Background: Male fertility contributes to the life quality of couples. Although exercise has been reported to mitigate the declining trend in sperm quality, the available reports are conflicting, and the precise influence on male fertility indices warrants further investigation. Hence, this study evaluated the effect of exercise on sperm quality, pregnancy outcomes, sex hormones, and markers of oxidative stress and inflammation in men. Methods: This is a systematic review and meta-analysis that evaluated exercise interventions, including aerobic, resistance, and combined modalities, on conventional and advanced semen parameters, and pregnancy and live birth rates. Results: Exercise considerably improved ejaculate volume, sperm count, motility, morphology, and sperm DNA integrity. Also, exercise enhanced seminal total antioxidant capacity (TAC) and decreased seminal reactive oxygen species, malondialdehyde, and pro-inflammatory cytokines levels. More so, pregnancy and live birth rates increased in the exercise group when compared with the control. Nonetheless, exercise did not show any considerable effect on testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) levels. The observed effects varied by exercise type and duration, with moderate aerobic exercise showing beneficial effects. Moderate aerobic exercise enhances sperm quality and improves pregnancy outcomes by attenuating oxidative stress and inflammation. Conclusions: These findings show that moderate aerobic exercise is a promising non-pharmacological strategy in male infertility management. However, more clinical trials are required to optimize exercise protocols for reproductive benefits. The PROSPERO Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024622166, CRD42024622166.
Background: Men experience disproportionately higher rates of cardiovascular disease, occupational injuries, mental health stigma, and reduced healthcare utilization compared to women, yet workplace health initiatives often overlook gender-specific needs. Human Resource Management (HRM) practices represent a critical organizational mechanism for addressing men’s health disparities. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, a comprehensive search was conducted across PubMed, Scopus, Web of Science, and Business Source Complete for peer-reviewed studies published between 2010 and 2025. Two independent reviewers screened articles and assessed quality using standardized tools. Studies were included if they focused exclusively on male employee populations or provided gender-disaggregated results. Results: Fourteen studies met the inclusion criteria and were synthesized narratively. Strategic HRM practices were associated with improvements in men’s cardiovascular health behaviors, psychological well-being, and stress levels, though effect sizes varied across HRM domains. Key functions, including flexible work arrangements, occupational health training, supportive leadership development, and comprehensive benefits packages, were positively associated with male employees’ health outcomes. Conclusions: HRM serves as an important organizational function for improving men’s health. Gender-sensitive Human Resources (HR) policies, integration of men’s health into talent management strategies, and enhanced training for HR professionals to recognize male-specific health barriers are recommended. The PROSPERO Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261301036, CRD420261301036.
First responders (FRs), including Law enforcement officers (LEOs), firefighters, and paramedics, face repeated trauma exposure and organizational stressors that elevate the risk for post-traumatic stress disorder (PTSD) and common mental disorders (CMDs). Given this disproportionate burden, male FRs, constituting the majority of this workforce, encounter additional help-seeking barriers rooted in occupational culture and masculine role expectations. This narrative review synthesizes evidence (2019–2025) on epidemiology, risk factors, diagnostic strategies, prevention frameworks, treatment modalities, and quality-of-life outcomes associated with PTSD and CMDs among male FRs. A comprehensive literature search was conducted across PubMed, PsycINFO, MEDLINE, and Scopus for peer-reviewed articles published between January 2019 and March 2025 addressing mental health outcomes in first responder populations. PTSD prevalence among FRs ranges from 7–37%, with depression (15–25%), anxiety (15–20%), and hazardous alcohol use (25–30%) frequently co-occurring. Risk determinants include cumulative trauma exposure, moral injury, organizational stressors, shift work-induced sleep disruption, and stigma. Validated screening instruments, including the Posttraumatic Stress Disorder Checklist for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (PCL-5), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7), demonstrate acceptable psychometric properties in this population. Cognitive processing therapy (CPT), prolonged exposure, and Eye Movement Desensitization and Reprocessing (EMDR) show large effect sizes (Cohen’s d = 0.8–1.5) for PTSD reduction. Integrated management combining psychotherapy with sleep interventions and workplace accommodations yields superior functional outcomes. Male FRs require integrated workplace-based clinical programs addressing trauma exposure, organizational stressors, and cultural barriers. Future research should prioritize longitudinal designs and implementation science approaches.
