Male infertility contributes to 20%–70%of infertile couple cases worldwide.One of the key challenges in this area is asthenozoospermia or reduced sperm motility.A particular subset,known as isolated asthenozoospermia...Male infertility contributes to 20%–70%of infertile couple cases worldwide.One of the key challenges in this area is asthenozoospermia or reduced sperm motility.A particular subset,known as isolated asthenozoospermia(iASZ),in which low motility occurs without abnormalities in sperm count or shape,often goes unnoticed and is not well understood.This narrative review attempts to compile the state of knowledge regarding the etiology,diagnosis,and treatment of iA SZ and to identify knowledge gaps that need further investigation with an emphasis on physiological,genetic,and molecular mechanisms.We conducted a focused literature search using PubMed and Web of Science,covering studies published between 2000 and 2024.We included articles that explored the structure,function,diagnosis,and treatment of iASZ.We find sperm motility is influenced by multiple factors,from structural components like mitochondria and the flagellum,to biochemical signals and genetic mutations.In men with iASZ,issues such as mitochondrial dysfunction,oxidative stress,or specific gene defects may impair motility.While routine semen analysis helps flag low motility,it often fails to explain why it occurs—highlighting the need for advanced tests like DNA fragmentation tests,genetic screening,and high-resolution imaging.As regards treatment,lifestyle changes,varicocele surgery,and antioxidants can offer some benefit.Assisted reproduction techniques,especially intracytoplasmic sperm injection(ICSI),remain central for achieving pregnancy when other options fail.iA SZ deserves more attention as a distinct and treatable cause of male infertility.By improving how we diagnose and manage this condition,supported by further research,we can offer better outcomes for affected couples hoping to conceive.展开更多
Varicocele is a common entity found in 15%of men and is the most common reversible cause of male factor infertility.Guidelines have been developed to guide urologists in deciding which patients would benefit from vari...Varicocele is a common entity found in 15%of men and is the most common reversible cause of male factor infertility.Guidelines have been developed to guide urologists in deciding which patients would benefit from varicocelectomy.Yet studies published over the last decade showed the emergence of predictors of success of varicocelectomy using nomograms and other predictive models with statistical analysis.The emergence of artificial intelligence(AI)and machine learning revolutionized the clinician's approach to medicine.The virtual branch of AI,represented by machine learning,has been a very exciting topic for clinicians and researchers over the last years,especially after the launching of ChatGPT-3.5.Urology has been at the forefront of integrating advances in AI into its everyday practice.We aim to shed light on the present literature describing the use of AI in predicting the outcomes of varicocelectomy.Machine learning is being used to predict the improvement in semen parameters after varicocelectomy.These algorithms are derived from studies and data present in the literature and predictive models developed throughout the last two decades and have a superior performance to that of traditional nomograms.However,these models require further research and validation but are anticipated to surpass the accuracy of all current resources,setting forward a new era of varicocele workup and management in the years to come.This paper offers a wide review on the current evidence behind varicocele surgery and the integration of AI in medicine,urology and its use in predicting improvement in sperm parameters post-varicocelectomy.展开更多
Ten percent of infertile males have azoospermia,classified into obstructive and nonobstructive types,which require specific medical or surgical treatments.In nonobstructive azoospermia,advancements in microsurgery all...Ten percent of infertile males have azoospermia,classified into obstructive and nonobstructive types,which require specific medical or surgical treatments.In nonobstructive azoospermia,advancements in microsurgery allow for effective sperm retrieval in about half of cases.This review aimed to highlight the most recent studies utilizing whole exome sequencing(WES)and seminal/serum biomarkers aim to predict micro-dissection testicular sperm extraction(micro-TESE)outcomes and reduce failure rates.WES identifies rare genetic mutations affecting spermatogenesis that could explain micro-TESE failures,improving preoperative assessments.Despite its potential,WES is limited by high costs.Biomarkers such as Anti-Müllerian Hormone and testis-expressed sequence 101 protein can indicate spermatogenic activity,though standardization of these measurements is needed for accuracy.Additionally,microRNAs as non-invasive markers offer potential in assessing spermatogenic reserve and classifying azoospermia types,but their efficacy in identifying specific spermatogenic disorders remains under researched,necessitating further studies on multivariate miRNA models.展开更多
Erectile dysfunction(ED)is the inability to achieve or maintain an erection sufficient for satisfactory sexual performance,affecting over 50% of men aged 50 and older.ED is often linked to lifestyle factors and comorb...Erectile dysfunction(ED)is the inability to achieve or maintain an erection sufficient for satisfactory sexual performance,affecting over 50% of men aged 50 and older.ED is often linked to lifestyle factors and comorbidities,such as diabetes and cardiovascular disease.Although conventional treatments such as phosphodiesterase type 5 inhibitors(PDE5is)and penile prostheses are commonly used,there is increasing interest in regenerative therapies,including platelet-rich plasma(PRP),which may address the underlying causes of ED.This narrative review examines ongoing trials on intracavernosal PRP for ED to better understand its potential as a treatment and offers recommendations for future research to improve the quality of evidence supporting its use.A literature search was conducted in December 2024 across PubMed,ScienceDirect,and Scopus for articles evaluating PRP for ED.The keywords used for search were PRP,ED,and randomized controlled trial.The review focused on relevant studies,with titles,abstracts,and full texts examined for key details.Five randomized clinical trials,two metaanalyses,and a systematic review were identified,revealing significant variability in PRP preparation,dosage,and follow-up protocols,which hindered definitive conclusions about its efficacy.Although the available evidence suggests promising potential for PRP in ED treatment,methodological inconsistencies highlight the need for further research.Standardization of PRP preparation and administration protocols,along with larger and longerterm trials,is essential to establish its clinical benefits for ED treatment.展开更多
