Effects of circumcision on male sexual functions： systematic review and meta-analysis

This meta-analysis was performed to assess sexual functions following adult male circumcision. We searched the Cochrane Central Register of Controlled Trials, PUBMED, EMBASE, the Cochrane Database of Systematic Review and Web of Science from their inception until January 2013 to identify all eligible studies that reported on men＇s sexual function after circumcision. The Cochrane Collaboration＇s RevMan 5.2 software was employed for data analysis, and the fixed or the random effect model was selected depending on the proportion of heterogeneity. We identified 10 studies, which described a total of 9317 circumcised and 9423 uncircumcised men who were evaluated for the association of circumcision with male sexual function. There were no significant differences in sexual desire （odds ratio （OR）： 0.99; 95% confidence interval （CI）： 0.92-1.06）, dyspareunia （OR： 1.12; 95% Ch 0.52-2.44）, premature ejaculation （OR. 1.13; 95% Ch 0.83-1.54）, ejaculation latency time （OR： 1.33; 95% Ch 0.69-1.97）, erectile dysfunctions （OR： 0.90; 95% Ch 0.65-1.25） and orgasm difficulties （OR： 0.97; 95% Ch 0.83-1.13）. These findings suggest that circumcision is unlikely to adversely affect male sexual functions. However, these results should be evaluated in light of the low quality of the existing evidence and the significant heterogeneity across the various studies. Well-designed and prospective studies are required for a further understanding of this topic.

Infant male circumcision: An evidence-based policy statement

Here we review the international evidence for benefits and risks of infant male circumcision (MC) and use this to develop an evidence-based policy statement for a developed nation setting, focusing on Australia. Evidence from good quality studies that include meta-analyses and randomized controlled trials showed that MC provides strong protection against: urinary tract infections and, in infancy, renal parenchymal disease;phimosis;paraphimosis;balanoposthitis;foreskin tearing;some heterosexually transmitted infections including HPV, HSV-2, trichomonas, HIV, and genital ulcer disease;thrush;inferior hygiene;penile cancer and possibly prostate cancer. In women, circumcision of the male partner protects against HPV, HSV-2, cervical cancer, bacterial vaginosis, and possibly Chlamydia. MC has no adverse effect on sexual function, sensitivity, penile sensation or satisfaction and may enhance the male sexual experience. Adverse effects are uncommon (<1%), and virtually all are minor and easily treated. For maximum benefits, safety, convenience and cost savings, MC should be performed in infancy and with local anesthesia. A risk-benefit analysis shows benefits exceed risks by a large margin. Over their lifetime up to half of uncircumcised males will suffer a medical condition as a result of retaining their foreskin. The ethics of infant MC and childhood vaccination are comparable. Our analysis finds MC is beneficial, safe and cost-effective, and should optimally be performed in infancy. In the interests of public health and individual wellbeing, adequate parental education, and steps to facilitate access and affordability should be encouraged in developed countries.

Critical evaluation of unscientific arguments disparaging affirmative infant male circumcision policy

We evaluate recent claims opposing infant male circumcision,a procedure now supported by the evidencebased policy of the American Academy of Pediatrics.We find those criticisms depend on speculative claims about the foreskin and obfuscation of the strong scientific evidence supporting pediatric policy development.An argument that circumcision should be delayed to allow a boy to make up his own mind as an adult fails to appreciate the psychological,scheduling and financial burdens later circumcision entails,so reducing the likelihood that it will occur.In contrast,early infant circumcision is convenient,safer,quicker,lower risk,healing is faster,cosmetic outcome is routinely good and the lifetime benefits accrue immediately.Benefits include reduction in urinary tract infections,inflammatory skin conditions,foreskin problems,and,when older,substantial protection against sexually transmitted infections and genital cancers in the male and his female sexual partners.Some authorities regard the failure to offer parents early infant circumcision as unethical,just as it would be unethical to fail to encourage the vaccination of children.In conclusion,the criticisms of evidence-based infant male circumcision policy are seriously flawed and should be dismissed as unhelpful to evidence-based development and implementation of pediatric policy intended to improve public health and individual wellbeing.