Semen analysis is traditionally used to assess male fertility but has limited application beyond reproductive evaluation. Emerging evidence suggests that abnormal semen parameters may serve as indicators of broader health risks extending beyond fertility. Multiple studies have demonstrated associations between impaired semen quality or infertility and increased risks of sexual dysfunction, cancer, and chronic disease. Collectively, these findings highlight the potential for semen analysis to shed light beyond exclusive fertility assessment, and to provide broader insight into measures of a man’s long-term health. This review aims to summarize current evidence of the relationship between semen parameters with long-term health outcomes, and to evaluate the potential role of semen analysis as a screening tool for men’s overall health. Literature was sourced from PubMed and Scopus with an emphasis on articles published between 2020–2025. Keywords used included “Semen analysis”, “Infertility”, “Cancer”, and “Chronic Disease”. Only full-length texts from peer reviewed sources were included. Abnormal semen parameters have been associated with higher rates of erectile dysfunction, premature ejaculation, and reduced libido. Men with infertility or impaired semen quality demonstrate increased risks of testicular and prostate cancers, as well as other malignancies. Beyond oncologic outcomes, infertile men are associated with higher incidences of hyperlipidemia, renal disease, and chronic pulmonary disease, and are more likely to develop diabetes, ischemic heart disease, and substance use disorders. Furthermore, abnormal semen parameters have been associated with increased all-cause mortality. Although abnormal semen parameters may not represent early manifestations of chronic disease, men with infertility or impaired semen quality appear to be more susceptible to various health conditions. Semen analysis performed during fertility evaluation may therefore provide valuable insight into a man’s overall health and potential long-term health risks, facilitating early detection and intervention.
Background: Recent literature has shown that up to one in every four early onset Eating Disorder presentations are male. Males account for 10–25% cases of Eating Disorders. Despite the relatively high prevalence of Eating Disorders in males, the research is limited. Our systematic review focuses on long-term physical health outcomes such as Body Mass Index (BMI)/weight and mortality in males who had undergone psychiatric inpatient admission for Anorexia Nervosa (AN) between the ages of 13 and 17 years. All outcomes were measured at least one year post-discharge. Methods: Articles published in peer reviewed journals between January 2012 and January 2023 in CENTRAL, MEDLINE, Embase and PsycINFO were searched. Following the screening of 1422 abstracts, 63 full text articles were retrieved and assessed for eligibility. Three articles were included in the review, of which, one was a Randomised Control Trial. An updated search completed in May 2025, did not find additional articles for inclusion. Results: In total, 31 males were included across the three studies. Three out of the thirty-one males died at follow-up and all three came from the same study. There was an overall improvement in BMI and BMI percentiles in males across all studies. Conclusions: Due to scarcity in literature focussing on adolescent male AN, it may be difficult to apply our findings within clinical contexts. Our review highlights the importance of addressing this gap in research and issues around providing generic treatments to young people with AN during admission without much consideration to gender differences. The PROSPERO Registration: The systematic review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) on 14 April 2023 (CRD42023407092, https://www.crd.york.ac.uk/PROSPERO/view/CRD42023407092).
Background: Male sexual health and mental health are closely linked, yet a quantitative synthesis of recent evidence is limited. Objectives: This study synthesized observational evidence published between 2020 and 2025 on depressive symptoms among adult men with erectile dysfunction (ED) and on the association between ED and depression; broader male sexual dysfunction evidence was summarized narratively when clinically relevant. Methods: We searched PubMed, EMBASE, Cochrane Library, PsycINFO, and Scopus, and conducted random-effects meta-analyses with prespecified subgroup analyses by measurement instrument. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). Results: Eight observational studies (24,563 participants) were included. Among ED samples, pooled depression prevalence was 22.1% (Patient Health Questionnaire-9 (PHQ-9) ≥10; 95% confidence interval (CI): 7.6%–49.5%) and 65.0% (Self-rating Depression Scale (SDS) ≥53; 95% CI: 60.7%–69.0%). Among men with major depressive disorder (MDD), the pooled sexual dysfunction prevalence (Arizona Sexual Experience Scale (ASEX)-defined) was 54.0% (95% CI: 23.2%–82.0%). In a population-based study, ED was associated with approximately two-fold higher odds of depressive symptoms (adjusted odds ratio (aOR) 2.021; 95% CI: 1.797–2.272). In men with MDD, depressive symptom severity correlated strongly with sexual dysfunction severity (r = 0.640). Conclusion: ED and depression frequently co-occur in adult men. Current observational evidence supports integrated screening and collaborative care across urology and mental health services, but causal inferences remain limited. The PROSPERO Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261280261, CRD420261280261.