Nonobstructive azoospermia(NOA)is a serious form of male infertility with therapeutic options limited to trials of endocrine manipulations and repertoire of surgical interventions,also known as surgical sperm retrieva...Nonobstructive azoospermia(NOA)is a serious form of male infertility with therapeutic options limited to trials of endocrine manipulations and repertoire of surgical interventions,also known as surgical sperm retrieval(SSR)procedures.Despite its invasive nature,SSR remains crucial in the management of NOA,offering infertile males the opportunity of fathering their biological children using assisted reproductive technologies.Success rates of SSR are variably governed by several factors including the genetic background,preoperative endocrine optimization,testicular histopathology,surgeon's microsurgical expertise,and laboratory technological and technical team's capability.This paper explores the significant role of artificial intelligence(AI)in the process of sperm retrieval among NOA patients.The role of AI has evolved from basic predictive models used for outcome assessment and patient counseling,to advanced image processing capabilities for assessing sperm parameters,and now to cutting-edge applications in identifying the rare sperm present in the azoospermic microdissection testicular sperm extraction tissue samples.展开更多
Peyronie's disease(PD)is an inflammatory andfibrotic disease which resultsin disfiguring and often distressing penile curvature deformity,affecting up toone in nine men in the United States,and between 0.3%and 13....Peyronie's disease(PD)is an inflammatory andfibrotic disease which resultsin disfiguring and often distressing penile curvature deformity,affecting up toone in nine men in the United States,and between 0.3%and 13.1%of menglobally.It progresses through an acute phase,associated with pain,as thefibrosis develops.In the quiescent phase,penile pain ceases and deformitystabilizes.The precise etiology remains unknown despite ongoing work toelucidate the biological underpinning.The diagnosis is guided by history andphysical examination.Except for ultrasonography,imaging is not routinelyrecommended.Current management is predicated on symptomatic controland slowing progression in the acute phase,and correction of bothersomecurvature in the stable phase.Most nonsurgical treatment options are poorlysupported by available evidence,with the exceptions of traction therapy andcertain intralesional injections.Surgical treatment,considered only afterstabilization,is guided by severity and the presence or absence of erectilefunction and is highly individualized.Investigations are ongoing into severalareas,including the exact biological mechanisms leading to plaque formationand failure of resolution;the effects of co‐existing systemic disease;the role ofimaging in diagnosis and surgical planning;combination and regenerativenonsurgical therapies;and improvements in surgical techniques.As diag-nostic accuracy improves and targeted treatments become available,man-agement of PD will become progressively tailored to an individual's particulardisease.In this review,we summarize the current knowledge regarding PD,including etiology and epidemiology,diagnosis,management,cutting‐edgeresearch,and future directions in care of this condition.展开更多
Testosterone plays a pivotal role in male health throughout the lifespan.Men generally exhibit higher serum testosterone levels than women,influencing critical aspects of male physiology.It drives normal sexual differ...Testosterone plays a pivotal role in male health throughout the lifespan.Men generally exhibit higher serum testosterone levels than women,influencing critical aspects of male physiology.It drives normal sexual differentiation during fetal development,promotes the acquisition of pubertal traits,and induces the development of secondary male sex characteristics.While testosterone levels naturally decline with age,this decrease varies greatly between individuals,indicating that aging alone does not account for any specific testosterone level.The interindividual variability highlights the influence of both genetic and environmental factors on testosterone production.Abnormal changes in testosterone levels,whether excessive or deficient,can have significant implications for men's health,contributing to conditions such as hypogonadism,cardiovascular disease,sexual disorders,and metabolic disorders.Precision medicine provides personalized testosterone treatment options for hypogonadism,taking into account genetic,hormonal,and lifestyle aspects to improve outcomes.This tailored approach is also relevant in dealing with broader reproductive and sexual health issues,ensuring effective and individualized care.This review focuses on testosterone's varied involvement in men's health,using biomarkers and precision medicine breakthroughs to inform tailored therapy and future research.展开更多
