Aim： To evaluate the relationship between testicular function and testicular volume measured by using Prader orchidometry and ultrasonography （US） to determine the critical testicular volume indicating normal testi...Aim： To evaluate the relationship between testicular function and testicular volume measured by using Prader orchidometry and ultrasonography （US） to determine the critical testicular volume indicating normal testicular function by each method. Methods： Total testicular volume （right plus left testicular volume） was measured in 794 testes in 397 men with infertility （mean age, 35.6 years） using a Prader orchidometer and also by ultrasonography. Ultrasonographic testicular volumes were calculated as length x width x height x 0.71. To evaluate volume-function relationships, patients were divided into 10 groups representing 5-mL increments of total testicular volume by each method from below 10 mL to 50 mL or more. Results： Mean total testicular volume based on Prader orchidometry and US were 36.8 mL and 26.3 mL, respectively. Semen volume, sperm density, total sperm count, total motile sperm count, and serum FSH, LH, and testosterone all correlated significantly with total testicular volume measured by either method. Mean sperm density was in the oligozoospermic range in patients with total testicular volume below 35 mL by orchidometry or below 20 mL by ultrasonography. Mean total sperm count was subnormal in patients with total testicular volume below 30 mL by orchidometry or under 20 mL by ultrasonography. Conclusion： Testicular volume measured by either ultrasonography or Prader orchidometry correlated significantly with testicular function. However, critical total testicular volume indicating normal or nearly normal testicular function was 30 mL to 35 mL using Prader orchidometer and 20 mL using ultrasonography. Prader orchidometry morphometrically and functionally overestimated the testicular volume in comparison to US. （Asian JAndro12008 Mar; 10： 319-324）展开更多
To compare the impact of the scrotal vs inguinal orchidopexy approach on the testicular function of infants with cryptorchidism,a randomized controlled trial was conducted involving boys who were 6–12 months old at s...To compare the impact of the scrotal vs inguinal orchidopexy approach on the testicular function of infants with cryptorchidism,a randomized controlled trial was conducted involving boys who were 6–12 months old at surgery and were diagnosed with clinically palpable,inguinal undescended testis.Between June 2021 and December 2021,these boys at Fujian Maternity and Child Health Hospital(Fuzhou,China)and Fujian Children’s Hospital(Fuzhou,China)were enrolled.Block randomization with a 1:1 allocation ratio was employed.The primary outcome was testicular function assessed by testicular volume,serum testosterone,anti-Müllerian hormone(AMH),and inhibin B(InhB)levels.Secondary outcomes included operative time,amount of intraoperative bleeding,and postoperative complications.Among 577 screened patients,100(17.3%)were considered eligible and enrolled in the study.Of the 100 children who completed the 1-year follow-up,50 underwent scrotal orchidopexy and 50 underwent inguinal orchidopexy.The testicular volume,serum testosterone,AMH,and InhB levels in both groups increased markedly after surgery(all P<0.05),but there were no apparent differences between groups at 6 months and 12 months after operation(all P>0.05).No differences between the scrotal and inguinal groups were noted regarding the operative time(P=0.987)and amount of intraoperative bleeding(P=0.746).The overall complication rate(2.0%)of the scrotal group was slightly lower than that of the inguinal group(8.0%),although this difference was not statistically significant(P>0.05).Both scrotal and inguinal orchiopexy exerted protective effects on testicular function in children with cryptorchidism,with similar operative status and postoperative complications.Scrotal orchiopexy is an effective alternative to inguinal orchiopexy in children with cryptorchidism.展开更多
Objective:To investigate the effects of 30-day treatment with therapeutic dose equivalent levels of tramadol on serum testosterone level,sperm parameters,and testicular histology in rats.Methods:Thirty-five Wistar rat...Objective:To investigate the effects of 30-day treatment with therapeutic dose equivalent levels of tramadol on serum testosterone level,sperm parameters,and testicular histology in rats.Methods:Thirty-five Wistar rats were equally divided into seven groups.Group 1(the control group)received distilled water(0.5 mL)daily for 30 days.Groups 2-4 were gavaged with therapeutic dose equivalent levels of tramadol(1.25,2.50 and 5.00 mg/kg/day body weight,respectively)in two equal divided doses for 30 