This mini-review aims to examine fatigue management strategies that specifically target neuromuscular fatigue in soccer players. A literature search identified five studies involving male semi-professional players (mean age ranging from 21.8 ± 0.9 to 25 ± 3 years), all of which used a randomized crossover design. One study applied a real competitive match, while four used the Loughborough Intermittent Shuttle Test (LIST) to simulate match demands. Neuromuscular outcomes included maximal voluntary contraction (MVC), voluntary activation (VA), quadriceps potentiated twitch force (Qtw,pot), and electromyography (EMG) parameters, including the root mean square (RMS) normalized to the maximal compound muscle action potential (Mmax) (RMS/Mmax). This review identifies five potential strategies for managing neuromuscular fatigue: cold water immersion (CWI), phase change material (PCM) garments, ischemic preconditioning (IPC), chronic beetroot juice supplementation (BEET), and acute acetaminophen ingestion (ACT). Preliminary results suggest that CWI and BEET may influence both central and peripheral components, whereas PCM, IPC, and ACT primarily affect markers associated with the central drive at specific assessment intervals. Implementing these strategies may accelerate neuromuscular recovery, attenuate fatigue onset, help maintain force production, and potentially optimize subsequent performance. This mini-review provides preliminary evidence-informed recommendations for the stakeholders in the soccer industry, from players to conditioning coaches, and highlights precautions regarding their potential misapplication or excessive use.
Background: This systematic review examines the physiological basis of age-related testosterone decline and the acute and chronic effects of different exercise protocols on testosterone levels. This study aimed to evaluate the influence of different training modalities on testosterone responses and explore the potential relevance of these findings to age-related hormonal changes, including andropause. Methods: A systematic literature search was performed in PubMed, Web of Science, Scopus, and Google Scholar from July to October 2025. Studies were considered for inclusion if they investigated the acute and chronic effects of various exercise protocols on testosterone levels and andropause-related outcomes in humans. Twenty studies met the eligibility criteria after the screening process and were included in the qualitative synthesis. Results: This bidirectional effect of exercise on testosterone might play a role in maintaining anabolic–catabolic balance and may be relevant to the physiological processes associated with andropause in older men. Regular, age-appropriate, and capacity-appropriate exercise programs might support testosterone regulation; however, their direct effects on andropause-related symptoms are unclear. While these findings provide important insights into exercise-induced hormonal regulation, most of the included studies were conducted in younger, healthy, or athletic populations. Therefore, the observed responses should primarily be interpreted as mechanistic or physiological evidence rather than direct clinical evidence applicable to men experiencing andropause. Conclusions: In conclusion, exercise-based lifestyle interventions could represent a promising supportive strategy for maintaining testosterone homeostasis and mitigating the features associated with age-related decline in testosterone levels. However, since most of the included studies were conducted in younger, athletic, or otherwise non-clinical populations, the current evidence should be interpreted primarily as mechanistic and supportive rather than as direct clinical evidence for men with established andropause. The PROSPERO Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261345492, CRD420261345492.