Background:Prostate cancer,a prevalent malignancy in men,often results in erectile dysfunction(ED),particularly following treatments like radical prostatectomy(RP)and radiotherapy,significantly affecting quality of li...Background:Prostate cancer,a prevalent malignancy in men,often results in erectile dysfunction(ED),particularly following treatments like radical prostatectomy(RP)and radiotherapy,significantly affecting quality of life.Managing ED in prostate cancer survivors is critical.Inflatable penile prosthesis(IPP)implantation is a well-established treatment for ED,yet the literature on satisfaction rates for patients with a history of androgen deprivation therapy(ADT)remains sparse.We aimed to investigate the impact of ADT on satisfaction rates in patients undergoing IPP implantation following RP or radiation therapy(XRT).Methods:A retrospective review of 529 patient charts identified 96 eligible patients who underwent IPP implantation post-prostate cancer treatment and completed the 11-item Erectile Dysfunction Inventory of Treatment Satisfaction(EDITS)questionnaire.Patients were stratified into two groups based on ADT status,and their satisfaction scores were compared.Effect sizes were used to assess clinical relevance alongside statistical significance(p=0.0344).Results:Patients receiving ADT had significantly lower EDITS scores(p=0.0344)compared to those not on ADT.RP patients reported higher satisfaction post-IPP compared to XRT patients,even after controlling for ADT.Additionally,coronary artery disease(CAD)was associated with lower satisfaction scores.Conclusion:ADT significantly lowers patient satisfaction post-IPP,with RP patients generally reporting higher satisfaction than XRT patients.These findings highlight the importance of counseling prostate cancer patients on ADT's impact on long-term sexual satisfaction and suggest areas for further research to enhance outcomes.展开更多
Background:Tubular ectasia of rete testis(TERT)is a benign condition due to dilatation of the rete testis as a consequence of multiple etiologies,including postinfectious,trauma,prior inguinal or scrotal surgeries,mec...Background:Tubular ectasia of rete testis(TERT)is a benign condition due to dilatation of the rete testis as a consequence of multiple etiologies,including postinfectious,trauma,prior inguinal or scrotal surgeries,mechanical compression of extratesticular excretory ducts,and congenital malformation.TERT is a rare and underreported condition in the medical literature.Its association with infertility is lacking in the literature.Case Presentation:We present a rare case of primary infertility and obstructive azoospermia associated with TERT.We performed extensive literature regarding the possible etiologies,associations,clinical diagnosis,and different management options of this entity.Our patient is a 33-year-old man presented with primary infertility.He was found to have obstructive azoospermia.During scrotal exploration,the diagnosis of intratesticular obstruction due to TERT was made.The couple was advised to undergo intracytoplasmic sperm injection using testicular sperms.This is the third report of TERT associated with azoospermia.Conclusion:TERT is usually asymptomatic but can occasionally be associated with pain or abnormal semen analysis,but further studies are required to confirm its effect on fertility.Fortunately,it has a benign course and typically does not require surgical intervention.It is vital to differentiate it from neoplastic conditions.展开更多
Telemedicine has rapidly integrated into healthcare,overcoming initial barriers such as regulatory restrictions and technological limitations.Its role in sexual medicine,especially urology,has been accelerated by tech...Telemedicine has rapidly integrated into healthcare,overcoming initial barriers such as regulatory restrictions and technological limitations.Its role in sexual medicine,especially urology,has been accelerated by technological advances and the COVID-19 pandemic.However,as telehealth continues to expand,key ethical challenges emerge,including concerns over privacy,healthcare equity,and informed consent.These challenges are particularly important in sexual medicine,where sensitive patient data and intimate conditions are involved.We aimed to examine the ethical implications of telemedicine in sexual medicine,focusing on data security,consent processes,and healthcare disparities.We further emphasize the importance of maintaining high ethical standards while integrating telemedicine as a complement to traditional care,ensuring that patient outcomes are not compromised.展开更多
Benign prostatic hyperplasia(BPH)is a common condition among agingmen,often leading to lower urinary tract symptoms(LUTS)of varyingseverity.Both medical and surgical treatments for BPH can negatively impactsexual func...Benign prostatic hyperplasia(BPH)is a common condition among agingmen,often leading to lower urinary tract symptoms(LUTS)of varyingseverity.Both medical and surgical treatments for BPH can negatively impactsexual function,affecting patients'overall quality of life.This has highlightedthe need for minimally invasive interventions that minimize sexual side ef-fects.Rezum,a water vapor therapy,has gained popularity in managing BPHand LUTS due to its proposed potential to preserve sexual function.Thisscoping review examines the impact of Rezum therapy on sexual function inpatients treated for BPH.The review was conducted following the JoannaBriggs Institute(JBI)methodology for scoping reviews.A comprehensivesearch was performed using the PubMed and Scopus databases up to August2024.Articles were included if they involved patients treated with Rezum forBPH and reported the effect of Rezum on sexual function using validatedscoring tools.A total of 15 studies encompassing 2,425 patients,met theinclusion criteria.Erectile function was assessed in all studies using theInternational Index of Erectile Function(IIEF)scores.Of these,seven studiesreported no significant changes in erectile function scores,six demonstratedimprovements,and two reported a significant decline.Ejaculatory functionwas evaluated using the Male Sexual Health Questionnaire(MSHQ).TheMSHQ‐Bother score was reported in seven studies,with three indicatingimprovement and none reporting deterioration.The MSHQ‐Function scorewas reported in eight studies,with only one study reporting a decline,whilethe remaining studies found no significant changes.In conclusion,Rezumtherapy for managing BPH shows favorable outcomes for sexual function or,at the very least,does not negatively impact it.Thesefindings can guidepatient counseling,especially for those seeking to preserve ejaculation.Further research is needed to compare Rezum with other treatment optionsregarding sexual function.展开更多
