Aromatase activity has commonly been associated with male infertility characterized by testicular dysfunction with low serum testosterone and/or testosterone to estradiol ratio.In this subset of patients,and particula...Aromatase activity has commonly been associated with male infertility characterized by testicular dysfunction with low serum testosterone and/or testosterone to estradiol ratio.In this subset of patients,and particularly in those with hypogonadism,elevated levels of circulating estradiol may establish a negative feedback on the hypothalamic–pituitary–testicular axis by suppressing follicle-stimulating hormone(FSH)and luteinizing hormone(LH)production and impaired spermatogenesis.Hormonal manipulation via different agents such as selective estrogen modulators or aromatase inhibitors to increase endogenous testosterone production and improve spermatogenesis in the setting of infertility is an off-label option for treatment.We carried out a systematic review and meta-analysis of the literature of the past 30 years in order to evaluate the benefits of the use of aromatase inhibitors in the medical management of infertile/hypoandrogenic males.Overall,eight original articles were included and critically evaluated.Either steroidal(Testolactone)or nonsteroidal(Anastrozole and Letrozole)aromatase inhibitors were found to statistically improve all the evaluated hormonal and seminal outcomes with a safe tolerability profile.While the evidence is promising,future prospective randomized placebo-controlled multicenter trials are necessary to better define the efficacy of these medications.展开更多
Inflatable penile prostheses are an important tool in the treatment of medically refractory erectile dysfunction.One of the major complications associated with these prostheses is infections,which ultimately require d...Inflatable penile prostheses are an important tool in the treatment of medically refractory erectile dysfunction.One of the major complications associated with these prostheses is infections,which ultimately require device explanation and placement of a new device.Over the past several decades,significant work has been done to reduce infection rates and optimize treatment strategies to reduce patient morbidity.This article reviews the current state of knowledge surrounding penile prosthesis infections,with attention to the evidence for methods to prevent infection and best practices for device reimplantation.展开更多
Dear Editor,Penile fracture is an infrequent urologic emergency with a nationwide incidence of 1 in 100000 men in the United States.1 Blunt trauma during sexual intercourse(penile-perineal impact)is the primary cause ...Dear Editor,Penile fracture is an infrequent urologic emergency with a nationwide incidence of 1 in 100000 men in the United States.1 Blunt trauma during sexual intercourse(penile-perineal impact)is the primary cause of penile fracture,but a variety of alternative mechanisms of injury have been reported in the literature.2 The vast majority of penile fractures occur in the external corpus cavernosum and manifest with the classic“eggplant deformity.”The location of these fractures makes them amenable to repair through a circumcising,degloving incision.展开更多
文摘Aromatase activity has commonly been associated with male infertility characterized by testicular dysfunction with low serum testosterone and/or testosterone to estradiol ratio.In this subset of patients,and particularly in those with hypogonadism,elevated levels of circulating estradiol may establish a negative feedback on the hypothalamic–pituitary–testicular axis by suppressing follicle-stimulating hormone(FSH)and luteinizing hormone(LH)production and impaired spermatogenesis.Hormonal manipulation via different agents such as selective estrogen modulators or aromatase inhibitors to increase endogenous testosterone production and improve spermatogenesis in the setting of infertility is an off-label option for treatment.We carried out a systematic review and meta-analysis of the literature of the past 30 years in order to evaluate the benefits of the use of aromatase inhibitors in the medical management of infertile/hypoandrogenic males.Overall,eight original articles were included and critically evaluated.Either steroidal(Testolactone)or nonsteroidal(Anastrozole and Letrozole)aromatase inhibitors were found to statistically improve all the evaluated hormonal and seminal outcomes with a safe tolerability profile.While the evidence is promising,future prospective randomized placebo-controlled multicenter trials are necessary to better define the efficacy of these medications.
文摘Inflatable penile prostheses are an important tool in the treatment of medically refractory erectile dysfunction.One of the major complications associated with these prostheses is infections,which ultimately require device explanation and placement of a new device.Over the past several decades,significant work has been done to reduce infection rates and optimize treatment strategies to reduce patient morbidity.This article reviews the current state of knowledge surrounding penile prosthesis infections,with attention to the evidence for methods to prevent infection and best practices for device reimplantation.
文摘Dear Editor,Penile fracture is an infrequent urologic emergency with a nationwide incidence of 1 in 100000 men in the United States.1 Blunt trauma during sexual intercourse(penile-perineal impact)is the primary cause of penile fracture,but a variety of alternative mechanisms of injury have been reported in the literature.2 The vast majority of penile fractures occur in the external corpus cavernosum and manifest with the classic“eggplant deformity.”The location of these fractures makes them amenable to repair through a circumcising,degloving incision.