Background: Benign prostatic hyperplasia (BPH) gives rise to benign prostatic enlargement owing to unregulated hyperplasia of the epithelial and fibromuscular components within the transition zone and periurethral area. Vitamin D is a pleiotropic steroid hormone with functions that encompass the modulation of calcium and phosphate metabolism and the preservation of skeletal health, but prospective evidence in BPH is unclear. Methods: We analyzed data from 195,074 participants in the UK Biobank (recruited 2006–2010) with valid vitamin D measurements and without prevalent BPH. Serum vitamin D was measured using the chemiluminescent immunoassay approach (units: nmol/L). Incident BPH cases were identified through linkage to hospital, primary care, and death registry records until 2022. We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Vitamin D was modeled as both a continuous variable and in quartiles. Dose-response relationships were examined using restricted cubic splines, with thresholds determined by maximally selected rank statistics. Subgroup and sensitivity analyses assessed robustness. Results: Over a median follow-up of 13.3 years, 21,168 incident BPH cases were documented. Lower serum vitamin D was associated with an increased risk of BPH. Multivariable-adjusted HRs (95% CIs) were calculated for participants grouped by serum 25-hydroxyvitamin D (25(OH)D) quartiles, yielding values of 1.00 (reference), 0.95 (0.91, 0.99), 0.94 (0.90, 0.98), and 0.95 (0.91, 0.98) for the first to fourth quartiles, respectively. Each 1-standard deviation (SD = 20.9) increase corresponded to a 2% lower risk (HR = 0.98, 95% CI: 0.97–0.99). Restricted cubic spline analysis revealed a progressive decrease in risk with evidence of nonlinearity, which may exist due to saturation effect. Conclusions: Based on large-scale prospective cohort data from the UK Biobank, this study validates that serum 25(OH)D levels are inversely associated with BPH risk.
Background: The decline in male sperm production capacity may be related not only to the testes themselves but also may be indirectly influenced by other tissues outside the testes. However, the association between extragonadal tissues and testicular function has not been systematically investigated. Methods: Using the public Genotype-Tissue Expression database (GTEx) bulk RNA-seq dataset, we stratified GTEx subjects into testis functional "good" and "poor" groups based on the expression profiles of spermatogenesis-related genes in testicular tissues. To identify the influence of extragonadal tissues on male fertility, we then compared RNA-seq data of various non-testicular tissues between these two groups. Results: Our findings reveal significant associations between testicular function and the pituitary gland, adrenal gland, lungs, liver, and key brain regions involved in neuroendocrine regulation, including the amygdala, substantia nigra, anterior cingulate cortex, and frontal cortex. Conclusions: These results suggest potential extragonadal pathways that may be associated with male fertility, and provide potential candidate biomarkers for testicular dysfunction diagnosis.
Background: To explore the current status of frailty in elderly patients with benign prostatic hyperplasia (BPH) and analyze the influencing factors. Methods: This study used a cross-sectional design, in which we selected 220 inpatients aged >60 years who were admitted to the Departments of Geriatrics and Urology and diagnosed with BPH. Participants were categorized into a non-frail (normal) group (n = 83) and a frail group (n = 137) according to the Tilburg Frailty Indicator (TFI). General characteristics were collected, and the Mini Nutritional Assessment-Short Form (MNASF), Montreal Cognitive Assessment (MoCA), and a reverse questionnaire survey were administered. Univariate analysis, correlation analysis, and binary logistic regression were conducted to identify factors associated with frailty in elderly BPH patients. Results: Univariate analysis showed that the main factors influencing frailty in elderly BPH patients were age, International Prostate Symptom Score (IPSS), disease duration, alcohol consumption, body mass index (BMI), personal monthly income, number of chronic diseases, MNA-SF score, and MoCA score (all p <0.05). The total TFI score was negatively correlated with both MNA-SF (r = -0.297) and MoCA (r = -0.209), and these correlations were statistically significant (p < 0.05). In the binary logistic chronic diseases, and MNA-SF score emerged as the main factors associated with frailty (p < 0.05). Conclusions: Older adults with BPH often have a long disease course, may consume alcohol, and frequently present with multiple chronic conditions. For them, higher IPSS scores and lower MNA-SF scores are associated with a greater likelihood of frailty, indicating that nutritional status and symptom burden warrant particular attention. Thus, targeted assessment and interventions could be implemented to reduce frailty risk in this population.
