1,721,042 research outputs found
Effects of percutaneous varicocele repair on testicular volume and function: results from a 12-month follow-up
Full text linkVaricocele – the excessive dilatation of the pampiniform venous plexus of the spermatic cord – is a common finding in males of reproductive age since adolescence. Its prevalence is debated, as estimates from different populations yield different results: however, it is usually reported that varicocele may occur in up to 15% of all males between 15 and 19 years, with a much lower prevalence before puberty. Testicular damage resulting from varicocele has been variably associated with reduced testicular volume, impaired spermatogenesis, and increased sperm DNA damage, although the mechanisms involved are still not completely understood. It is therefore unsurprising that it is listed as one of the most frequent causes of male infertility and that its prevalence is much higher in infertile men, at 30-40% in primary and 80-85% in secondary infertility.
Existing guidelines propose different approaches on when and how to treat varicocele. Reduced ipsilateral testicular size is one of the indications for treatment, above all in adolescents. As 80-90% of testicular volume is made up of germ cells within seminiferous tubules, an asymmetrical reduction in testicular volume is universally accepted as a sign of testicular damage. Improvements in testicular volume, sperm parameters and DNA fragmentation have been variably reported following surgical treatment of varicocele; however, to our knowledge, no study has yet described the long-term effects of percutaneous varicocele embolization on testicular volume or function. As this treatment is regularly used in clinical practice, we retrospectively assessed testicular volume catch-up growth and changes in testicular function during a 12-month follow-up in a single center protocol-driven study
Disfunzioni sessuali contemporanee: la sessualità nei giovani adulti
No full textNegli adolescenti e nei giovani adulti, la salute sessuale e riproduttiva è un bene prezioso, da tutelare e proteggere; tuttavia, sin troppo spesso la letteratura scientifica trascura questa importante fase della vita. Scopo di questa rassegna è discutere delle principali problematiche della sessualità dei giovani, identificando i fattori di rischio, approfondendo il ruolo di Internet e le possibili ricadute sulla salute sessuale
Testosterone replacement therapy: the emperor's new clothes
No full textThe mean age of the world population has steadily increased in the last decades, as a result of increased life expectancy and reduced birth rate. Global aging has led to a greater worldwide cost for healthcare: hormonal alterations contribute to the pathogenesis of several conditions and might cause a significant reduction in the perceived sense of well-being. Menopause is archetypal of hormonal alterations occurring during aging: in males, sex hormones do not decrease abruptly, yet testosterone levels decrease steadily and continuously during aging, ultimately resulting in late-onset hypogonadism. Treatment of this condition might mitigate most symptoms; however, testosterone replacement therapy (TRT) should be prescribed only in selected patients and it should not be considered as an antiaging treatment. In recent years, different authors have questioned health risks associated with testosterone treatment; while position statements from many scientific societies seem to be reassuring, the Food and Drug Administration has issued a warning in regard to the possible side effects of this therapy. We aim to review recent controversies and discoveries in regard to TRT
Erectile dysfunction in aging male
Full text linkWith the increasing longevity in men and women, sexual health concerns have become more and more important and demands for help are far more common than in the past. Erectile dysfunction's severity and prevalence both increase with aging: since erectile dysfunction is a symptom, physicians should diagnose underlying pathologies that might lead to it instead of focusing on finding a viable treatment. Cardiovascular alterations occur in the elderly, and might lead to erectile dysfunction because of penile blood flow impairment: diabetes, smoking, and sedentary life-style, being risk factors for vascular pathologies, can affect erectile function. Metabolic syndrome and psychological factors are highly prevalent in aging men, and might be other important determinants of erectile dysfunction.Drugs play a role in the pathogenesis of erectile dysfunction, as they can alter hormonal or vascular mechanics needed for achieving or maintaining erection. Alterations in penile vessels can be observed in the elderly: lack of androgens might lead to a reduction of smooth muscle cells content in the penis and an increase in the caliber of vascular spaces. Hypogonadism, when present, should be treated regardless of age; furthermore, synergistic effects have been found during testosterone replacement therapy when using an oral therapy with a PDE-5 inhibitor (sildenafil, vardenafil or tadalafil). These therapies are effective in the elderly, with no increase in the frequency of adverse events, and might also help in providing relief from lower urinary tract symptoms. (www.actabiomedica.it). © Mattioli 1885
Endocrine evaluation of erectile dysfunction
No full textErectile dysfunction is highly prevalent, affecting up to half of men in their 50-70s, and has been variably associated to a variety of causes including unhealthy lifestyles, such as smoking or overweight, or comorbidities such as hypertension, diabetes mellitus, and neurological disorders. General interest toward ED has exploded since the introduction of phosphodiesterase type 5 inhibitors-oral drugs that are widely accepted as the first line treatment in patients suffering from this conditions. In the last decade, the time lapse between first symptoms of sexual disorders and seeking of medical advice has greatly reduced. Unfortunately, none of the PDE5i has been proven curative, but rather acts as a symptomatic treatment. The availability of very active and safe drugs, however, diminished the space for diagnosis and search of etiological treatments. This is particularly true for the several endocrinopathies associated with ED. A number of epidemiological data support an inverse relationship between sexual health and testosterone levels, and it is well accepted that testosterone deficiency is a good marker of sexual and physical frailty. However, several other hormones, including LH, prolactin, TSH, and FT4 are involved in sexual functioning and should be investigated in a proper work-out of ED. Existing guidelines provide information almost entirely focusing on late-onset hypogonadism and therapeutic strategies; this mini-review aims to provide a wider spectrum of the diagnostic endocrine work-out of ED patients unrevealing the complexity of conditions, overt or subclinical, which can affect ED
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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