Renal ischemia-reperfusion (I/R) remains a leading cause of acute renal failure in both native and transplanted kidneys. Hypoxia-inducible factor (HIF)-1α is a protective factor against renal I/R injury (rIRI). However, the downstream mechanisms through which HIF-1α exerts its protective effects in rIRI remain to be fully elucidated. rIRI was induced in heterozygous HIF-1α knockout (hKO) mice. To establish an in vitro model of rIRI, a human tubular cell line (HK2) was subjected to hypoxia-reoxygenation (H/R). rIRI-induced hKO mice exhibited elevated serum creatinine levels compared with rIRI-induced wild-type (WT) mice. Furthermore, tubular cell death was observed earlier in WT mice during the initial phase of I/R, whereas it was reduced in hKO mice. Phagocytosis of damaged tubular cells by macrophages was diminished in hKO mice, suggesting that the clearance of cellular debris plays a critical role in renal tissue repair and regeneration. Furthermore, glutathione-specific γ-glutamyl cyclotransferase 1 (CHAC1), a known cell death inducer, was upregulated in the tubular cells of WT mice but not hKO mice following I/R. The overexpression of CHAC1 in HK2 cells induced cell death, whereas siRNA-mediated CHAC1 knockdown attenuated cell death in HK2 cells subjected to H/R. These findings collectively suggest that CHAC1 plays a pivotal role in regulating tubular cell death during rIRI. Our findings indicate that controlled cell death induction is essential for rIRI recovery. CHAC1, a key factor in this process, is a potential therapeutic target for rIRI.NEW & NOTEWORTHY Here, we reported that HIF-1α upregulates glutathione-specific γ-glutamyl cyclotransferase 1 (CHAC1), a regulator of cell death and oxidative stress, in rIRI. Our results suggested that CHAC1 plays a pivotal role in regulating tubular cell death during rIRI, and the controlled tubular cell death induced by CHAC1 is essential for rIRI recovery. This proposes novel mechanisms underlying rIRI recovery.

Can abstinence from nicotine contribute to the recovery of the nicotine-induced damage in the male reproductive organs (MROs)? What are the effects on the offspring? Abstinence, by decreasing the nicotine-induced oxidative-stress(OS) in MROs, may contribute to production of sperm with better quality that can further affect the offspring development epigenetically. According to the WHO 1.3 billion people are tobacco-users worldwide (36.7% of men and 7.8% of women). Nicotine exposure can impair the steroidogenesis and spermatogenesis, resulting in decreased sperm concentration and motility. By increasing the OS nicotine may induce damage to the chromatin structure of sperm and impair the fertilizing capacity. In the present study, nicotine was selected as the primary addictive component in cigarettes and electronic cigarettes to investigate its effects in the MROs and to further identify the epigenetic impact of paternal exposure to nicotine on the offspring’s development. Additionally, the role of abstinence was investigated. Sixty male Wistar rats were separated equally into three groups: a) the Nico-group (n = 20) that was treated with nicotine (100 μg/ml) orally for 10 weeks, b) the Abstinence-group (n = 20) that was treated with nicotine (100 μg/ml) orally for 7 weeks followed by 3 weeks of abstinence from nicotine and c) the Control group (n = 20) that had free access to fresh water daily for the same period of time (10 weeks). Five days before the completion of the 10-week treatment, each male rat was placed in the same cage with two female rats and mating studies were performed. Subsequently all male rats were sacrificed and OS parameters were measured in MROs and histological evaluation was performed. Offspring-development was recorded up to the 28th day. Nicotine treatment significantly increased OS-markers levels and their expression in the testis, epididymis and seminal vesicles (SV) in Nico−group compared to Abstinence and Control groups. Total antioxidant capacity was significantly decreased both in the epididymal and testicular tissues of the Nico group compare to Abstinence or Control groups. Cotinine, the predominant metabolite of nicotine, was present at high levels in urine, serum and seminal vesicular fluid(SVF) of Nico−group compared to Abstinence-group (P<0.05). Testosterone levels were significantly lower in Nico-group compared to Control−group, while abstinence partially corrected this abnormality. Cytochrome P450(CYP2A6), the primary enzyme responsible for the oxidation of nicotine and cotinine was strongly expressed and localized in the epithelial cells of the epididymis in Nico−group. 8-hydroxy-2-deoxyguanosine (8-OHdG), one of the major products of DNA-oxidation was strongly expressed in the epididymal and seminal vesicular tissues of the Nico-group compared to the Abstinence and the Control group. The number of offspring in Nico-group was slightly decreased compared to the other two groups. The development of offspring and their body weights were recorded on 2nd, 3rd, 5th, 14th and 28th postnatal days. The body weight of offspring of the Nico-group was significantly lower compared to Abstinence or Control groups at all time-points measured. Extending the abstinence period up to one spermatogenic cycle could probably give better results in terms of tissue morphology, but even 3-week abstinence was beneficial. Nicotine exposure increases OS in MROs and creates a toxic environment in which spermatozoa are produced in the testis, become mature in the epididymis and are transported in the SVF until they reach the female reproductive system. Accumulated OS damages the sperm-DNA, which affects epigenetically the development of the offspring. No