Early infant male circumcision:Systematic review,risk-benefit analysis,and progress in policy

AIM To determine whether recent evidence-based United States polices on male circumcision(MC) apply to comparable Anglophone countries,Australia and New Zealand.METHODS Articles in 2005 through 2015 were retrieved from PubM ed using the keyword "circumcision" together with 36 relevant subtopics.A further PubM ed search was performed for articles published in 2016.Searches of the EMBASE and Cochrane databases did not yield additional citable articles.Articles were assessed for quality and those rated 2+ and above according to the Scottish Intercollegiate Grading System were studied further.The most relevant andrepresentative of the topic were included.Bibliographies were examined to retrieve further key references.Randomized controlled trials,recent high quality systematic reviews or meta-analyses(level 1++ or 1+ evidence) were prioritized for inclusion.A risk-benefit analysis of articles rated for quality was performed.For efficiency and reliability,recent randomized controlled trials,metaanalyses,high quality systematic reviews and large welldesigned studies were used if available.Internet searches were conducted for other relevant information,including policies and Australian data on claims under Medicare for MC.RESULTS Evidence-based policy statements by the American Academy of Pediatrics(AAP) and the Centers for Disease Control and Prevention(CDC) support infant and later age male circumcision(MC) as a desirable public health measure.Our systematic review of relevant literature over the past decade yielded 140 journal articles that met our inclusion criteria.Together,these showed that early infant MC confers immediate and lifelong benefits by protecting against urinary tract infections having potential adverse long-term renal effects,phimosis that causes difficult and painful erections and "ballooning" during urination,inflammatory skin conditions,inferior penile hygiene,candidiasis,various sexually transmissible infections in both sexes,genital ulcers,and penile,prostate and cervical cancer.Our risk-benefit analysis showed that benefits exceeded procedural risks,which are predominantly minor,by up to 200 to 1.We estimated that more than 1 in 2 uncircumcised males will experience an adverse foreskin-related medical condition over their lifetime.Wide-ranging evidence from surveys,physiological measurements,and the anatomical location of penile sensory receptors responsible for sexual sensation strongly and consistently suggested that MC has no detrimental effect on sexual function,sensitivity or pleasure.United States studies showed that early infant MC is cost saving.The evidence supporting early infant MC has further strengthened since the positive AAP and CDC reviews.CONCLUSION Affirmative MC policies are needed in Australia and New Zealand.Routine provision of accurate,unbiased education,and access in public hospitals,will maximize health and financial benefits.

Comments by opponents on the British Medical Association’s guidance on non-therapeutic male circumcision of children seem one-sided and may undermine public health

The British Medical Association(BMA)guidance on non-therapeutic circumcision(NTMC)of male children is limited to ethical,legal and religious issues.Here we evaluate criticisms of the BMA’s guidance by Lempert et al.While their arguments promoting autonomy and consent might be superficially appealing,their claim of high procedural risks and negligible benefits seem one-sided and contrast with high quality evidence of low risk and lifelong benefits.Extensive literature reviews by the American Academy of Pediatrics and the United States Centers for Disease Control and Prevention in developing evidence-based policies,as well as risk-benefit analyses,have found that the medical benefits of infant NTMC greatly exceed the risks,and there is no reduction in sexual function and pleasure.The BMA’s failure to consider the medical benefits of early childhood NTMC may partly explain why this prophylactic intervention is discouraged in the United Kingdom.The consequence is higher prevalence of preventable infections,adverse medical conditions,suffering and net costs to the UK’s National Health Service for treatment of these.Many of the issues and contradictions in the BMA guidance identified by Lempert et al stem from the BMA’s guidance not being sufficiently evidence-based.Indeed,that document called for a review by others of the medical issues surrounding NTMC.While societal factors apply,ultimately,NTMC can only be justified rationally on scientific,evidence-based grounds.Parents are entitled to an accurate presentation of the medical evidence so that they can make an informed decision.Their decision either for or against NTMC should then be respected.