consecutive days,and sacrificed on day 31.Groups 5-7 received similar tramadol treatments as above but they were allowed for another 30 days to recover after receiving the last dose and sacrificed on day 61 for reversibility study.Serum testosterone level and epididymal sperm were analyzed,and histopathological examination of the testis was carried out.Results:Tramadol treatment significantly decreased serum testosterone levels compared with the control group.Furthermore,tramadol treatment inhibited sperm motility and significantly and dose-dependently decreased sperm count and viability compared with the control group.In addition,tramadol significantly increased morphological abnormalities in sperm(P<0.05).The above effects of tramadol were reduced in the reversible groups.Testis histopathological examination revealed disintegrated cell architecture,eroded and atrophied seminiferous tubules,and a marked decrease in the number of spermatogenic cells in the tramadol treated groups.The histopathological changes were restored in the reversible groups,but improvement was not complete in the 5.00 mg/kg tramadol treated reversible group.Conclusions:Long term treatment with tramadol at clinical dose levels may adversely affect testosterone level,sperm parameters,and testicular histology,but they are reversible at lower doses.展开更多
Although alcohol is widely used, its impact on the male reproductive function is still controversial. Over the years, many studies have investigated the effects of alcohol consumption on sperm parameters and male infe...Although alcohol is widely used, its impact on the male reproductive function is still controversial. Over the years, many studies have investigated the effects of alcohol consumption on sperm parameters and male infertility. This article reviews the main preclinical and clinical evidences. Studies conducted on the experimental animal have shown that a diet enriched with ethanol causes sperm parameter abnormalities, a number of alterations involving the reproductive tract inhibition, and reduced mouse oocyte in vitro fertilization rate. These effects were partly reversible upon discontinuation of alcohol consumption. Most of the studies evaluating the effects of alcohol in men have shown a negative impact on the sperm parameters. This has been reported to be associated with hypotestosteronemia and low-normal or elevated gonadotropin levels suggesting a combined central and testicular detrimental effect of alcohol. Nevertheless, alcohol consumption does not seem to have much effect on fertility either in in vitro fertilization programs or population-based studies. Finally, the genetic background and other concomitant, alcohol consumption-related conditions influence the degree of the testicular damage. In conclusion, alcohol consumption is associated with a deterioration of sperm parameters which may be partially reversible upon alcohol consumption discontinuation.展开更多
Although suppressed serum testosterone （T） is common in ageing men, only a small proportion of them develop the genuine syndrome of low T associated with diffuse sexual （e.g., erectile dysfunction）, physical （e.g...Although suppressed serum testosterone （T） is common in ageing men, only a small proportion of them develop the genuine syndrome of low T associated with diffuse sexual （e.g., erectile dysfunction）, physical （e.g. loss of vigor and frailty） and psychological （e.g., depression） symptoms. This syndrome carries many names, including male menopause or climacterium, andropause and partial androgen deficiency of the ageing male （PADAM）. Late-onset hypogonadism （LOH） describes it best and is therefore generally preferred. The decrease of T in LOH is often marginal, and hypogonadism can be either due to primary testicular failure （low T, high luteinizing hormone （LH）） or secondary to a hypothalamic-pituitary failure （low T, low or inappropriately normal LH）. The latter form is more common and it is usually associated with overweight/obesity or chronic diseases （e.g., type 2 diabetes mellitus, the metabolic syndrome, cardiovascular and chronic obstructive pulmonary disease, and frailty）. A problem with the diagnosis of LOH is that often the symptoms （in 20%-40% of unselected men） and low circulating T （in 20% of men 〉70 years of age） do not coincide in the same individual. The European Male Ageing Study （EMAS） has recently defined the strict diagnostic criteria for LOH to include the simultaneous presence of reproducibly low serum T （total T 〈11 nmol 1-1 and free T 〈220 pmol 1-1） and three sexual symptoms （erectile dysfunction, and reduced frequency of sexual thoughts and morning erections）. By these criteria, only 2% of 40- to 80-year-old men have LOH. In particular obesity, but also impaired general health, are more common causes of low T than chronological age per se. Evidence-based information whether, and how, LOH should be treated is sparse. The most logical approach is lifestyle modification, weight reduction and good treatment of comorbid diseases. T replacement is widely used for the treatment, but evidence-based information about its real benefits and short- and long-term risks, is not yet available. In this review, we will summarize the current conceets and controversies in the Dathogenesis, diagnosis and treatment of LOH.展开更多