Abstract Study question Can a second successive-ejaculate (SSE) be an option for patients with poor sperm parameters (PSPs) on ovum pick-up (OPU)-day who prefer to undergo conventional-IVF (c-IVF)? Summary answer SSE can be a valid option for patients with PSPs who do not wish to undergo ICSI as an assisted reproductive technology (ART) treatment. What is known already ART is applied when first-line treatment for infertility (timed intercourse or intrauterine insemination) is unsuccessful. The male partner is requested to follow ejaculatory abstinence, which according to the WHO guidelines is 2-7 days, while ESHRE recommends 3-4 days. Among these couples there are cases that require ICSI due to semen analysis with PSPs on the day of OPU. However, some couples are reluctant to undergo ICSI and prefer c-IVF as a treatment method. For those cases, we request a second semen sample on the same day (time interval: 1-4 h) and c-IVF is performed using the two ejaculates combined. Study design, size, duration This is a single-centre retrospective study employing 212 semen from male partners with PSPs in the first semen collection on the OPU-day and subsequently, an SSE was requested in order to perform c-IVF according to patients’ wishes. The data were collected from May 2006 to October 2023 in our clinic (SSE-group). The Control group included 271 semen samples from men where c-IVF was conducted using one ejaculate from January to December 2021 in our clinic. Participants/materials, setting, methods The sperm parameters were analysed according to the WHO manual for the examination and processing of human semen and compared between the first and second ejaculates in the SSE-group. Fertilisation rate (FR), percentage of clinically utilised embryos and clinical pregnancy rate were compared between the SSE-group and the Control group. The SSE-group had 254 ART-cycles and the mean maternal age was 36.8±4.9y.o. The Control group included 432 ART-cycles and the mean maternal age was 38.1±5.2y.o. Main results and the role of chance In SSE-group the semen volume of the first ejaculate was significantly higher compared to the second ejaculate (P< 0.0001). The sperm concentration and sperm motility were significantly higher in the second ejaculate compared to the first one (P<0.0001). In the same fashion, the total-motile sperm-count was significantly higher in the second ejaculate compared to the first (P=0.01). All the semen parameters in the Control group were significantly higher compared to both first and second ejaculates from the SSE-group (P<0.00001). The normal FR was significantly higher in the Control group compared to the SSE–group (P<0.01). On the other hand, there was no significant difference in the percentage of embryos that could be utilized (cryopreserved + freshly-transferred) between the two groups (P=0.218). Pregnancy rate for fresh embryo transfers (ETs) was significantly higher in the SSE-group compared to the Control (P=0.005), while there was no significant difference between the two groups for pregnancy rate for frozen/thawed ETs (P=0.728). The main strength of our study is that the utilisation of the SSE combined with the first ejaculate did not decrease the pregnancy rate for the couples with PSPs that wished to follow c-IVF as their treatment and it could actually provide an effective option for them. Limitations, reasons for caution SSE may improve the sperm parameters and give the opportunity to infertile couples to undergo c-IVF according to their wish. However, since the FR was lower in the SSE-group, it is of paramount importance to provide sufficient explanation to those couples and obtain their consent when requesting an SSE. Wider implications of the findings Overall, SSE had positive effect to a large number of parameters evaluated in this study. Additionally, the rate of utilised embryos was similar between the two groups. Two successive-ejaculates combined can be employed without any negative impact for couples with PSPs on the OPU-day that are reluctant to undergo ICSI. Trial registration number not applicable