Background:Obstructive azoospermia(OA)is a prevalent cause of male infertility in Qatar and globally,with vasectomy reversal(VV)and vasoepididymostomy(VE)being the primary surgical treatments.While microsurgical techn...Background:Obstructive azoospermia(OA)is a prevalent cause of male infertility in Qatar and globally,with vasectomy reversal(VV)and vasoepididymostomy(VE)being the primary surgical treatments.While microsurgical techniques have advanced,data from the Middle East remain limited,influenced by the region's distinct demographic and cultural factors.This study aimed to evaluate the outcomes of microsurgical VV and VE performed for OA in a tertiary center in the Middle East,with a focus on success rates,influencing factors,and the unique regional characteristics of OA.Methods:A retrospective cohort study analyzed 105 patients with OA undergoing VV or VE over a period of 10 years.Data on demographics,clinical variables,surgical findings,and postoperative outcomes were assessed.Success was defined as sperm presence in semen within 3–6 months post-surgery.Results:The overall success rate for VV was 85.7%,with similar rates across bilateral and unilateral procedures.VE success was 50%,with bilateral intussusception technique yielding superior outcomes(71.9%).Factors predicting success included shorter obstructive interval for VV and bilateral reconstruction for VE.Conclusion:Microsurgical VV remains a reliable first-line treatment for OA,achieving high success rates consistent with international benchmarks.VE presents greater variability in outcomes,highlighting the complexity of managing epididymal obstruction and the importance of advanced surgical techniques like intussusception.The distinct etiological patterns observed in the Middle East emphasize the need for tailored approaches to diagnosis,surgical planning,and patient counseling.展开更多
Guiting Lin MD,PhD,School of Medicine,University of California,San Francisco,USA Dr.Guiting Lin is a Professor of Urology and co-director of Kunppe Molecular Urology Laboratory at University of California,San Francisc...Guiting Lin MD,PhD,School of Medicine,University of California,San Francisco,USA Dr.Guiting Lin is a Professor of Urology and co-director of Kunppe Molecular Urology Laboratory at University of California,San Francisco(UCSF).Dr.Lin trained in Surgery at the Harbin Medical University in Harbin,China and specialized in Urologic Surgery at Peking University,China's premier medical school located in Beijing.In 2001,Dr.Lin joined the Department of Urology at University of California,San Francisco as a Postdoctoral Research Fellow.He was promoted to Assistant Researcher in 2005,to Assistant Professor in 2007,to Associate Professor in 2010,and to Professor in 2017.In China,Dr.Lin received numerous awards from the Shandong Ministry of Health,and Peking University.His UCSF research has also received recognition,including the 2002 Outstanding Young Researcher award and 2016 ISSM Zorgniotti-Newman Prize given by the International Society for Sexual and Impotence Research.展开更多
Submission deadline:31 October 2025 UroPrecision is delighted to announce a special issue on Liquid Biopsy in Genitourinary(GU)Oncology,focusing on prostate,renal,and bladder cancers.This issue,led by Dr.Shidong Jia,D...Submission deadline:31 October 2025 UroPrecision is delighted to announce a special issue on Liquid Biopsy in Genitourinary(GU)Oncology,focusing on prostate,renal,and bladder cancers.This issue,led by Dr.Shidong Jia,Dr.Liang Cheng,and Dr.Joshua Linscott,will highlight the latest advancements in liquid biopsy technologies and their clinical applications,including diagnosis,prognosis,treatment monitoring,and drug development for GU malignancies.展开更多
Guiting Lin MD,PhD,School of Medicine,University of California,San Francisco,USA Dr.Guiting Lin is a Professor of Urology and co-director of Kunppe Molecular Urology Laboratory at University of California,San Francisc...Guiting Lin MD,PhD,School of Medicine,University of California,San Francisco,USA Dr.Guiting Lin is a Professor of Urology and co-director of Kunppe Molecular Urology Laboratory at University of California,San Francisco(UCSF).Dr.Lin trained in Surgery at the Harbin Medical University in Harbin,China and specialized in Urologic Surgery at Peking University,China's premier medical school located in Beijing.In 2001,Dr.Lin joined the Department of Urology at University of California,San Francisco as a Postdoctoral Research Fellow.He was promoted to Assistant Researcher in 2005,to Assistant Professor in 2007,to Associate Professor in 2010,and to Professor in 2017.In China,Dr.Lin received numerous awards from the Shandong Ministry of Health,and Peking University.His UCSF research has also received recognition,including the 2002 Outstanding Young Researcher award and 2016 ISSM Zorgniotti-Newman Prize given by the International Society for Sexual and Impotence Research.展开更多
Eissa et al.'s review warmly invites readers into the often-overlooked realm of isolated asthenozoospermia(iASZ),a condition marked by reduced sperm motility that affects 16%–24%of male infertility cases.With a n...Eissa et al.'s review warmly invites readers into the often-overlooked realm of isolated asthenozoospermia(iASZ),a condition marked by reduced sperm motility that affects 16%–24%of male infertility cases.With a nod to the authors’dedication,this work masterfully compiles insights into the physiological,genetic,and molecular underpinnings of iASZ,offering a clear guide to its etiology,diagnosis,and management.展开更多
Saad et al.'s review~([1]),“Emerging trends in the management of non-obstructive azoospermia,”offers a compelling synthesis of cutting-edge diagnostic and therapeutic strategies for non-obstructive azoospermia(N...Saad et al.'s review~([1]),“Emerging trends in the management of non-obstructive azoospermia,”offers a compelling synthesis of cutting-edge diagnostic and therapeutic strategies for non-obstructive azoospermia(NOA),a challenging condition affecting 10%–15%o infertile men.By highlighting advances in whole exome sequencing(WES),biomarkers like Anti-Müllerian hormone(AMH)and microRNAs(miRNAs),and microdissection testicular sperm extraction(micro-TESE),the authors chart a path toward precision medicine in male infertility.Their exploration of AI and gene-editing technologies like CRISPR/Cas9 underscores the transformative potential of these innovations.展开更多