The testis is an immune-privileged organ susceptible to oxidative stress and inflammation,two major factors implicated in male infertility.A reduction in the concentration and activities of testicular function biomark...The testis is an immune-privileged organ susceptible to oxidative stress and inflammation,two major factors implicated in male infertility.A reduction in the concentration and activities of testicular function biomarkers has been shown to correlate with impaired hypothalamic-pituitary-testicular axis and oxidative stress.However,the use of natural products to ameliorate these oxidative stress-induced changes may be essential to improving male reproductive function.Quercetin possesses several pharmacological activities that may help to combat cellular reproduction-related assaults,such as altered sperm function and reproductive hormone dysfunction,and dysregulated testicular apoptosis,oxidative stress,and inflammation.Studies have shown that quercetin ameliorates testicular toxicity,largely by inhibiting the generation of reactive oxygen species,with the aid of the two antioxidant pharmacophores present in its ring structure.The radical-scavenging property of quercetin may alter signal transduction of oxidative stress-induced apoptosis,prevent inflammation,and increase sperm quality in relation to the hormonal concentration.In this review,the therapeutic potential of quercetin in mediating male reproductive health is discussed.展开更多
目的评价MR扩散加权成像(DWI)睾丸ADC值对评估生精功能的价值。方法本研究纳入睾丸穿刺活检证实生精功能减低者为病例组A组(n=18),年龄20~40岁,平均(28.1±5.1)岁;以精液检查正常者为对照组,按年龄段设立3个对照组:对照组B(n=18),年...目的评价MR扩散加权成像(DWI)睾丸ADC值对评估生精功能的价值。方法本研究纳入睾丸穿刺活检证实生精功能减低者为病例组A组(n=18),年龄20~40岁,平均(28.1±5.1)岁;以精液检查正常者为对照组,按年龄段设立3个对照组:对照组B(n=18),年龄20~30岁,平均(25.4±3.1)岁;对照组C(n=22),年龄31~40岁,平均(35.4±3.3)岁;对照组D(n=16),年龄41~50岁,平均(43.4±4.3)岁。均采用3.0 T MR机行睾丸常规平扫及DWI序列扫描,DWI扫描采用EPI序列(b值分别取0,900,4000),ADC图自动生成。由同一位医生在影像工作站采用手动选取尽可能大的兴趣区测量双侧睾丸ADC值。采用独立样本t检验,比较病例组与对照组、各对照组之间的ADC值;通过ROC曲线分析,计算诊断睾丸生精减低时的ADC最佳临界值。结果病例组A组睾丸平均ADC值(0.479±0.025)mm^2/s,对照组B为(0.446±0.018)mm^2/s,对照组C为(0.458±0.033)mm^2/s,对照组D为(0.468±0.033)mm^2/s。3个对照组进行组间ADC值的比较均有明显统计学差异(P<0.001),表明尽管生精功能还能保持正常范围,但随年龄增长睾丸ADC值逐渐增高。而病例组睾丸平均ADC值明显高于所有对照组(P<0.001)。通过ROC分析,本组诊断睾丸生精功能减低时的ADC最佳临界值为0.473 mm^2/s,敏感度及特异度分别是84.1%和73.7%。结论采用MR扩散加权成像(DWI)睾丸ADC值测量能有效对睾丸生精功能进行初步评估。展开更多
文摘Aim： To evaluate the relationship between testicular function and testicular volume measured by using Prader orchidometry and ultrasonography （US） to determine the critical testicular volume indicating normal testicular function by each method. Methods： Total testicular volume （right plus left testicular volume） was measured in 794 testes in 397 men with infertility （mean age, 35.6 years） using a Prader orchidometer and also by ultrasonography. Ultrasonographic testicular volumes were calculated as length x width x height x 0.71. To evaluate volume-function relationships, patients were divided into 10 groups representing 5-mL increments of total testicular volume by each method from below 10 mL to 50 mL or more. Results： Mean total testicular volume based on Prader orchidometry and US were 36.8 mL and 26.3 mL, respectively. Semen volume, sperm density, total sperm count, total motile sperm count, and serum FSH, LH, and testosterone all correlated significantly with total testicular volume measured by either method. Mean sperm density was in the oligozoospermic range in patients with total testicular volume below 35 mL by orchidometry or below 20 mL by ultrasonography. Mean total sperm count was subnormal in patients with total testicular volume below 30 mL by orchidometry or under 20 mL by ultrasonography. Conclusion： Testicular volume measured by either ultrasonography or Prader orchidometry correlated significantly with testicular function. However, critical total testicular volume indicating normal or nearly normal testicular function was 30 mL to 35 mL using Prader orchidometer and 20 mL using ultrasonography. Prader orchidometry morphometrically and functionally overestimated the testicular volume in comparison to US. （Asian JAndro12008 Mar; 10： 319-324）
基金The authors would like to acknowledge the Provincial Health Special Subsidy Project of Fujian Provincial Finance Department(No.[2020]467).