A Comparative Evaluation of the Voluntary Medical Male Circumcision Program for Seke and Goromonzi Districts, Mashonaland East Province, Zimbabwe, 2017

Background: In 2009, Zimbabwe incorporated Voluntary Medical Male Circumcision (VMMC) to a consortium of measures to eliminate HIV transmission by 2030. Seke and Goromonzi districts simultaneously commenced implementing VMMC. These districts have comparable population, geography, and support yet scored varied performances. Cumulatively, (2009-2016) Seke achieved 83% while Goromonzi achieved 15% of set circumcision targets. We compared the performance of the VMMC program in the 2 districts. Methodology: A process evaluation was conducted modelled on a logical framework. Interviewer-administered questionnaires and checklists were used to collect data. Epi info7 was used to generate frequencies and proportions. Results: Three health facilities in Seke and four in Goromonzi were implementing VMMC. Material resources were maintained at three months buffer stock and human resources equitably distributed between the two districts. Additional support (three nurses), from the national army, was received by Seke, and management provided vehicle support for program activities. Goromonzi conducted half of the targeted mobilisations (6/12) and Seke 12/12. Similar amounts of financial support were simultaneously disbursed. Seke circumcised 99.5% (4716) and Goromonzi 48.5% (2372) of annual targets. Adverse reactions were 0.04% (2) for Seke and 2.3% (55) for Goromonzi for same period with no review meetings conducted. Seke participants attributed performance to effective demand creation (22;100%), effective coordination (20;90.9%) and management support (21;95.5%). Goromonzi participants cited delayed payments (20;90.9%), lack of active leadership involvement in planning and execution (14;63.6%) and weak mobilisations (11;50%) to have worked against the program. Conclusion: Effective demand creation and coordination, manpower boost and leadership support enhanced VMMC program performance for Seke and was therefore recommended for Goromonzi. Resource availability did not translate to performance in Goromonzi where lack of active leadership involvement in planning and execution, weak mobilisations resulted in poor results. Robust demand creation strategies were suggested for both districts.

Overcoming Barriers to Uptake of Voluntary Medical Male Circumcision in a Traditionally Circumcising Community in Machinga District, Malawi

Introduction: Voluntary medical male circumcision (VMMC) reduces chances of contracting HIV during heterosexual intercourse in males, and risk of cervical cancer in their female sexual partners. However, its uptake among traditionally circumcising communities, where male circumcision carries a cultural significance, has not been studied. Previous research has focused on barriers to uptake of VMMC in non-circumcising communities. This study was conducted to determine socio-cultural barriers to VMMC uptake in order to identify culture-sensitive and evidence-based interventions to increase its uptake. Methodology: This exploratory mixed methods cross-sectional study generated quantitative data from 262 randomly sampled sexually active men;and qualitative data through four focus-group discussions with 58 purposely selected male participants and 10 key informants. Results: The study established that only 6.3% (n = 15) of those circumcised (90.8%, n = 238) were circumcised in clinical setting. Limited access to VMMC services, cost, pain, being attended to by female providers and cultural influences were the major hindrances to uptake of VMMC. Conclusion: Although there is a paradigm shift of preference from traditional male circumcision to VMMC in this community, its uptake is low. The study recommends that besides introducing mobile VMMC services, the Ministry of Health should collaborate with traditional circumcisers and local leaders to provide gender-and-culture-sensitive safer medical male circumcision services.

Twentieth Century Wanzams among the Asante People of Ghana: A Historical Study of the Facts on Male Circumcision

This paper studies the history of circumcision amongst religious and traditional societies and the arguments on the medical or non-medical essence of the practice. The paper further highlights amongst the Asante people of Ghana, a practice argued to have been introduced by Islamic Wanzams who are severally referred to as Muslim Circumcision Surgeons. Often circumcision amongst communities in West, Southern Africa, Asia and other Aboriginal groups has been spurred on by customs and traditions [1]. Yet the case of Asante was different. Hence attention has been paid to the history of circumcision amongst the people of Asante. More significantly, the health implications associated with circumcision surgery in Asante have been highlighted. Possible benefits from the practice of circumcision and the potential dangers associated with it, especially the operations of the Asante circumcision surgeons (Wanzams) have been amply scrutinised in the narrative. In the conclusion, attention is paid to some of the scientific arguments for male circumcision. The study is purely qualitative relying on documentary and non-documentary sources. Some of the documentary sources have been gleaned from journal articles, news papers and books etc. The non-documentary data have been sourced from interviews. Both the documentary and non-documentary sources have been thematically pieced together to form a social history of medicine narrative which has potential ramifications on the essence of male circumcision by Wanzams, as well as the need for further research, training and dialogue in the practice in Ghana and Asante in particular.