Deadline for submission:Submission are welcome throughout the year UroPrecision is excited to announce the launch of our new column,"UroPrecision Cuts,"dedicated to showcasing ground-breaking surgical innova...Deadline for submission:Submission are welcome throughout the year UroPrecision is excited to announce the launch of our new column,"UroPrecision Cuts,"dedicated to showcasing ground-breaking surgical innovations in the realm of urology,with a strong focus on precision medicine.This platform provides a vibrant space for surgeons,researchers,and medical professionals to share and engage in discussions about surgical techniques,approaches,and procedures that define the forefront of precision urological surgery.展开更多
Submission deadline:31 October 2025 UroPrecision is delighted to announce a special issue on Liquid Biopsy in Genitourinary(GU)Oncology,focusing on prostate,renal,and bladder cancers.This issue,led by Dr.Shidong Jia,D...Submission deadline:31 October 2025 UroPrecision is delighted to announce a special issue on Liquid Biopsy in Genitourinary(GU)Oncology,focusing on prostate,renal,and bladder cancers.This issue,led by Dr.Shidong Jia,Dr.Liang Cheng,and Dr.Joshua Linscott,will highlight the latest advancements in liquid biopsy technologies and their clinical applications,including diagnosis,prognosis,treatment monitoring,and drug development for GU malignancies.展开更多
Gang Song MD,PhD,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China Dr.Gang Song is a Professor of Ur...Gang Song MD,PhD,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China Dr.Gang Song is a Professor of Urology in the Department of Urology at the National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China.He serves as the Secretary of several scientific societies,including the Youth Committee of the Chinese Urological Doctor Association and the Youth Committee of the Genitourinary Oncology Committee of the Beijing Anti-Cancer Association.展开更多
文摘Male infertility contributes to 20%–70%of infertile couple cases worldwide.One of the key challenges in this area is asthenozoospermia or reduced sperm motility.A particular subset,known as isolated asthenozoospermia(iASZ),in which low motility occurs without abnormalities in sperm count or shape,often goes unnoticed and is not well understood.This narrative review attempts to compile the state of knowledge regarding the etiology,diagnosis,and treatment of iA SZ and to identify knowledge gaps that need further investigation with an emphasis on physiological,genetic,and molecular mechanisms.We conducted a focused literature search using PubMed and Web of Science,covering studies published between 2000 and 2024.We included articles that explored the structure,function,diagnosis,and treatment of iASZ.We find sperm motility is influenced by multiple factors,from structural components like mitochondria and the flagellum,to biochemical signals and genetic mutations.In men with iASZ,issues such as mitochondrial dysfunction,oxidative stress,or specific gene defects may impair motility.While routine semen analysis helps flag low motility,it often fails to explain why it occurs—highlighting the need for advanced tests like DNA fragmentation tests,genetic screening,and high-resolution imaging.As regards treatment,lifestyle changes,varicocele surgery,and antioxidants can offer some benefit.Assisted reproduction techniques,especially intracytoplasmic sperm injection(ICSI),remain central for achieving pregnancy when other options fail.iA SZ deserves more attention as a distinct and treatable cause of male infertility.By improving how we diagnose and manage this condition,supported by further research,we can offer better outcomes for affected couples hoping to conceive.
文摘Varicocele is a common entity found in 15%of men and is the most common reversible cause of male factor infertility.Guidelines have been developed to guide urologists in deciding which patients would benefit from varicocelectomy.Yet studies published over the last decade showed the emergence of predictors of success of varicocelectomy using nomograms and other predictive models with statistical analysis.The emergence of artificial intelligence(AI)and machine learning revolutionized the clinician's approach to medicine.The virtual branch of AI,represented by machine learning,has been a very exciting topic for clinicians and researchers over the last years,especially after the launching of ChatGPT-3.5.Urology has been at the forefront of integrating advances in AI into its everyday practice.We aim to shed light on the present literature describing the use of AI in predicting the outcomes of varicocelectomy.Machine learning is being used to predict the improvement in semen parameters after varicocelectomy.These algorithms are derived from studies and data present in the literature and predictive models developed throughout the last two decades and have a superior performance to that of traditional nomograms.However,these models require further research and validation but are anticipated to surpass the accuracy of all current resources,setting forward a new era of varicocele workup and management in the years to come.This paper offers a wide review on the current evidence behind varicocele surgery and the integration of AI in medicine,urology and its use in predicting improvement in sperm parameters post-varicocelectomy.
文摘Ten percent of infertile males have azoospermia,classified into obstructive and nonobstructive types,which require specific medical or surgical treatments.In nonobstructive azoospermia,advancements in microsurgery allow for effective sperm retrieval in about half of cases.This review aimed to highlight the most recent studies utilizing whole exome sequencing(WES)and seminal/serum biomarkers aim to predict micro-dissection testicular sperm extraction(micro-TESE)outcomes and reduce failure rates.WES identifies rare genetic mutations affecting spermatogenesis that could explain micro-TESE failures,improving preoperative assessments.Despite its potential,WES is limited by high costs.Biomarkers such as Anti-Müllerian Hormone and testis-expressed sequence 101 protein can indicate spermatogenic activity,though standardization of these measurements is needed for accuracy.Additionally,microRNAs as non-invasive markers offer potential in assessing spermatogenic reserve and classifying azoospermia types,but their efficacy in identifying specific spermatogenic disorders remains under researched,necessitating further studies on multivariate miRNA models.