文摘To compare the impact of the scrotal vs inguinal orchidopexy approach on the testicular function of infants with cryptorchidism,a randomized controlled trial was conducted involving boys who were 6–12 months old at surgery and were diagnosed with clinically palpable,inguinal undescended testis.Between June 2021 and December 2021,these boys at Fujian Maternity and Child Health Hospital(Fuzhou,China)and Fujian Children’s Hospital(Fuzhou,China)were enrolled.Block randomization with a 1:1 allocation ratio was employed.The primary outcome was testicular function assessed by testicular volume,serum testosterone,anti-Müllerian hormone(AMH),and inhibin B(InhB)levels.Secondary outcomes included operative time,amount of intraoperative bleeding,and postoperative complications.Among 577 screened patients,100(17.3%)were considered eligible and enrolled in the study.Of the 100 children who completed the 1-year follow-up,50 underwent scrotal orchidopexy and 50 underwent inguinal orchidopexy.The testicular volume,serum testosterone,AMH,and InhB levels in both groups increased markedly after surgery(all P<0.05),but there were no apparent differences between groups at 6 months and 12 months after operation(all P>0.05).No differences between the scrotal and inguinal groups were noted regarding the operative time(P=0.987)and amount of intraoperative bleeding(P=0.746).The overall complication rate(2.0%)of the scrotal group was slightly lower than that of the inguinal group(8.0%),although this difference was not statistically significant(P>0.05).Both scrotal and inguinal orchiopexy exerted protective effects on testicular function in children with cryptorchidism,with similar operative status and postoperative complications.Scrotal orchiopexy is an effective alternative to inguinal orchiopexy in children with cryptorchidism.
文摘Objective:To investigate the effects of 30-day treatment with therapeutic dose equivalent levels of tramadol on serum testosterone level,sperm parameters,and testicular histology in rats.Methods:Thirty-five Wistar rats were equally divided into seven groups.Group 1(the control group)received distilled water(0.5 mL)daily for 30 days.Groups 2-4 were gavaged with therapeutic dose equivalent levels of tramadol(1.25,2.50 and 5.00 mg/kg/day body weight,respectively)in two equal divided doses for 30 consecutive days,and sacrificed on day 31.Groups 5-7 received similar tramadol treatments as above but they were allowed for another 30 days to recover after receiving the last dose and sacrificed on day 61 for reversibility study.Serum testosterone level and epididymal sperm were analyzed,and histopathological examination of the testis was carried out.Results:Tramadol treatment significantly decreased serum testosterone levels compared with the control group.Furthermore,tramadol treatment inhibited sperm motility and significantly and dose-dependently decreased sperm count and viability compared with the control group.In addition,tramadol significantly increased morphological abnormalities in sperm(P<0.05).The above effects of tramadol were reduced in the reversible groups.Testis histopathological examination revealed disintegrated cell architecture,eroded and atrophied seminiferous tubules,and a marked decrease in the number of spermatogenic cells in the tramadol treated groups.The histopathological changes were restored in the reversible groups,but improvement was not complete in the 5.00 mg/kg tramadol treated reversible group.Conclusions:Long term treatment with tramadol at clinical dose levels may adversely affect testosterone level,sperm parameters,and testicular histology,but they are reversible at lower doses.
文摘Although alcohol is widely used, its impact on the male reproductive function is still controversial. Over the years, many studies have investigated the effects of alcohol consumption on sperm parameters and male infertility. This article reviews the main preclinical and clinical evidences. Studies conducted on the experimental animal have shown that a diet enriched with ethanol causes sperm parameter abnormalities, a number of alterations involving the reproductive tract inhibition, and reduced mouse oocyte in vitro fertilization rate. These effects were partly reversible upon discontinuation of alcohol consumption. Most of the studies evaluating the effects of alcohol in men have shown a negative impact on the sperm parameters. This has been reported to be associated with hypotestosteronemia and low-normal or elevated gonadotropin levels suggesting a combined central and testicular detrimental effect of alcohol. Nevertheless, alcohol consumption does not seem to have much effect on fertility either in in vitro fertilization programs or population-based studies. Finally, the genetic background and other concomitant, alcohol consumption-related conditions influence the degree of the testicular damage. In conclusion, alcohol consumption is associated with a deterioration of sperm parameters which may be partially reversible upon alcohol consumption discontinuation.