Abstract Study question Can the artificial removal of the zona pellucida (ZP) at the pronuclear (PN)-stage prevent severe fragmentation in early-cleavage embryos and improve good-quality blastocyst development rate? Summary answer The artificial removal of the ZP at the 2PN-stage could prevent significantly severe fragmentation in early-cleavage embryos and improved the good-quality blastocyst development rate. What is known already Recent analysis using time-lapse culture demonstrated that fragments during early-cleavage occur at the site of the perivitelline threads between the ZP and the embryo membrane (Reprod Biomed Online 2017;35:640-5,646-56). Based on these findings we conducted a pilot study on embryonic development after ZP-removal using abnormally-fertilized oocytes (J Assist Reprod Gene2020;37:1349-54). We showed that the inter-blastomere adhesion was maintained and fragmentation was significantly lower in the ZP-free embryos than in the ZP-intact embryos. Therefore, we attempted to apply this method to patients who have given full consent and had repeatedly failed to conceive due to severe fragmentation in early cleavage-stage embryos. Study design, size, duration This is a single-centre retrospective exploratory study of 34 patients that were scheduled to undergo ART-treatment in our clinic between February 2020 and January 2021. They had been previously treated in our facilities (January 2016 to January 2020) with less than 10% morphologically good-quality blastocysts due to severe fragmentation. None of these patients became pregnant during their initial treatments. Totally, 173 2PN-zygotes were obtained, with 101 allocated to ZP-free group and 72 to ZP-intact group. Participants/materials, setting, methods Normally-fertilized oocytes were placed in 0.125M sucrose-containing HEPES-medium (approximately 5min) and cultured under: 1) ZP-free, in which the ZP was completely removed from the ooplasm by laser-irradiation and a medium-blowing method with a biopsy-pipette, or 2) ZP-intact. ZP-free and ZP-intact zygotes were cultured in sequential medium. Embryos were either freshly transferred on Day-2(ZP-intact group only, according to patients’ wishes), or Day-5/6, or they were cryopreserved on Day-5/6/7 for future embryo transfer cycles for both groups. Main results and the role of chance Even allocation of the normally fertilised oocytes to the two groups was not possible, due to the patients’ request to include more zygotes in the ZP-free group. Therefore, no specific criteria were set other than the rule that all the normally fertilised oocytes of each patient must be allocated into both groups at the time of allocation. As a result, each patient had 2PN zygotes assigned to both ZP-free and ZP-intact groups. Rates of good-quality embryos, blastocyst development, morphologically good-quality blastocyst development and cryopreservation demonstrated significant improvement (all P < 0.01) in the ZP-free group compared to the ZP-intact group. Pregnancy rates in ZP-intact group were 5.9% per patient and 5.3% per embryo transferred, while in ZP-free group 37.5% per patient and 24.3% per embryo transferred. Our results demonstrate that in difficult-to-treat cases where embryos with good morphology cannot be obtained due to excessive fragmentation at the early-cleavage, embryonic development can be significantly improved by artificial removal of ZP at the 2PN-stage. We believe that the ZP-free method has opened a new door in assisted reproductive medicine and can provide the opportunity to obtain blastocysts with good-morphology from an embryo that would probably not have become a blastocyst otherwise. Limitations, reasons for caution A comparative analysis between the two groups was not possible due to the small number of patients, the inclusion of fresh embryos as well as frozen embryos, and the non-randomized data. The imbalance was attributed to the fact that patients wanted us to allocate more oocytes to the ZP-free group. Wider implications of the findings The development of treatment methods based on new ideas should always take into consideration the possibility of associated risks. In the future, we will examine the criteria for selecting patients for whom this method is useful, as well as verify its safety and effectiveness by conducting a prospective randomized analysis. Trial registration number not applicable