Does Male Circumcision Adversely Affect Sexual Sensation, Function, or Satisfaction? Critical Comment on Morris and Krieger (2013)

Morris and Krieger (2013) have argued that male circumcision does not impact adversely on sexual sensation, satisfaction, and/or function. In the present paper, it is argued that such a view is untenable. By selectively citing Morris’ own non-peer-reviewed letters and opinion pieces purporting to show flaws in studies reporting evidence of negative effects of circumcision, and by failing adequately to account for replies to these letters by the authors of the original research (and others), Morris and Krieger give an incomplete and misleading account of the available literature. Consequently, Morris and Krieger reach an implausible conclusion that is inconsistent with what is known about the anatomy and functions of the penile foreskin, and the likely effects of its surgical removal.

An Evaluation of the Adverse Events Following Voluntary Medical Male Circumcision Surveillance System in Zvimba District, Zimbabwe, 2020

Background: The Adverse Events following Voluntary Medical Male Circumcision Surveillance System (VMMC AESS) serves to identify adverse events (AEs) for safe provision of VMMC. In 2019, Zvimba District reported two adverse events out of 542 circumcisions translating to a 0.4% AE rate against an acceptable threshold of 2% and this is suggestive of underreporting. We evaluated the system to verify existence of underreporting of AEs, assess the surveillance system attributes and evaluate data quality. Methods: A descriptive cross-sectional study was conducted using the updated Center for Disease Control (CDC) guidelines for surveillance system evaluation. We proportionately sampled VMMC client intake records and purposively selected health workers involved in the VMMC programme into the study. An interviewer-administered questionnaire was used to collect data from 14 - 30 December 2020 on knowledge of the VMMC AESS among health care workers and surveillance system attributes. We used a checklist to check for data quality. Data were analysed using Epi Info 7 statistical software. Results: Of the 31 health workers that participated in the study, 21 (68%) had fair knowledge of the surveillance system. Out of 384 records reviewed, 104 had missing data on AE monitoring days 7 and 42. Sixteen (52%) of participants regarded filling AE reporting forms as difficult and the process as time-consuming. The surveillance system was not representative as only two out of eight facilities were conducting outreaches in hard-to-reach areas. Conclusion: There was possible underreporting of adverse events as about a quarter of reviewed records had missing data on AE monitoring days and the system’s performance was threatened by poor data quality and unavailability of reporting forms. The system was rendered acceptable though unstable, not representative and not simple and the health workers were not making use of the surveillance system. We recommended retraining on the surveillance system for all health care workers involved in VMMC in Zvimba District.

Male circumcision： towards a World Health Organisation normative practice in resource limited settings

There is now grade 1 evidence that male circumcision （MC） reduces the risk of a man acquiring HIV. Modelling studies indicate MC could in the next 10 years save up to 2 million lives in those African countries with high HIV prevalence. Several African countries are now scaling up public health MC programmes. The most effective immediate public health MC programmes in Africa will need to target 18-20 years old men. In the longer term there is a need for infant circumcision programmes. In order to implement more widespread MC there is a need to make the surgical procedures as simple as possible so that safe operations can be performed by paramedical staff. The WHO Manual of Male Circumcision under local anaesthetic was written with these objectives in mind. Included in the manual are three adult techniques and four paediatric procedures. The adult procedures are the dorsal slit, the for- ceps guided and the sleeve resection methods. Paediatric methods included are the plastibell technique, the Mogen and Gomco shield method and a standard surgical dorsal slit procedure. Each method is described in a step by step manner with photographic and line drawing illustrations. In addition to the WHO manual of surgical technique a teaching course has been developed and using this course it has been possible in one week to train a circumcision surgeon who has had no or minimal previous surgical experience. Further scaling will require training of circumcision surgeons, monitoring performance, training the trainer workshops as well as advocacy at national, international and government meetings. In addition to proceeding with standardised methods work is in progress to assess novel techniques in adults such as stay on ring devices and policies are being formulated as to how to assess new devices. Also work is in progress to explore efficiencies in surgical processing by task sharing. Proper informed consent and safety remain paramount and great care has to be taken as programmes in Africa scale up. In continental China where the HIV epidemic is at a much earlier stage there may be a case for considering infant circumcision but great care will be needed to ensure that there is no harm.