Background: Firefighting imposes extreme physical and psychological demands. Elevated body mass index (BMI) and high body fat percentage (FAT%) may impair operational performance and increase cardiometabolic risk. This study provides the first comprehensive, age-stratified analysis of BMI and FAT% among professional firefighters in Montenegro. Methods: A cross-sectional sample of 148 male career firefighters (mean age 35.4 +/- 11.3 years; range 20-60 years) from nine municipalities (Budva, Danilovgrad, Kolasin, Kotor, Mojkovac, Niksic, Pluzine, Podgorica, Zabljak) was assessed between April 2024 and February 2025. Anthropometric measures included body height, weight, and pectoral, abdominal, and front-thigh skinfolds. BMI was calculated (kg/m(2)), and FAT% estimated via the Jackson & Pollock three-site equation. One-way Analysis of Variance (ANOVA) with Bonferroni post-hoc tests and Multivariate Analysis of Variance (MANOVA) examined age-group differences (seven categories: <25, 25-29, 30-34, 35-39, 40-44, 45-49, >= 50 years). Results: Mean BMI and FAT% were 28.05 +/- 4.44 kg/m2 and 21.12 +/- 8.15%, respectively-both in the over-weight/above-average ranges. Both indicators increased significantly with age (BMI: F = 3.071, p = 0.007; FAT%: F = 4.735, p < 0.001), with marked differences between firefighters <30 years and those >= 35 years. While BMI plateaued after age 45, FAT%continued to rise, suggesting age-related lean-mass loss. Conclusions: A majority of Montenegrin firefighters exceed recommended BMI and FAT% thresholds, with a clear age-related deterioration in body composition. We recommend implementing routine, career-long monitoring of body composition, coupled with targeted fitness and nutrition interventions, to enhance operational readiness and long-term health.
Background: Prostate cancer (PCa) is a major cause of cancer-related deaths in men, with challenges in early detection and effective treatment. Plasma proteins have emerged as promising diagnostic biomarkers and therapeutic due to their accessibility and reflection of tumor-related systemic changes. Methods: We performed a Mendelian randomization (MR) analysis to identify causal plasma proteins associated with PCa. Multi-omics data, including bulk RNA sequencing (RNA-seq), single-cell RNA sequencing (scRNA-seq), and spatial transcriptomics, were integrated to explore molecular, cellular, and spatial expression patterns. Functional enrichment analysis (Gene Ontology (GO)/Kyoto Encyclopedia of Genes and Genomes (KEGG)), diagnostic receiver operating characteristic (ROC) analysis, immune infiltration analysis, and molecular docking were conducted to elucidate their biological roles and therapeutic potential. Results: MR analysis identified 66 plasma proteins associated with PCa, highlighting their roles in extracellular matrix remodeling and inflammation. Multiomics integration revealed four key biomarkers (transforming growth factor beta 3 (TGFB3), insulin-like growth factor binding protein 6 (IGFBP6), Golgi membrane protein 1 (GOLM1), and serpin family F member 1 (SERPINF1)) with distinct spatial expression patterns and links to tumor progression and immune modulation. TGFB3, IGFBP6, and SERPINF1 correlated positively with immune infiltration and checkpoints, while GOLM1 showed negative correlations. A combined diagnostic model achieved excellent accuracy (area under the curve (AUC) = 0.911). Functional enrichment connected these factors to pathways like Suppressor of Mothers Against Decapentaplegic (SMAD) signaling and Wingless/Integrated (Wnt) signaling. Small molecule screening and molecular docking identified diethylstilbestrol as a therapeutic candidate targeting TGFB3 and IGFBP6. Conclusions: Our findings provide novel insights into the molecular mechanisms of PCa and highlight promising diagnostic and therapeutic targets. Further experimental validation and clinical studies are needed to confirm these results and assess their translational potential.