文摘Erectile dysfunction(ED)is the inability to achieve or maintain an erection sufficient for satisfactory sexual performance,affecting over 50% of men aged 50 and older.ED is often linked to lifestyle factors and comorbidities,such as diabetes and cardiovascular disease.Although conventional treatments such as phosphodiesterase type 5 inhibitors(PDE5is)and penile prostheses are commonly used,there is increasing interest in regenerative therapies,including platelet-rich plasma(PRP),which may address the underlying causes of ED.This narrative review examines ongoing trials on intracavernosal PRP for ED to better understand its potential as a treatment and offers recommendations for future research to improve the quality of evidence supporting its use.A literature search was conducted in December 2024 across PubMed,ScienceDirect,and Scopus for articles evaluating PRP for ED.The keywords used for search were PRP,ED,and randomized controlled trial.The review focused on relevant studies,with titles,abstracts,and full texts examined for key details.Five randomized clinical trials,two metaanalyses,and a systematic review were identified,revealing significant variability in PRP preparation,dosage,and follow-up protocols,which hindered definitive conclusions about its efficacy.Although the available evidence suggests promising potential for PRP in ED treatment,methodological inconsistencies highlight the need for further research.Standardization of PRP preparation and administration protocols,along with larger and longerterm trials,is essential to establish its clinical benefits for ED treatment.
文摘Nonobstructive azoospermia(NOA)is a serious form of male infertility with therapeutic options limited to trials of endocrine manipulations and repertoire of surgical interventions,also known as surgical sperm retrieval(SSR)procedures.Despite its invasive nature,SSR remains crucial in the management of NOA,offering infertile males the opportunity of fathering their biological children using assisted reproductive technologies.Success rates of SSR are variably governed by several factors including the genetic background,preoperative endocrine optimization,testicular histopathology,surgeon's microsurgical expertise,and laboratory technological and technical team's capability.This paper explores the significant role of artificial intelligence(AI)in the process of sperm retrieval among NOA patients.The role of AI has evolved from basic predictive models used for outcome assessment and patient counseling,to advanced image processing capabilities for assessing sperm parameters,and now to cutting-edge applications in identifying the rare sperm present in the azoospermic microdissection testicular sperm extraction tissue samples.
文摘Peyronie's disease(PD)is an inflammatory andfibrotic disease which resultsin disfiguring and often distressing penile curvature deformity,affecting up toone in nine men in the United States,and between 0.3%and 13.1%of menglobally.It progresses through an acute phase,associated with pain,as thefibrosis develops.In the quiescent phase,penile pain ceases and deformitystabilizes.The precise etiology remains unknown despite ongoing work toelucidate the biological underpinning.The diagnosis is guided by history andphysical examination.Except for ultrasonography,imaging is not routinelyrecommended.Current management is predicated on symptomatic controland slowing progression in the acute phase,and correction of bothersomecurvature in the stable phase.Most nonsurgical treatment options are poorlysupported by available evidence,with the exceptions of traction therapy andcertain intralesional injections.Surgical treatment,considered only afterstabilization,is guided by severity and the presence or absence of erectilefunction and is highly individualized.Investigations are ongoing into severalareas,including the exact biological mechanisms leading to plaque formationand failure of resolution;the effects of co‐existing systemic disease;the role ofimaging in diagnosis and surgical planning;combination and regenerativenonsurgical therapies;and improvements in surgical techniques.As diag-nostic accuracy improves and targeted treatments become available,man-agement of PD will become progressively tailored to an individual's particulardisease.In this review,we summarize the current knowledge regarding PD,including etiology and epidemiology,diagnosis,management,cutting‐edgeresearch,and future directions in care of this condition.
文摘Testosterone plays a pivotal role in male health throughout the lifespan.Men generally exhibit higher serum testosterone levels than women,influencing critical aspects of male physiology.It drives normal sexual differentiation during fetal development,promotes the acquisition of pubertal traits,and induces the development of secondary male sex characteristics.While testosterone levels naturally decline with age,this decrease varies greatly between individuals,indicating that aging alone does not account for any specific testosterone level.The interindividual variability highlights the influence of both genetic and environmental factors on testosterone production.Abnormal changes in testosterone levels,whether excessive or deficient,can have significant implications for men's health,contributing to conditions such as hypogonadism,cardiovascular disease,sexual disorders,and metabolic disorders.Precision medicine provides personalized testosterone treatment options for hypogonadism,taking into account genetic,hormonal,and lifestyle aspects to improve outcomes.This tailored approach is also relevant in dealing with broader reproductive and sexual health issues,ensuring effective and individualized care.This review focuses on testosterone's varied involvement in men's health,using biomarkers and precision medicine breakthroughs to inform tailored therapy and future research.