Male Circumcision Does Not Reduce Sexual Function, Sensitivity or Satisfaction

We disagree with Boyle’s recent article questioning our systematic review in Journal of Sexual Medicine in 2013 (Volume 10, pages 2644-2657). In particular, he disputed the quality ranking we assigned to 7 of the 36 articles that met our inclusion criteria. These had been ranked for quality by the Scottish Intercollegiate Guidelines Network (SIGN) grading system. We found that, “the highest-quality studies suggest that medical male circumcision has no adverse effect on sexual function, sensitivity, sexual sensation or satisfaction.” This conclusion was supported by two randomized controlled trials, regarded as high-quality (1++) evidence and the majority of surveys and studies involving physiological measurements comparing uncircumcised and circumcised men. Here we explain why the 2 randomized controlled trials merit a 1++ ranking and why 4 reports that Boyle believes merit a higher ranking only meet the criteria set down for low quality (2?) evidence according to the SIGN system. We therefore stand by our conclusions. These are supported by a meta-analysis of sexual dysfunctions and by a recent detailed systematic review of the histological correlates of male sexual sensation.

Advances in DNA methylation and its role in cytoplasmic male sterility in higher plants

The impact of epigenetic modifications like DNA methylation on plant phenotypes has expanded the possibilities for crop development.DNA methylation plays a part in the regulation of both the chromatin structure and gene expression,and the enzyme involved,DNA methyltransferase,executes the methylation process within the plant genome.By regulating crucial biological pathways,epigenetic changes actively contribute to the creation of the phenotype.Therefore,epigenome editing may assist in overcoming some of the drawbacks of genome editing,which can have minor off-target consequences and merely facilitate the loss of a gene’s function.These drawbacks include gene knockout,which can have such off-target effects.This review provides examples of several molecular characteristics of DNA methylation,as well as some plant physiological processes that are impacted by these epigenetic changes in the plants.We also discuss how DNA alterations might be used to improve crops and meet the demands of sustainable and environmentally-friendly farming.

Morphological and cytological assessments reveal pollen degradation causes pollen abortion in cotton cytoplasmic male sterility lines

Background Understanding the mechanism of male sterility is crucial for producing hybrid seeds and developing sterile germplasm resources.However,only a few cytoplasmic male sterility(CMS)lines of cotton have been produced due to several challenges,like inadequate variation of agronomic traits,incomplete sterility,weak resilience of restorer lines,and difficulty in combining strong dominance.Therefore,the morphological and cytological identification of CMS in cotton will facilitate hybrid breeding.Results Two F_(2) segregating populations of cotton were constructed from cytoplasmic male sterile lines(HaA and 01A,maternal)and restorer lines(HaR and 26R,paternal).Genetic analysis of these populations revealed a segregation ratio of 3:1 for fertile to sterile plants.Phenotypic analysis indicated no significant differences in traits of flower bud development between sterile and fertile plants.However,sterile plants exhibited smaller floral organs,shortened filament lengths,and anther atrophy on the flowering day in comparison with the fertile plants.When performed scanning electron microscopy(SEM),the two F_(2) populations revealed morphological variations in the anther epidermis.Cellular analysis showed no significant differences in pollen development before pollen maturation.Interestingly,between the pollen maturation and flowering stages,the tapetum layer of sterile plants degenerated prematurely,resulting in abnormal pollen grains and gradual pollen degradation.Conclusion The results of this study suggest that fertility-restoring genes are controlled by a single dominant gene.Sterile plants exhibit distinctive floral morphology,which is characterized by stamen atrophy and abnormal anthers.Pollen abortion occurs between pollen maturity and flowering,indicating that premature tapetum degradation may be the primary cause of pollen abortion.Overall,our study provides a theoretical basis for utilizing CMS in hybrid breeding and in-depth investigation of the dominant configuration of cotton hybrid combinations,mechanisms of sterility,and the role of sterile and restorer genes.

