimitationsIn the group of patients having previously undergone BPH surgery, the possibility of recall bias should be taken into account when interpreting the study's findings. However, maintaining sexual function was also important for the group of patients seriously considering surgery in the next year suggesting that these considerations are not solely due to recall bias. Additionally, the results were limited by the small sample size of participants in groups A (n = 149) and B (n = 151).ConclusionIt was found that past and future BPH surgery patients attribute a significant importance toward the maintenance of their sexual function. Although novel approaches with better sexual outcomes such as Rezum and UroLift for prostates <80 mL, and Aquablation for any size prostate are available, more research is needed to investigate their long-term effects on sexual function before they can be recommended to patients.Bouhadana D, Nguyen D-D, Zorn KC, et al. Patient Perspectives on Benign Prostatic Hyperplasia Surgery: A Focus on Sexual Health. J Sex Med 2020;17:2108–2112.     

Gender ratio of migraine without aura: observations over time

Abstract Migraine without aura is typically considered a female condition. The purpose of this study was to determine if there have been any changes in the female-to-male ratio of the disease over time. We included in the study all patients with migraine without aura (n=3457) referred to the Parma University Headache Centre between 1976 and 1995. They were divided into subgroups with respect to gender and year-range of onset of migraine (before 1960, in the 1960s, in the 1970s, in the 1980s, and between 1990 and 1995). Gender ratio ranged from 3.6:1 (in patients with onset before 1960) to 2.8:1 (in patients with onset in the 1980s), with no statistically significant changes during the observation period.     

实验性精索静脉曲张对大鼠睾丸生精细胞凋亡的影响

目的 :探讨大鼠精索静脉曲张对睾丸生精细胞凋亡的影响 ,阐明精索静脉曲张引起不育的病理机制。　方法 :选用雄性SD大鼠 32只 ,随机分为假手术组、4 5d模型组、6 0d模型组及 90d模型组。采用肾静脉缩窄法建立精索静脉曲张动物模型 ,流式细胞术分别检测各组大鼠睾丸凋亡细胞数及各级生精细胞数。　结果 :假手术组未出现明显的凋亡峰 ,各模型组均出现明显的凋亡峰 ,且随着造模时间的延长凋亡峰增高。　结论 :精索静脉曲张可引起睾丸生精细胞大量凋亡 ,各级生精细胞数减少 ,这可能是精索静脉曲张引起睾丸生精功能障碍从而导致不育的根本机制     

132例男性不育患者遗传学病因分析

目的：对男性不育患者进行遗传学病因分析，并探讨其遗传效应。方法：采取132例男性不育患者外周血进行染色体核型分析。结果：132例男性不育患者中，染色体异常24例，染色体变异22例。其中大Y20例，47，XXY18例，45．XY，t(13；14)3例，小Y和46，XY，inv(9)各2例，46，XY，t(9；22)1例。结论：染色体异常是男性不育的重要原因，并建议男性不育患者进行基因诊断，以便确诊是否属于遗传病，为生育提供指导，避免盲目治疗。     

精子顶体酶活性检测对诊断男性不育症的价值

目的比较各种质量精液的精子顶体酶活性。方法分光光度比色法检测顶体酶活性。结果各种质量精液的精子顶体酶活性均显著低于对照组P<0.001。结论精子顶体酶可作为了解精子生育力的一项可靠指标。     

生精丸治疗男性不育60例临床研究

目的观察生精丸对男性不育的治疗作用.方法选择120例男性不育患者,随机分为治疗组和对照组.每组60例,分别给予生精丸和五子衍宗丸治疗.治疗前后以WLJY-9000伟力彩色精子质检系统进行精液参数分析,并检测血液睾酮(T)水平,同时观察病人服用生精丸期间有无明显不良反应.结果治疗组精子密度、活率、活力以及运动参数和睾酮水平等指标均明显高于对照组(P＜0.05),痊愈率、显效率及总有效率亦高于对照组(P＜0.05),且服药期间无明显的不良反应.结论生精丸有从整体上纠正精液异常的功效,能使病人精子数量、质量、睾酮水平得到提高.     

脉冲式皮下注射黄体生成素释放激素治疗男性促性腺激素缺乏症(附14例报道)

目的　观察脉冲式黄体生成素释放激素 (LHRH)皮下注射对男性促性腺激素缺乏症的治疗效果。　方法　给予知情同意的男性促性腺激素缺乏症 14例患者LHRH脉冲式腹壁皮下注射 ,每 90min 1个脉冲 (每个脉冲 10 μg) ,治疗 3～≥ 12个月。　结果　除 2例无效外 ,余 12例 (86% )有效 ,表现为青春期发育加速 ,体力增强 ,睾丸明显增大 ,阴茎增长 ,阴毛和腋毛生长。 5例有遗精现象 ,2例精液常规中有精子生成 ,所有患者在治疗期间性激素水平改善。　结论　脉冲式LHRH皮下注射是符合生理的替代治疗 ,是对男性特发性促性腺激素缺乏症可取的治疗方式。     

无机汞对男工内分泌和大鼠睾丸微量元素的影响

应用放射免疫分析法（ＲＩＡ）和流行病学调查，对４０名接触汞和４０名非接触汞男工进行了血清甲状腺激素、性激素水平和生殖功能的测定。结果表明，接触组男工的阳萎、早泄、性欲减退发生率和男工妻子的早产、自然流产发生率以及血清甲状腺激素（ＦＴ３和ＦＴ４）含量明显增多，每周性交次数和血清睾酮含量显著减少。上述各项与对照组比较差异非常显著。应用火焰光度法，对氯化汞染毒后大鼠睾丸组织的微量元素进行测定，实验组的锌值明显降低。结果提示氯化汞能够影响甲状腺激素、睾酮和锌元素水平。