文摘Background:Prostate cancer,a prevalent malignancy in men,often results in erectile dysfunction(ED),particularly following treatments like radical prostatectomy(RP)and radiotherapy,significantly affecting quality of life.Managing ED in prostate cancer survivors is critical.Inflatable penile prosthesis(IPP)implantation is a well-established treatment for ED,yet the literature on satisfaction rates for patients with a history of androgen deprivation therapy(ADT)remains sparse.We aimed to investigate the impact of ADT on satisfaction rates in patients undergoing IPP implantation following RP or radiation therapy(XRT).Methods:A retrospective review of 529 patient charts identified 96 eligible patients who underwent IPP implantation post-prostate cancer treatment and completed the 11-item Erectile Dysfunction Inventory of Treatment Satisfaction(EDITS)questionnaire.Patients were stratified into two groups based on ADT status,and their satisfaction scores were compared.Effect sizes were used to assess clinical relevance alongside statistical significance(p=0.0344).Results:Patients receiving ADT had significantly lower EDITS scores(p=0.0344)compared to those not on ADT.RP patients reported higher satisfaction post-IPP compared to XRT patients,even after controlling for ADT.Additionally,coronary artery disease(CAD)was associated with lower satisfaction scores.Conclusion:ADT significantly lowers patient satisfaction post-IPP,with RP patients generally reporting higher satisfaction than XRT patients.These findings highlight the importance of counseling prostate cancer patients on ADT's impact on long-term sexual satisfaction and suggest areas for further research to enhance outcomes.
文摘Background:Tubular ectasia of rete testis(TERT)is a benign condition due to dilatation of the rete testis as a consequence of multiple etiologies,including postinfectious,trauma,prior inguinal or scrotal surgeries,mechanical compression of extratesticular excretory ducts,and congenital malformation.TERT is a rare and underreported condition in the medical literature.Its association with infertility is lacking in the literature.Case Presentation:We present a rare case of primary infertility and obstructive azoospermia associated with TERT.We performed extensive literature regarding the possible etiologies,associations,clinical diagnosis,and different management options of this entity.Our patient is a 33-year-old man presented with primary infertility.He was found to have obstructive azoospermia.During scrotal exploration,the diagnosis of intratesticular obstruction due to TERT was made.The couple was advised to undergo intracytoplasmic sperm injection using testicular sperms.This is the third report of TERT associated with azoospermia.Conclusion:TERT is usually asymptomatic but can occasionally be associated with pain or abnormal semen analysis,but further studies are required to confirm its effect on fertility.Fortunately,it has a benign course and typically does not require surgical intervention.It is vital to differentiate it from neoplastic conditions.
文摘Telemedicine has rapidly integrated into healthcare,overcoming initial barriers such as regulatory restrictions and technological limitations.Its role in sexual medicine,especially urology,has been accelerated by technological advances and the COVID-19 pandemic.However,as telehealth continues to expand,key ethical challenges emerge,including concerns over privacy,healthcare equity,and informed consent.These challenges are particularly important in sexual medicine,where sensitive patient data and intimate conditions are involved.We aimed to examine the ethical implications of telemedicine in sexual medicine,focusing on data security,consent processes,and healthcare disparities.We further emphasize the importance of maintaining high ethical standards while integrating telemedicine as a complement to traditional care,ensuring that patient outcomes are not compromised.
文摘Benign prostatic hyperplasia(BPH)is a common condition among agingmen,often leading to lower urinary tract symptoms(LUTS)of varyingseverity.Both medical and surgical treatments for BPH can negatively impactsexual function,affecting patients'overall quality of life.This has highlightedthe need for minimally invasive interventions that minimize sexual side ef-fects.Rezum,a water vapor therapy,has gained popularity in managing BPHand LUTS due to its proposed potential to preserve sexual function.Thisscoping review examines the impact of Rezum therapy on sexual function inpatients treated for BPH.The review was conducted following the JoannaBriggs Institute(JBI)methodology for scoping reviews.A comprehensivesearch was performed using the PubMed and Scopus databases up to August2024.Articles were included if they involved patients treated with Rezum forBPH and reported the effect of Rezum on sexual function using validatedscoring tools.A total of 15 studies encompassing 2,425 patients,met theinclusion criteria.Erectile function was assessed in all studies using theInternational Index of Erectile Function(IIEF)scores.Of these,seven studiesreported no significant changes in erectile function scores,six demonstratedimprovements,and two reported a significant decline.Ejaculatory functionwas evaluated using the Male Sexual Health Questionnaire(MSHQ).TheMSHQ‐Bother score was reported in seven studies,with three indicatingimprovement and none reporting deterioration.The MSHQ‐Function scorewas reported in eight studies,with only one study reporting a decline,whilethe remaining studies found no significant changes.In conclusion,Rezumtherapy for managing BPH shows favorable outcomes for sexual function or,at the very least,does not negatively impact it.Thesefindings can guidepatient counseling,especially for those seeking to preserve ejaculation.Further research is needed to compare Rezum with other treatment optionsregarding sexual function.