The average age of fathers at first pregnancy has risen significantly over the last decade owing to various variables, including a longer life expectancy, more access to contraception, later marriage, and other factors. As has been proven in several studies, women over 35 years of age have an increased risk of infertility, pregnancy problems, spontaneous abortion, congenital malformations, and postnatal issues. There are varying opinions on whether a father’s age affects the quality of his sperm or his ability to father a child. First, there is no single accepted definition of old age in a father. Second, much research has reported contradictory findings in the literature, particularly concerning the most frequently examined criteria. Increasing evidence suggests that the father’s age contributes to his offspring’s higher vulnerability to inheritable diseases. Our comprehensive literature evaluation shows a direct correlation between paternal age and decreased sperm quality and testicular function. Genetic abnormalities, such as DNA mutations and chromosomal aneuploidies, and epigenetic modifications, such as the silencing of essential genes, have all been linked to the father’s advancing years. Paternal age has been shown to affect reproductive and fertility outcomes, such as the success rate of in vitro fertilisation (IVF), intracytoplasmic sperm injection (ICSI), and premature birth rate. Several diseases, including autism, schizophrenia, bipolar disorders, and paediatric leukaemia, have been linked to the father’s advanced years. Therefore, informing infertile couples of the alarming correlations between older fathers and a rise in their offspring’s diseases is crucial, so that they can be effectively guided through their reproductive years.

Strong evidence indicates that pelvic floor muscle training (PFMT) increases pelvic floor muscles' strength (PFMS) and improves stress urinary incontinence and female sexual function. The study aims to examine the association between pelvic floor muscle strength and female sexual function in healthy nulliparous women. Forty-five sexually active women aged 22-35 years participated in the study. All women completed the FSFI questionnaire, validated in the Greek language. Two examiners evaluated pelvic floor muscle strength using both, the Modified Oxford Grading Scale and the Peritron manometer. Women formed two groups using the median values of Peritron manometer measurements of the total population. Group A included 21 females with weak pelvic floor contraction (≤ 41,1 cm H20), and Group B included 24 females with a strong pelvic floor (>41,2 cm H20). The results were analyzed with Mann-Whitney U tests for FSFI results and Spearman's correlation for the Modified Oxford Grading Scale and Peritron manometer values. There was no significant difference between the two groups concerning the participants’ demographic characteristics. Women with a strong pelvic floor (Group B) exhibited higher statistically significant results (p<0.001) in desire (Group A:3.11±0.14 vs Group B:3.91±0.21), arousal (4.08±0.53 vs 4.99±0.41), orgasm (4.22±0.36 vs 5.37±0.69), satisfaction (4.22±0.36 vs 5.37±0.69), lubrication (4.12±0.43 vs 5.01±0.49) and total FSFI score (27.12±1.09 vs 31.71±1.26). There was no statistically significant difference in the pain domain. There was also a strong correlation between PFMS evaluated with Modified Oxford Grading Scale and PFMS assessed Peritron manometer values (r=0.69). The strength of the pelvic floor muscles is an essential factor concerning better female sexual function No Conflicts of Interest

The knowledge on male reproduction is constantly expanding, especially in treating infertility due to non-obstructive azoospermia (NOA). Varicocele is occasionally diagnosed in a subpopulation of males with NOA. Varicocele repair in NOA-men may contribute to the reappearance of spermatozoa in semen. However, spontaneous pregnancies are observed in only a small percentage of NOA-men post-varicocelectomy. Additionally, it has been reported that the repair of varicocele in NOA-men (before the performance of sperm retrieval techniques) may increase the testicular sperm recovery rate. In addition, it increases the pregnancy rate in intracytoplasmic sperm injection (ICSI) programs in NOA-men without spermatozoa in the semen post-varicocelectomy. In addition, to the improvement in Sertoli cellular secretory function, varicocelectomy may increase the secretory function of Leydig cells, which subsequently results in improved androgen production, raising the probability to negate the need for testosterone replacement therapy in cases of late-onset hypogonadism. On the other hand, the benefit of varicocelectomy in patients with NOA is still debatable. The current review study aims to provide a critical and extensive review of varicocele repair in males with NOA. This study additionally focuses on the impact of varicocele repair on sperm retrieval rates and its influence on the ICSI outcomes for those couples who remain negative for spermatozoa in their semen samples post-varicocelectomy.