Influential Factors of Restorer of New Cytoplasmic Male Sterile(NER) on Anther Culture

Some influential factors of anther culture were studied preliminarily by conducting anther culture of the restorers of new cytoplasmic male sterile （NER）. Several results were obtain from this experiment and they were listed as follow：① MS cultrure medium with such hormones as 2,4-D 2 mg/L,6-BA 0.5 mg/L, NAA 0.5 mg/L was the best suitable for callus induction of NER. ②The difference of induction rate was significantly different between different plant age groups. From the 110th day to 141th day,the induction rate was increased with the increase of age and the difference of induction rate reached 0.01 significant difference level. The induction rate reached the highest value in the 141th day then it declined gradually. ③The combined use of 2, 4-D and 6-BA with proper increase of 2,4-D was good for inducing callus. ④The green plantlet induction rate of NER was increased when the concentration of 6-BA increased from 2 mg/L to 4 mg/L. Adding ZT from 0.5 mg/L to 2 mg/L. 6-BA would led 2.47% increase of green plantlet olantlet induction rate.

A study on the cognitive status of human papillomavirus among adult males in Tianjin based on the health belief model

Background:To understand the health beliefs and knowledge of human papillomavirus among adult males in Tianjin.Methods:An online questionnaire survey was conducted from 18 January 2023 to 6 March 2023 using snowball sampling method.Analyze the health belief scores and human papillomavirus(HPV)and HPV vaccine knowledge scores of adult males in Tianjin,and analyze their influencing factors.Results:A total of 388 adult males in Tianjin were surveyed,with an average total score of 3.23±0.04 for their health beliefs.Among them,the average scores for perceived severity,perceived susceptibility,perceived impairment,perceived benefit,and self-efficacy were 3.41±1.05,2.37±1.20,2.96±1.00,3.51±0.90,and 3.36±1.08,respectively.Multiple linear regression analyses showed education was a factor influencing health beliefs.The average total score of knowledge is 64.09±15.62,with 277 people scoring above 60,and a pass rate of 71.4%.Through multiple linear regression analysis,education level,emotional status,whether disease testing has been done,and whether family and friends have been diagnosed with HPV positive are the main influencing factors.Conclusion:The awareness rate of HPV among adult males in Tianjin is still acceptable,but there are still misconceptions.The overall level of health beliefs is moderate,and the perceived susceptibility level is low.It is necessary to strengthen health education on HPV related knowledge for males and improve their cognitive level.

Development of Japonica Male Sterile Lines Integrating Cytoplasmic Male Sterility and Photosensitive Genic Male Sterility

Acknowledgement It has been previously established that the BT type of cytoplasmic male sterility （CMS） is induced by high temperatures, while photosensitive genic male sterility （PGMS） seed sets by low temperatures induce. In the current study, we have bred photosensitive cytoplasmic male sterility （PCMS） lines （2308SA and 2310SA） by crossing the CMS line with the PGMS japonica line with maintainer genes. The sterility of PCMS japonica was consequently controlled by two groups of male sterile genes resulting from the integration of PGMS and CMS genes. The results on plant fertility, at different sowing times, were as follows： （a） Under conditions of natural long-day photoperiod and at temperatures above 35~C, the PGMS gene regulated PCMS japonica sterility - the higher the temperature, the lower the pollen fertility. However, bagged seed sets of PCMS japonica, not exposed to high temperatures, induced the CMS seed set. （b） Exposure to long-day photoperiod and temperature conditions between 35℃ and the critical sterility inducing temperature of PGMS resulted in both PGMS and CMS gene controlled sterility of PCMS japonica, which exhibited stable characteristics. （c） When exposed to critical sterility inducing temperatures or short-day photoperiod and daily high temperatures below 32℃, the BT type of the CMS gene regulated PCMS sterility. Under these conditions, the PGMS gene rendered male sterility insusceptible to occasional cool summer days when this PCMS line, adopted for hybrid seed production, develops into panicle differentiation stage. The present study also investigated the fertility restoration, seed production and combining ability of PCMS japonica so as to optimize its use.

