A Systematic Review and Framework for the Use of Hormone Therapy with Salvage Radiation Therapy for Recurrent Prostate Cancer

Context

Salvage radiotherapy (SRT) is a standard of care for men who recur postprostatectomy, and recent randomized trials have assessed the benefit and toxicity of adding hormone therapy (HT) to SRT with differing results.

Oestradiol‐17β is a local factor inducing the early stage of spermatogenesis in mouse testes

This study was undertaken to elucidate the effect of testicular oestradiol‐17β (E₂) on spermatogenesis. Spermatogonial development and spermatogenic gene expression in testicular germ cells were investigated using an in vitro culture system supplemented with E₂. E₂ stimulated spermatocytogenic development of cultured testicular germ cells regardless of the addition of follicle‐stimulating hormone and testosterone to the culture medium. E₂ also induced the expression of genes encoding synaptonemal complex protein 1 and protamine 1, proteins required for spermatogenesis. In conclusion, the results of this study suggest that E₂ is a spermatocytogenic factor that acts via the stimulation of spermatogenic gene expression.     

Transplant nephrectomy after graft failure: is it so risky? Impact on morbidity,mortality and alloimmunization

Purpose

To determine the impact of transplant nephrectomy on morbidity and mortality and HLA immunization.

Methods

All patients who underwent transplant nephrectomy in our centre between 2000 and 2016 were included in this study. A total of 2822 renal transplantations and 180 transplant nephrectomies were performed during this period.

Results

The indications for transplant nephrectomy were graft intolerance syndrome: 47.2%, sepsis: 22.2%, vascular thrombosis: 15.5%, tumour: 8.3% and other 6.8%. Transplant nephrectomies were performed via an intracapsular approach in 61.7% of cases. The blood transfusion rate was 50%, the morbidity rate was 38% and the mortality rate was 3%. Transplant nephrectomies more than 12 months after renal transplant failure were associated with more complications (p?=?0.006). Transfusions in the context of transplant nephrectomy had no significant impact on alloimmunization.

Conclusion

The risk of bleeding, and therefore of transfusion, constitutes the major challenge of this surgery in patients eligible for retransplantation. Even if transfusions in this context of transplant nephrectomy had no significant impact on alloimmunization, this high-risk surgery, whenever possible, must be performed electively in a well-prepared patient.

     

DNAH6 is a novel candidate gene associated with sperm head anomaly

Globozoospermia and acephalic spermatozoa are two rare sperm head anomalies associated with male infertility. Combination of the two phenotypes in the same patient is extremely rare, so the underlying pathogenesis of this disorder remains unclear. Here, we report a 35‐year‐old infertile male, who presented with 30% of sperm‐lacked heads and 69% of sperm round‐headed or small‐headed with neck thickening in his ejaculate. Subsequent whole‐exome sequencing (WES) analysis identified compound heterozygous variants within the DNAH6 gene. DNAH6 is a testis‐specific‐expressed protein that was localised to the neck region in the spermatozoa of normal control; however, immunofluorescent staining failed to detect DNAH6 protein in the patient's spermatozoa. Quantitative real‐time PCR analysis also showed the complete absence of DNAH6 mRNA in the patient's spermatozoa. Moreover, two cycles of in vitro fertilisation (IVF)‐assisted reproduction were carried out, but pregnancy was not achieved after embryo transfer. Therefore, rare sequence variants in DNAH6 might be susceptibility risks for human sperm head anomaly.     

Association between male accesory gland infections and prostate cancer in Turkish men: A case–control study

It is well known that chronic inflammation contributes to several forms of human cancer. Although several studies have investigated the association between prostatitis and prostate cancer, there is a lack of specifically designed study about male accessory gland infections (MAGI) and prostate cancer co‐occurrence. We aimed to investigate this association with a case–control study in Turkish men. A total of 155 patients were enrolled to the study. After the pathological examination of the transrectal ultrasound‐guided prostate biopsy specimens, patients were divided the two groups as control and prostate cancer and the presence of MAGI was determined. Of 155 patients, 145 met inclusion criteria. In the prostate cancer group, MAGI diagnose was determined in 18 of 31 patients (58.06%), while it was determined in 25 of 114 (21.93%) patients in the control group (p = .001). A significant correlation between MAGI and pathological Gleason score also revealed (p = .0001). We demonstrated that men with MAGI have increased risk for the development of prostate cancer. Moreover, in this population, most of the prostate cancers tend to be clinically significant or high grade.     

Circumcision does not have effect on premature ejaculation: A systematic review and meta‐analysis

We attempted to evaluate whether circumcision has an effect on premature ejaculation. We searched three databases: PubMed, EMBASE and Google scholar on 1 May 2016 for eligible studies that referred to male sexual function after circumcision. No language restrictions were imposed. The Cochrane Collaboration's RevMan 5.2 software was employed for data analysis, and the fixed or the random‐effect model was selected depending on the heterogeneity. Twelve studies were included in the meta‐analysis, containing a total of 10019 circumcised and 11570 uncircumcised men. All studies were divided into five subgroups by types of study design to evaluate the effect of circumcision on premature ejaculation (PE). Intravaginal ejaculation latency time (IELT), difficulty of orgasm, erectile dysfunction (ED) and pain during intercourse were also assessed because PE was usually discussed along with these subjects. There were no significant differences in PE (odds ratio [OR], 0.90; 95% confidence interval (CI), 0.72‐1.13; p = .37) and orgasm (OR, 1.04; 95% CI, 0.89‐1.21; p = .65) between circumcised and uncircumcised group. However, IELT (OR, 0.72; 95% CI, 0.60‐0.83; p < .00001), ED (OR, 0.42;95% CI, 0.22‐0.78; p = .40) and pain during intercourse (OR, 0.36; 95% CI, 0.17‐0.76; p = .007) favoured circumcised group. Based on these findings, circumcision does not have effect on PE.