Purpose:Clean intermittent self-catheterization (CISC) is a safe and effective alternative to managing incomplete bladder emptying in patients afflicted with neurogenic bladder conditions. The Intermittent Catheterisation Difficulty Questionnaire (ICDQ) is a validated questionnaire concerning the assessment of catheter use and patient difficulties during CISC. The present study aimed to translate and validate the ICDQ into the Greek language. A subsequent outcome was to substantiate the requirement of both urologist consultation with patients undergoing CISC and the detailed evaluation of various therapeutic options with the consultation of other specialist physicians.Material and Methods:The study was undertaken between March 2022 and July 2022 and involved patients in an outpatient department of a Rehabilitation Centre. Sixty-two neurologic patients suffering from spinal cord injury (SCI), multiple sclerosis (MS), cauda equina (CE), and myelitis represented a convenience sample. To calculate test-retest reliability, patients filled out two consecutive questionnaires; an initial one and a second after one week. The socio and demographic circumstances of all participants were evaluated.Results:The mean ICDQ total score at the test and retest was 5.96±1.28 (mean total score ± standard deviation) and 5.91±1.29, respectively. Evaluation of the data concerning alterations between men and women did not reveal statistically significant differences. Cronbach's alpha coefficient was 0.94, which proves the inter-correlation between the different topics. An ICC of 0.97 indicated very high intra-rater reliability.Conclusion:ICDQ, a valid and reliable self-administered screening tool for CISC difficulties faced by patients using this procedure regularly, was successfully translated and validated into Greek. A more detailed evaluation and understanding of these difficulties would enhance the quality of CISC and allow for more suitable treatment and the selection of catheter types used. These improved treatment strategies are possible as repeated use and constant comparison of ICDQ scores determine treatment impact, facilitating treatment regimen modification, should it be required.

You have accessJournal of UrologyCME1 May 2022MP06-15 THE LONG ARM OF CHROMOSOME 9 CONTAINS A GENE THAT REGULATES PPARγ IN BLADDER CANCER Ryutaro Shimizu, Masashi Honda, Shogo Teraoka, Tetsuya Yumioka, Bunya Kawamoto, Noriya Yamaguchi, Hideto Iwamoto, Panagiota Tsounapi, Shuichi Morizane, Katsuya Hikita, Takahito Ohira, Hiroyuki Kugoh, and Atsushi Takenaka Ryutaro ShimizuRyutaro Shimizu More articles by this author , Masashi HondaMasashi Honda More articles by this author , Shogo TeraokaShogo Teraoka More articles by this author , Tetsuya YumiokaTetsuya Yumioka More articles by this author , Bunya KawamotoBunya Kawamoto More articles by this author , Noriya YamaguchiNoriya Yamaguchi More articles by this author , Hideto IwamotoHideto Iwamoto More articles by this author , Panagiota TsounapiPanagiota Tsounapi More articles by this author , Shuichi MorizaneShuichi Morizane More articles by this author , Katsuya HikitaKatsuya Hikita More articles by this author , Takahito OhiraTakahito Ohira More articles by this author , Hiroyuki KugohHiroyuki Kugoh More articles by this author , and Atsushi TakenakaAtsushi Takenaka More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002523.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Bladder cancers are roughly two molecular subtypes: luminal and basal, forming papillary and nodular tumors, respectively. In the early development of both types, high frequency of loss of heterozygosity (LOH) on the long arm of human chromosome 9 (9q) is observed, suggesting the presence of an important gene (group) on 9q involved in bladder cancer development. Here, we investigated the effects of chromosome 9q transfer on the cancer phenotype and molecular subtypes to elucidate the carcinogenic process in bladder cancer (Fig.1). METHODS: The basal-type bladder cancer cell line SCaBER was introduced with 9q (SCaBER#9q) via microcell-mediated chromosome transfer (MMCT) (Fig.2), using chromosome 4 (SCaBER#4) as a control. Proliferative and migrative capability changes were analyzed in each microcell hybrid clone by cell proliferation assay and wound healing assay. The expression levels of genetic markers of the luminal type (FOXA1, GATA3, and PPARγ) were examined by qRT-PCR and Western blotting. RESULTS: SCaBER#9q cells presented with significant morphological changes characterized by an enlarged and somewhat flat shape compared to parental SCaBER cells and SCaBER#4 cells. Cell proliferation assay showed a significant decrease in proliferative capacity of SCaBER#9q compared to the parental strain and control (p<0.001) (Fig.3 left). Wound-healing assay also showed a significant decrease in migration ability of SCaBER#9q (p<0.001). SCaBER#9q cells showed increased expression of FOXA1, GATA3, and PPARγ, but Western blotting analysis showed that only PPARγ expression was significantly upregulated (3.0-4.4-fold). CONCLUSIONS: Transfer of 9q into SCaBER cells increased the expression of PPARγ and decreased cell proliferation and migration, suggesting the presence of a group of genes regulating PPARγ in the 9q region. Source of Funding: nothing © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e82 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ryutaro Shimizu More articles by this author Masashi Honda More articles by this author Shogo Teraoka More articles by this author Tetsuya Yumioka More articles by this author Bunya Kawamoto More articles by this author Noriya Yamaguchi More articles by this author Hideto Iwamoto More articles by this author Panagiota Tsounapi More articles by this author Shuichi Morizane More articles by this author Katsuya Hikita More articles by this author Takahito Ohira More articles by this author Hiroyuki Kugoh More articles by this author Atsushi Takenaka More articles by this author Expand All Advertisement PDF DownloadLoading ...