Evaluation of the Pharmacological Potential of Strychnos camptoneura Trunk Bark Hydroethanol Extract on Reproductive Functions in Male Guinea Pigs (Cavia porcellus) Exposed to Cypermethrin

The main objective of this study was to evaluate the pharmacological potential of the hydroethanol extract of Strychnos camptoneura trunk bark on reproductive functions in male guinea pigs exposed to cypermethrin. The results showed that administration of the hydroethanolic extract (100 and 250 mg/kg) of Strychnos camptoneura trunk bark after exposure of the animals to cypermethrin induced a highly significant (p Strychnos camptoneura trunk bark produced a highly significant (p Strychnos camptoneura trunk bark may have protective effects against cypermethrin-induced male infertility due to its androgenic, spermatogenic and antiradical properties.

CCDC181 is required for sperm flagellum biogenesis and male fertility in mice

The structural integrity of the sperm flagellum is essential for proper sperm function.Flagellar defects can result in male infertility,yet the precise mechanisms underlying this relationship are not fully understood.CCDC181,a coiled-coil domain-containing protein,is known to localize on sperm flagella and at the basal regions of motile cilia.Despite this knowledge,the specific functions of CCDC181 in flagellum biogenesis remain unclear.In this study,Ccdc181 knockout mice were generated.The absence of CCDC181 led to defective sperm head shaping and flagellum formation.Furthermore,the Ccdc181 knockout mice exhibited extremely low sperm counts,grossly aberrant sperm morphologies,markedly diminished sperm motility,and typical multiple morphological abnormalities of the flagella(MMAF).Additionally,an interaction between CCDC181 and the MMAF-related protein LRRC46 was identified,with CCDC181 regulating the localization of LRRC46 within sperm flagella.These findings suggest that CCDC181 plays a crucial role in both manchette formation and sperm flagellum biogenesis.

Epidemiological and Clinical Aspects of Male Infertility in Patients Consulting at the Urology Department of the Yaounde Central Hospital

Introduction: About 10 to 15% of couples in the world and 20 to 30% in Cameroon consult for infertility problems. Infertility is of male origin in 40% of cases. Our objective was to evaluate the epidemiological and clinical aspects of male infertility in our setting. Methods: This was a cross-sectional and descriptive study, with retrospective data collection from the files of patients received for male infertility, over 5 years and 6 months (from January 1st, 2016 to April 30th, 2021) at the Urology Department of the Yaounde Central Hospital. Phone calls were made to patients with incomplete records for completion following a verbal consent. Data reported on data collection forms were entered into a data entry form designed on CSPro software version 7.2. The database was later exported for descriptive statistics using the IBM SPSS software version 23. Qualitative variables were summarized in frequencies and percentages while quantitative variables were summarized in means with their standard deviations for normally distributed data, or medians and interquartile ranges otherwise. Results: Out of 110 patients whose records were analyzed, the median age was 37.0 years, with an interquartile range of 8.3, with 55.5% in the age group 30 to 39 years. Of these 95 (86.4%) were married, 58 (52.7%) were from the West region, 76 (69.1%) were employed. Past history was dominated by mumps 40 (36.4%), varicocele surgery 25 (22.7%), alcoholism 87 (79.1%) and smoking 15 (13.6%). A disorder of spermatogenesis was found in all our patients: 37 (33.6%) azoospermia, 27 (24.6%) asthenospermia and 26 (23.7%) oligospermia patients. Paraclinical evidence of chlamydia and gonococcal infections were found respectively in 38 (34.5%) and 14 (12.7%) patients, varicocele and testicular dystrophy respectively in 95 (86.4%) and 38 (34.5%) patients. Infertility was primary in 67 (60.9%) patients. Conclusion: Most patients with infertility were in their thirties, had risky social habits and comorbidities. An early start of health promotion activities, comorbidities prevention and early detection of spermogram abnormalities would make it possible to reduce the frequency of male infertility.