文摘Background:Obstructive azoospermia(OA)is a prevalent cause of male infertility in Qatar and globally,with vasectomy reversal(VV)and vasoepididymostomy(VE)being the primary surgical treatments.While microsurgical techniques have advanced,data from the Middle East remain limited,influenced by the region's distinct demographic and cultural factors.This study aimed to evaluate the outcomes of microsurgical VV and VE performed for OA in a tertiary center in the Middle East,with a focus on success rates,influencing factors,and the unique regional characteristics of OA.Methods:A retrospective cohort study analyzed 105 patients with OA undergoing VV or VE over a period of 10 years.Data on demographics,clinical variables,surgical findings,and postoperative outcomes were assessed.Success was defined as sperm presence in semen within 3–6 months post-surgery.Results:The overall success rate for VV was 85.7%,with similar rates across bilateral and unilateral procedures.VE success was 50%,with bilateral intussusception technique yielding superior outcomes(71.9%).Factors predicting success included shorter obstructive interval for VV and bilateral reconstruction for VE.Conclusion:Microsurgical VV remains a reliable first-line treatment for OA,achieving high success rates consistent with international benchmarks.VE presents greater variability in outcomes,highlighting the complexity of managing epididymal obstruction and the importance of advanced surgical techniques like intussusception.The distinct etiological patterns observed in the Middle East emphasize the need for tailored approaches to diagnosis,surgical planning,and patient counseling.
文摘Guiting Lin MD,PhD,School of Medicine,University of California,San Francisco,USA Dr.Guiting Lin is a Professor of Urology and co-director of Kunppe Molecular Urology Laboratory at University of California,San Francisco(UCSF).Dr.Lin trained in Surgery at the Harbin Medical University in Harbin,China and specialized in Urologic Surgery at Peking University,China's premier medical school located in Beijing.In 2001,Dr.Lin joined the Department of Urology at University of California,San Francisco as a Postdoctoral Research Fellow.He was promoted to Assistant Researcher in 2005,to Assistant Professor in 2007,to Associate Professor in 2010,and to Professor in 2017.In China,Dr.Lin received numerous awards from the Shandong Ministry of Health,and Peking University.His UCSF research has also received recognition,including the 2002 Outstanding Young Researcher award and 2016 ISSM Zorgniotti-Newman Prize given by the International Society for Sexual and Impotence Research.
文摘Submission deadline:31 October 2025 UroPrecision is delighted to announce a special issue on Liquid Biopsy in Genitourinary(GU)Oncology,focusing on prostate,renal,and bladder cancers.This issue,led by Dr.Shidong Jia,Dr.Liang Cheng,and Dr.Joshua Linscott,will highlight the latest advancements in liquid biopsy technologies and their clinical applications,including diagnosis,prognosis,treatment monitoring,and drug development for GU malignancies.
文摘Guiting Lin MD,PhD,School of Medicine,University of California,San Francisco,USA Dr.Guiting Lin is a Professor of Urology and co-director of Kunppe Molecular Urology Laboratory at University of California,San Francisco(UCSF).Dr.Lin trained in Surgery at the Harbin Medical University in Harbin,China and specialized in Urologic Surgery at Peking University,China's premier medical school located in Beijing.In 2001,Dr.Lin joined the Department of Urology at University of California,San Francisco as a Postdoctoral Research Fellow.He was promoted to Assistant Researcher in 2005,to Assistant Professor in 2007,to Associate Professor in 2010,and to Professor in 2017.In China,Dr.Lin received numerous awards from the Shandong Ministry of Health,and Peking University.His UCSF research has also received recognition,including the 2002 Outstanding Young Researcher award and 2016 ISSM Zorgniotti-Newman Prize given by the International Society for Sexual and Impotence Research.
文摘Eissa et al.'s review warmly invites readers into the often-overlooked realm of isolated asthenozoospermia(iASZ),a condition marked by reduced sperm motility that affects 16%–24%of male infertility cases.With a nod to the authors’dedication,this work masterfully compiles insights into the physiological,genetic,and molecular underpinnings of iASZ,offering a clear guide to its etiology,diagnosis,and management.
文摘Saad et al.'s review~([1]),“Emerging trends in the management of non-obstructive azoospermia,”offers a compelling synthesis of cutting-edge diagnostic and therapeutic strategies for non-obstructive azoospermia(NOA),a challenging condition affecting 10%–15%o infertile men.By highlighting advances in whole exome sequencing(WES),biomarkers like Anti-Müllerian hormone(AMH)and microRNAs(miRNAs),and microdissection testicular sperm extraction(micro-TESE),the authors chart a path toward precision medicine in male infertility.Their exploration of AI and gene-editing technologies like CRISPR/Cas9 underscores the transformative potential of these innovations.
文摘Deadline for submission:Submission are welcome throughout the year UroPrecision is excited to announce the launch of our new column,"UroPrecision Cuts,"dedicated to showcasing ground-breaking surgical innovations in the realm of urology,with a strong focus on precision medicine.This platform provides a vibrant space for surgeons,researchers,and medical professionals to share and engage in discussions about surgical techniques,approaches,and procedures that define the forefront of precision urological surgery.
文摘Submission deadline:31 October 2025 UroPrecision is delighted to announce a special issue on Liquid Biopsy in Genitourinary(GU)Oncology,focusing on prostate,renal,and bladder cancers.This issue,led by Dr.Shidong Jia,Dr.Liang Cheng,and Dr.Joshua Linscott,will highlight the latest advancements in liquid biopsy technologies and their clinical applications,including diagnosis,prognosis,treatment monitoring,and drug development for GU malignancies.
文摘Gang Song MD,PhD,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China Dr.Gang Song is a Professor of Urology in the Department of Urology at the National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China.He serves as the Secretary of several scientific societies,including the Youth Committee of the Chinese Urological Doctor Association and the Youth Committee of the Genitourinary Oncology Committee of the Beijing Anti-Cancer Association.