We investigated the effect of the extent of pelvic lymph node dissection (LND) on biochemical recurrence (BCR) in patients with prostate cancer (PCa) without lymph node involvement (LNI) treated with robot-assisted radical prostatectomy (RARP). We retrospectively analyzed data from 378 patients who underwent RARP with LND at our hospital between October 2010 and June 2019. The BCR-free survival rate was determined using Kaplan–Meier analysis, and Cox regression analysis was used to investigate BCR prognostic factors. The total score calculated from the D’Amico risk classification and the percentage of positive biopsy cores were used for analysis. Patients were classified into 3 BCR risk groups (low risk: 0–3 points, intermediate risk: 4–5 points, and high risk: 6–8 points). Limited LND was performed in 161 patients (42.6%), extended LND in 217 patients (57.4%), and BCR was confirmed in 66 patients (17.5%) after RARP. Both univariate and multivariate analyses showed no significant difference in the association between the extent of LND and BCR. The Kaplan–Meier curve for BCR generated using our risk classification for patients with PCa without LNI showed no significant association between the extent of LND and BCR in the low-risk group (p = 0.790). A significantly improved BCR-free survival was observed in the extended LND group among patients with PCa at intermediate risk or higher (p < 0.05). According to our risk classification, BCR may be less likely to occur when extended LND is performed during RARP for patients with localized PCa at intermediate risk or higher.

Aims: This study investigated the effects of adipose-derived stem cell sheets on a rat model of detrusor underactivity. Main methods: Adipose-derived stem cell sheets were prepared from the subcutaneous adipose tissue of male Lewis rats. Female Lewis rats were assigned into four groups: control, sham operation, cryo-injury, and cryoinjury+sheet (n = 8 per group). Rats in the cryo-injury+sheet group were implanted with ASC sheets 3 days after cryo-injury induction and underwent cystometry 7 days later. Subsequently, reverse transcription-polymerase chain reaction (RT-PCR) and histopathological examinations were performed. Cell sheets expressing the green fluorescent protein were prepared and transplanted to confirm the viability and differentiation of the sheets. Fluorescence was confirmed using a fluorescence stereomicroscope on days 3, 7, 14, 21, and 28 after sheet implantation, and tissue immunostaining was performed. Key findings: Cystometry showed that sheet implantation improved the maximum intravesical pressure (P = 0.009) and the residual urine volume (P = 0.011). Furthermore, RT-PCR indicated that the mRNA levels of the angiogenic factors vascular endothelial growth factor and hepatocyte growth factor were significantly higher in the cryo-injury+sheet group than in the cryo-injury group (P = 0.045, P = 0.037, respectively). Histologically, sheet implantation resulted in an improvement in inflammation and increased the number of blood vessels. Green fluorescent protein-positive cells fused with von Willebrand factor-positive cells and differentiated into blood vessels 7 days after sheet implantation. Significance: Adipose-derived stem cell sheets transplanted into the bladder of cryo-injured rats differentiated into blood vessels and restored bladder contractile function 7 days after transplantation.