文摘Although suppressed serum testosterone （T） is common in ageing men, only a small proportion of them develop the genuine syndrome of low T associated with diffuse sexual （e.g., erectile dysfunction）, physical （e.g. loss of vigor and frailty） and psychological （e.g., depression） symptoms. This syndrome carries many names, including male menopause or climacterium, andropause and partial androgen deficiency of the ageing male （PADAM）. Late-onset hypogonadism （LOH） describes it best and is therefore generally preferred. The decrease of T in LOH is often marginal, and hypogonadism can be either due to primary testicular failure （low T, high luteinizing hormone （LH）） or secondary to a hypothalamic-pituitary failure （low T, low or inappropriately normal LH）. The latter form is more common and it is usually associated with overweight/obesity or chronic diseases （e.g., type 2 diabetes mellitus, the metabolic syndrome, cardiovascular and chronic obstructive pulmonary disease, and frailty）. A problem with the diagnosis of LOH is that often the symptoms （in 20%-40% of unselected men） and low circulating T （in 20% of men 〉70 years of age） do not coincide in the same individual. The European Male Ageing Study （EMAS） has recently defined the strict diagnostic criteria for LOH to include the simultaneous presence of reproducibly low serum T （total T 〈11 nmol 1-1 and free T 〈220 pmol 1-1） and three sexual symptoms （erectile dysfunction, and reduced frequency of sexual thoughts and morning erections）. By these criteria, only 2% of 40- to 80-year-old men have LOH. In particular obesity, but also impaired general health, are more common causes of low T than chronological age per se. Evidence-based information whether, and how, LOH should be treated is sparse. The most logical approach is lifestyle modification, weight reduction and good treatment of comorbid diseases. T replacement is widely used for the treatment, but evidence-based information about its real benefits and short- and long-term risks, is not yet available. In this review, we will summarize the current conceets and controversies in the Dathogenesis, diagnosis and treatment of LOH.
文摘The testis is an immune-privileged organ susceptible to oxidative stress and inflammation,two major factors implicated in male infertility.A reduction in the concentration and activities of testicular function biomarkers has been shown to correlate with impaired hypothalamic-pituitary-testicular axis and oxidative stress.However,the use of natural products to ameliorate these oxidative stress-induced changes may be essential to improving male reproductive function.Quercetin possesses several pharmacological activities that may help to combat cellular reproduction-related assaults,such as altered sperm function and reproductive hormone dysfunction,and dysregulated testicular apoptosis,oxidative stress,and inflammation.Studies have shown that quercetin ameliorates testicular toxicity,largely by inhibiting the generation of reactive oxygen species,with the aid of the two antioxidant pharmacophores present in its ring structure.The radical-scavenging property of quercetin may alter signal transduction of oxidative stress-induced apoptosis,prevent inflammation,and increase sperm quality in relation to the hormonal concentration.In this review,the therapeutic potential of quercetin in mediating male reproductive health is discussed.
文摘目的评价MR扩散加权成像(DWI)睾丸ADC值对评估生精功能的价值。方法本研究纳入睾丸穿刺活检证实生精功能减低者为病例组A组(n=18),年龄20~40岁,平均(28.1±5.1)岁;以精液检查正常者为对照组,按年龄段设立3个对照组:对照组B(n=18),年龄20~30岁,平均(25.4±3.1)岁;对照组C(n=22),年龄31~40岁,平均(35.4±3.3)岁;对照组D(n=16),年龄41~50岁,平均(43.4±4.3)岁。均采用3.0 T MR机行睾丸常规平扫及DWI序列扫描,DWI扫描采用EPI序列(b值分别取0,900,4000),ADC图自动生成。由同一位医生在影像工作站采用手动选取尽可能大的兴趣区测量双侧睾丸ADC值。采用独立样本t检验,比较病例组与对照组、各对照组之间的ADC值;通过ROC曲线分析,计算诊断睾丸生精减低时的ADC最佳临界值。结果病例组A组睾丸平均ADC值(0.479±0.025)mm^2/s,对照组B为(0.446±0.018)mm^2/s,对照组C为(0.458±0.033)mm^2/s,对照组D为(0.468±0.033)mm^2/s。3个对照组进行组间ADC值的比较均有明显统计学差异(P<0.001),表明尽管生精功能还能保持正常范围,但随年龄增长睾丸ADC值逐渐增高。而病例组睾丸平均ADC值明显高于所有对照组(P<0.001)。通过ROC分析,本组诊断睾丸生精功能减低时的ADC最佳临界值为0.473 mm^2/s,敏感度及特异度分别是84.1%和73.7%。结论采用MR扩散加权成像(DWI)睾丸ADC值测量能有效对睾丸生精功能进行初步评估。