Background: Social isolation has become an urgent public health concern in aging societies, yet the unique vulnerabilities of older men remain understudied. This study examined the association between functional dependency, assessed using activities of daily living (ADL) and instrumental activities of daily living (IADL), and social isolation among older men, and whether digital utilization moderates it. Methods: This crosssectional secondary analysis used data from 3779 male participants aged 65 years and older (mean age +/- standard deviation (SD), 74.0 +/- 6.5 years) from the 2023 National Survey of Older Koreans. Social isolation was defined as nonparticipation in social activities. Functional dependency was assessed through ADL and IADL scales and categorized into four functional subdomains based on the International Classification of Functioning (ICF) framework: mobility, self-care, domestic life, and cognitive-social activities. Binary logistic regression and moderation analyses using the PROCESS macro were performed to identify the main and interaction effects between functional dependency and digital utilization. Results: Both ADL dependency (adjusted odds ratio (OR) = 1.86, 95% confidence interval (CI) = 1.40-2.48, p < 0.001) and IADL dependency (adjusted OR = 1.37, 95% CI = 1.10-1.69, p = 0.005) were significantly associated with social isolation. Among functional subdomains, mobility (adjusted OR = 2.02) and self-care (adjusted OR = 1.71) showed the strongest associations. Digital utilization demonstrated a significant moderating effect on the relationship between ADL dependency and social isolation (B = 0.52, p = 0.017), indicating that higher digital competence attenuated the negative impact of functional decline. Conclusions: Functional dependency, particularly in mobility and self-care, is a critical determinant of social isolation among older men. Digital utilization serves as a protective resource, buffering the risk of social isolation associated with physical decline. These findings underscore the need for integrated interventions that enhance physical independence and digital engagement.
Suicide is a major public health crisis in South Africa, with men accounting for nearly 80% of the cases, significantly impacting male life expectancy. Socioeconomic hardships, mental health stigma, and inadequate support services contribute to this crisis. This study aimed to review and examine the factors driving high suicide rates among South African men and their effects on life expectancy. A narrative review methodology was adopted in this study. A systematic search of Google Scholar, PubMed, PsycINFO, Scopus, and ScienceDirect was conducted, covering studies from 2015 to 2024. Inclusion criteria focused on research addressing suicide rates, risk factors, mental health challenges, and life expectancy trends among South African men. Findings indicate that traditional masculinity norms discourage emotional expression and seeking help. Financial distress, unemployment, and substance abuse further increase psychological distress. Systemic barriers, including inadequate mental health policies and stigma, prevent early intervention and access to care. Addressing male suicide requires urgent multi-sectoral interventions, including mental health awareness campaigns, improved access to gender-sensitive services, and policies challenging harmful masculine norms. Strengthening economic support systems and community-based mental health initiatives can also reduce suicide rates and improve life expectancy among South African men.
Background: This study aimed to investigate the association between preoperative psoas muscle index (PMI), surgical and oncological outcomes, and the requirement for adjuvant radiotherapy (ART) in patients with prostate cancer (PCa) undergoing radical prostatectomy (RP). Methods: Fifty-eight patients who underwent RP for localized PCa between January 2021 and August 2024 were retrospectively evaluated. Demographic, clinical, and pathological characteristics, as well as preoperative PMI values, were recorded. The relationships between PMI, ART requirement, and pathological findings were analyzed. Additionally, the predictive performance of PMI for ART was assessed using Receiver Operating Characteristic (ROC) curve analysis. Results: The mean age of patients was 65.34 +/- 6.63 years, and the mean PMI was 6.12 +/- 1.44 cm(2)/m(2). ART was required in 31% of patients. The ART group had significantly lower PMI values (5.32 +/- 1.57 vs. 6.48 +/- 1.24 cm(2)/m(2); p = 0.01). Total Prostate Spesific Antigen (PSA) and PSA density were also significantly higher in the ART group (p = 0.002 and p = 0.001, respectively). Patients with pathological stage >= T3 and those with extraprostatic extension had significantly lower PMI values (p = 0.01 and p = 0.04, respectively). ROC analysis identified a cut-off value of 5.91 cm(2)/m(2) for PMI, with 68% sensitivity and 72%specificity (Area Under the Curve (AUC): 0.712; 95% Confidence Interval (CI): 0.560-0.865; p = 0.01). In multivariate analysis, lower PMI (Odds Ratio (OR) = 0.48, p = 0.027) and pathological T stage >= T3 (OR = 12.85, p = 0.014) independently predicted the need for ART. Conclusions: In patients undergoing RP, lower PMI was associated with adverse pathological features and ART requirement. Preoperative PMI assessment, when combined with PSA and PSA density, may provide additional value in predicting aggressive tumor behavior. Validation through larger, multicenter, prospective studies is warranted.