Purpose: Coronavirus disease (COVID-19) is a multi-organ viral infection with many manifestations. However, its impact on the genitourinary system is nowadays under investigation. This study aimed to evaluate the consequences on bladder function in patients suffering from post-acute COVID-19 syndrome (PACS) transferred to inpatient rehabilitation for long-term care after initial treatment for COVID-19 pathophysiology.Materials and Methods: All the patients were initially asked the question (after having recovered from the acute stage of COVID-19 disease): "Have you noticed a sudden, uncontrolled need to urinate and sometimes a urine leakage accompanying the voiding desire?" Sixty-six out of 147 patients responded positively to this question and were assessed with the AUA Urology Care Foundation Overactive Bladder Assessment Tool (AUA-OAB-tool). All included men were evaluated with the IPSS score.Results: The median age of patients was 59.5 (range 44-72). We identified 44 patients with newly diagnosed OAB (Group A; post-COVID assessment) and 22 with worsening OAB symptoms (Group B). The mean symptom score +/- standard deviation in Group A patients was 18.25 +/- 2.11 (using the above AUA OAB tool). In the patients of Group B, there was an increase in the above score from 10.43 +/- 1.52 (pre-COVID condition) to 17.87 +/- 1.89 (post-COVID assessment). In patients of Group A, the total quality of life (QOL) score was 17.74 +/- 2.34. Patients in Group B presented an escalation in total QOL score from 9.04 +/- 1.41 (pre-COVID) to 18.84 +/- 1.96 (post-COVID condition). There was no statistically significant difference in symptoms and QOL scores between men and women in groups A and B. There were 11 men in Group A and 5 in Group B with an IPSS score >20.Conclusion: OAB symptoms may be essential to PACS syndrome and influence quality of life, delaying full recovery.

The objective of this review study is to evaluate the therapeutic role of PDE5 inhibitors (PDE5is) in the amelioration of oligoasthenospermia in infertile males. PDE5is have a beneficial influence on the secretory function of the Leydig and Sertoli cells, the biochemical environment within the seminiferous tubule, the contractility of the testicular tunica albuginea, and the prostatic secretory function. In several studies, the overall effect of sildenafil and vardenafil increased quantitative and qualitative sperm motility. Furthermore, some studies indicate that PDE5is influence positively the sperm capacity to undergo capacitation under biochemical conditions that are known to induce the sperm capacitation process. Additional research efforts are necessary in order to recommend unequivocally the usage of sildenafil, vardenafil, or avanafil for the alleviation of male infertility.

Background:The efficacy of docetaxel and carboplatin with oral estramustine was evaluated in patients with castration-resistant prostate cancer.Patients and Methods:Patients were treated with intravenous docetaxel at 30 mg/m2 on days 1, 8, 15, and 22 of a 28-day cycle. Intravenous carboplatin (area under the curve, 6 mg/ml/min) was administered on day 1. Patients received oral estramustine at 626.8 mg/day throughout the treatment protocol. Patients were evaluated for response, with treatment continued until cancer progression or onset of severe adverse events.Results:Twenty patients with castration-resistant prostate cancer were treated for a median of 3.5 cycles. Prostate-specific antigen decreased by more than 30% in 18 patients, including 14 patients with a decrease of more than 50%. Median overall survival was 11 months, prostate-specific antigen progression-free survival was 6.5 months, and radiographic progression-free survival was 7 months.Conclusion:Docetaxel and carboplatin with oral estramustine shows efficacy against castration-resistant prostate cancer.

We investigated the association between positive surgical margin (PSM) status and biochemical recurrence (BCR) after robot-assisted radical prostatectomy (RARP) to develop a prognostic factor-based risk stratification model for BCR. We analyzed the data of 483 patients who underwent RARP at our hospital between October 2010 and April 2019; 435 patients without neoadjuvant therapy were finally included. The BCR-free survival rate was determined using Kaplan–Meier analysis. Effects of the PSM status, including the number of PSMs, Gleason score (GS) at a PSM, and the maximum PSM length for BCR, were investigated using Cox regression analysis. BCR was confirmed after RARP in 61 patients (14.0%), and PSM was confirmed in 74 patients (17.0%); PSM was a significant predictor of BCR (p < 0.001). The median number of PSMs was 2 (1–6), and the median maximum length of PSM was 6.0 (2.0–17.0) mm. Multivariable analysis showed lymph node invasion (p < 0.001), GS of ≥ 7 at a PSM (p = 0.022) and a maximum PSM length of > 6.0 mm (p = 0.003) were significant predictors of BCR. We classified the patients without lymph node invasion into good-, intermediate-, and poor-risk groups according to the other two risk factors (presence of 0, 1, and 2 factors, respectively) and rates of 1-year BCR-free survival (100.0, 72.7, and 48.1%, respectively). Higher GS at PSM and greater length of PSM were significant predictors of BCR after RARP, and console surgeons should be careful to prevent PSM during RARP.