Andrology in China： current status and 10 years＇ progress

Andrology has a long history in traditional Chinese medicine. There are records of male sexual health, male sexual dysfunction and male infertility from over thousands of years ago. Modern andrology in China had a late start, with the Chinese Androlo~ Association founded in 1995. Within last decade, andrology in China has grown rapidly. In this review article, we summarized the progress of androlo~ in last 10 years and outlined the current status of Chinese andrology with a special focus on progress in male erectile dysfunction, prostate diseases, male infertility and male hormonal contraception.

Clinical observation of loupe-assisted intussusception vasoepididymostomy in the treatment of obstructive azoospermia(analysis of 49 case reports)

To evaluate the clinical outcomes of loupe-assisted intussusception vasoepididymostomy(VE)in the treatment of epididymal obstructive azoospermia(EOA),we retrospectively analyzed data from 49 patients with EOA who underwent two-suture longitudinal intussusception vasoepididymostomy(LIVE)between 2000 and 2007.The data included the surgical method,postoperative motile sperm count per ejaculation,percentage of progressive motile sperm and patency and pregnancy outcomes.There were a total of 49 men undergoing scrotal exploration,and epididymal obstruction was found in all cases.Bilateral or unilateral anastomoses were performed in 40 and 6 men,respectively.The postoperative courses of 42 patients were followed up for more than 6 months,and the courses of 38 patients were followed up for more than 1 year.The overall patency and pregnancy rates were 71.4%and 26.3%,respectively.Moreover,progressive motile sperm was more frequently present in those patients who had undergone anastomosis at cauda than at corpus or caput.Pregnancy was achieved only in those patients who had undergone anastomosis at least on one side of the cauda epididymis.We think that the loupe-assisted method,with a lower overall cost and a simplified surgical procedure,can achieve satisfactory patency outcomes and pregnancy results.Data from this paper also suggest that paternity outcomes occur more frequently after anastomoses at cauda than at corpus or caput.

Medical management of erectile dysfunction in aging males： is it too late to treat？

Erectile dysfunction （ED） is a common disorder among aging males. However, most aging males refuse to seek medical help and believe that ED is an irreversible event in the aging process. The purpose of this study was to describe the current medical management of ED in aging males and to examine whether it is too late to treat this disorder in these elderly men. From 2007 to 2008, 4507 patients diagnosed with ED were gathered from 46 centers in China; 4241 completed the study, 3837 of whom were treated with sildenafil. The 3837 patients were divided into five groups based on age （group A： 20-30 years; group B： 31-40 years; group C： 41-50 years; group D： 51-60 years; and group E： 〉60 years）. After comparing pre- and posttreatment International Index of Erectile Function-Erectile Function domain （IIEF-EF） questionnaires, Erection Hardness Scale （EHS）, and IIEF Q13 （＂How satisfied have you been with your overall sex life？＂）, we discovered that the aging males had worse erectile function, erection hardness, and sexual satisfaction than the younger males （P〈 0.001）. After treatment, the improvement rates in the IIEF-EF, EHS, and IIEF Q13 scores were 107.0%, 83.1%, and 116.5%, respectively. The magnitude of these changes demonstrated significant differences among groups （P 〈 0.001）. Accordingly, aging males are likely to benefit more from medical treatment. We propose that aging males should be informed that age is not a limiting factor for medical ED management, and it is never too late to treat.

Studies on plasma endothelin changes in varicocele patients

Aim: To investigate the possible role endothelin may play in the pathogenesis of varicocele and varicocele-induced infer-tility. Methods: In varicocele patients, radioimmunoassay is used to determine the blood endothelin concentration inthe spermatic vein and the antecubital vein separately. Results: The blood endothelin concentration of the spermaticvein (66.8±23.5 pg/mL) was significantly higher (P <0.05) than that of the antecubital vein (55.3±25.3 pg/mL).The endothelin concentration in the spermatic vein in Grade Ⅱ varicocele patients was not significantly different from thatin Grade Ⅲ patients ( P = 0.87). Conclusion: The higher blood endothelin level in the spermatic vein may indicate theinvolvement of endothelin in the pathophysiology of varicocele and varicocele-induced infertility. (Asian J Androl 1999Sep ; 1: 159 - 160)