Background: This study investigated the mediating effects of anxiety and sleep duration on the relationship between health literacy and health-related quality of life (HRQoL) among middle-aged men. Methods: This descriptive study involved the secondary analysis of data obtained from the 2023 Korea National Health and Nutrition Examination Survey, an annual government-led survey examining health levels and behaviors. The participants in this study were 1171 middle-aged men aged 40-64 years. The main analysis involved the application of Hayes's PROCESS Macro for SPSS v.4.0, and Model 6 was used to determine the mediating effects of anxiety and sleep duration on the relationship between health literacy and HRQoL. Results: In Stage 1, health literacy had a significant effect on anxiety (B = -0.017, p = 0.040), and in Stage 2, health literacy (B = -0.062, p < 0.001) and anxiety (B = -0.050, p = 0.009) had a significant effect on sleep duration. In Stage 3, health literacy (B = 0.001, p < 0.001), anxiety (B = -0.009, p < 0.001), and sleep duration (B = 0.001, p < 0.001) significantly affected HRQoL. In Stage 4, health literacy had a significant effect on HRQoL (B = 0.001, p < 0.001). The total effect of health literacy on HRQoL increased from 0.001 to 0.002 (p < 0.001) when anxiety and sleep duration were included. Conclusions: This study has important implications for the HRQoL of middle-aged men. Significantly, to improve HRQoL among this cohort, it is necessary to increase health literacy and develop interventions to reduce anxiety and maintain adequate sleep time.
Background: Erectile dysfunction is a highly prevalent consequence of pelvic cancer treatment in males. For erectile dysfunction that is refractory to pharmacological intervention, surgical implantation of a penile prosthesis offers a more definitive treatment option. In this paper, we aim to assess patient decision satisfaction and regret levels amongst pelvic cancer patients who subsequently underwent penile prosthesis implantation, as there is a lack of data available amongst this patient cohort. Methods: A cross-sectional telephone survey was administered to men who underwent implantation of a penile prosthesis at a single tertiary andrology centre between December 2023 and May 2025. The survey purported to assess specific aspects of the post-prosthesis implantation experience, including cosmesis and ejaculatory function, as well as overall decision satisfaction and regret. Demographics were collected from medical records, and responses were analysed using simple data analysis and Fisher’s Exact Tests. Results: Eighteen men were identified who had developed erectile dysfunction secondary to pelvic cancer treatment and had subsequently undergone implantation of a penile prosthesis (mean age 62, mean Body Mass Index 28.9). Overall, 72% of patients were either “Happy” or “Very Happy” with their procedure, with only one patient stating that they would “Probably Not” undergo the procedure again. A significant association was identified between increased patient age and reduced decision satisfaction levels (p = 0.0294). Conclusions: Implantable penile prosthesis is generally a well-tolerated procedure amongst the male pelvic cancer patient cohort, with high overall decision satisfaction rates. This permits more informative pre-operative counselling allowing prospective patients to make more informed treatment decisions, and may provide greater confidence for patients worried about how treatment could affect their sexual function.
Background: This study aimed to determine how elevated male body mass index (BMI) influences semen characteristics, embryo quality during in vitro fertilizationembryo transfer (IVF-ET), and subsequent reproductive outcomes in infertile couples. Methods: We retrospectively collected and analyzed clinical records from all couples who underwent IVF-ET at our center between January 2022 and September 2025. The study included couples infertile for one year with normal karyotypes and excluded those using donor sperm, with major lifestyle/medical issues, or specific male reproductive disorders. Based on BMI classification standards for Chinese adults, participants were divided into a group of normally weight, overweight, and obese men. A total of 243 IVF-ET cycles (81 randomly selected per BMI group) were analyzed for semen parameters, embryo quality, and clinical outcomes; group differences were assessed using the Kruskal-Wallis (H statistic) for continuous data vs. chi 2 tests for categorical outcomes. Results: It was only observed that significant differences were identified in male sperm progressive motility (H = 7.203, p = 0.027), total sperm motility (H = 8.173, p = 0.017) among the three BMI groups (p < 0.05). It was observed that significant differences were identified in miscarriage rate (chi 2 = 11.383, p = 0.003), live birth rate (chi 2 = 6.045, p = 0.049) among the three BMI groups (p < 0.05). Conclusions: These findings indicate that increased male BMI has a detrimental effect on sperm progressive motility and may adversely influence the clinical outcomes of assisted reproductive treatment.
