Endoscopic Internal Urethrotomy in the Treatment of Male Urethral Stenosis in the Urology-Andrology Department of KARA Teaching Hospital (Togo)

Introduction: Endoscopic internal urethrotomy (EIU) is a method for stricture opening using transurethral incision by direct visualisation of the urethral channel, resulting in a widening of the urinary canal with the aim of improving the quality of bladder emptying. The aim of the study was to evaluate the indication and results of EIU in the treatment of stenosis of the male urethra in the Urology-Andrology Department of Kara Teaching Hospital. Methodology: This was a cross-sectional descriptive study with retrospective data collection in the Urology-Andrology department of Kara Teaching Hospital. It involved 21 records of patients with urethral stenosis treated by endoscopic internal urethrotomy (EIU) in the said department during the period from January 2021 to September 2023. The following variables were evaluated: age, circumstance of discovery, site, length, number, etiology of the urethral stenosis and evolution of the patients. Results: The mean age of the patients was 59.2 ± 11.7 years. Infectious etiology of stenosis was predominant with 10 patients (47.6%) followed by trauma with 5 cases (23.8%). The bulbar urethra was the most frequently observed site, with 11 cases (52.4%). The length was mostly less than 2 cm in 12 patients (57.1%). Stenosis was unique in 14 patients (66.7%). The mean postoperative follow-up time was 3.2 months. The result was immediately better in 11 patients (52.4%) and it was poor in 8 patients (38.1%) who required maintenance dilation sessions.

The effects and prospects of the integration of traditional Chinese medicine and Western medicine on andrology in China

Andrology has a long history in traditional Chinese medicine （TCM） discussions concerning andropathies, and documentation of relevant therapeutic methods abound in the ancient literature on TCM. Integrated treatment combining TCM and Western medicine has seen both broad and in-depth development, with formidable status in the field of modern andrology in China. This article attempts to demonstrate the unique advantage of integrated treatment in the therapy of andropathies through a review of the ancient literature on andrology in the field of TCM and on the integrative treatment of prostatic diseases, sexual dysfunction, male infertility and late-onset hypogonadism. There is a need for the advancement of a medical theory that integrates TCM and Western medicine practices to create a new therapeutic system with standardized therapeutic and evaluative protocols for diseases involving male sexual health.

Recent advances in andrology-related stem cell research

Stem cells hold great promise for regenerative medicine because of their ability to self-renew and to differentiate into various cell types. Although embryonic stem cells （BSC） have greater differentiation potential than adult stem cells, the former is lagging in reaching clinical applications because of ethical concerns and governmental restrictions. Bone marrow stem cells （BMSC） are the best-studied adult stem cells （ASC） and have the potential to treat a wide variety of diseases, including erectile dysfunction （ED） and male infertility. More recently discovered adipose tissuederived stem cells （ADSC） are virtually identical to bone marrow stem cells in differentiation and therapeutic potential, but are easier and safer to obtain, can be harvested in larger quantities, and have the associated benefit of reducing obesity. Therefore, ADSC appear to be a better choice for future clinical applications. We have previously shown that ESC could restore the erectile function of neurogenic ED in rats, and we now have evidence that ADSC could do so as well. We are also investigating whether ADSC can differentiate into Leydig, Sertoli and male germ cells. The eventual goal is to use ADSC to treat male infertility and testosterone deficiency. （Asian JAndrol 2008 Mar; 10： 171-175）

Advancement in biochemical assays in andrology

Determination of markers of sperm function, accessory sex gland secretion and silent male genital tractinflammation is of considerable diagnostic value in the evaluation of male infertility. The introduction of biochemicaltests into the analysis of male factor has the advantage that standardized assays with a coefficient of variationcharacteristic of clinical chemistry are performed, in contrast to biological test systems with a large variability.Biochemical parameters may be used in clinical practice to evaluate the sperm fertilizing capacity (acrosin, aniline blue,ROS), to characterize male accessory sex gland secretions (fructose, α-glucosidase, PSA), and to identify men withsilent genital tract inflammation (elastase, C'3 complement component, coeruloplasmin, IgA, IgG, ROS).

Bringing epigenetics into the diagnostics of the andrology laboratory： challenges and perspectives

Recent studies have shown significant associations of aberrant DNA methylation in spermatozoa with idiopathic male infertility, increased frequency of spontaneous abortions and imprinting disorders. Thus, the analysis of DNA methylation of specific genes in spermatozoa has the potential to become a new valuable diagnostic marker in clinical andrology. This perspective article discusses the current state and value of DNA methylation analysis in the diagnostic setup of infertile men and outlines challenges and perspectives. It highlights the potential of DNA methylation in andrological diagnostics and its putative benefit in the examination of hitherto idiopathic infertile patients is described.

Penile Fracture at the Department of Urology and Andrology, University Hospital, Brazzaville

Objective: The objectives of this study, was to analyze epidemiological diagnosis, therapeutic option and evolutionary aspects. Materials and methods: This is a retrospective study regarding clinical data of nine penile fracture patients who have been admitted in the department of urology (university hospital, Brazzaville) from January 2006 to December 2018. The study parameters were: epidemiological, diagnosis, operative details, outcomes after treatment, and sexual disorders. Results: The mean age was 46.3 ± 14 years, ranged from 25 to 73 years. The etiology of penile fracture was coitus in 5 cases, masturbation in 3 cases and rolling of the penis on the bed in one case. 8 patients were managed surgically. The complications noticed in the postoperative period and during the follow-up visits were penile curvature in 2 cases, and erectyl dysfunction in 2 cases. Conclusion: The diagnosis of penile fracture remains clinic. Immediate surgical management is necessary for good functional result.

Urologic Complications after Gynaecologic and Obstetric Surgery at the Urology-Andrology Teaching Clinic of Teaching Hospital of Cotonou

Objective: To study the epidemiology and current trend in the management of urologic complications following obstetric and gynaecologic surgeries at CUUA University hospital of Cotonou. Patients and Methods: It was a retrospective study of patients referred with urologic complications following obstetric and gynaecological surgeries. The study took place at the Teaching Clinic of Urology Andrology at CNHU of Cotonou between April 1, 2008 and March 31, 2013. Results: Forty-one patients were studied. They represented 3.5% of people hospitalized at CUUA throughout the study period. The average age was 41 years swith range of 20 and 57 years. Twenty-one (51.2%) of them were married. Thirty patients (73.2%) were referred from a non-academichospital, while 7 patients (17.1%) were referred from academic hospital. Caesarean section was the primary gynecological surgery in 22 cases (53.7%) and hysterectomy in 19 cases (46.3%). Clinically, the pre- dominant symptoms were leakage of urine throughout the vagina and obstructive anuria with or without back pain. We found 31 cases of VVF, 5 cases of bilateral ligation of the ureters, 3 cases of unilateral ligation of the ureter, 1 ureteralinjury and 1 uretero-vaginal fistula. These complications were diagnosed postoperatively in 95.1% of cases. Surgeries done included VVF repair in 31 cases (75.6%), unilateral ureteral reimplantation in 4 cases (9.8%), removal of ligation of the ureters in 3 cases (7.3%), bilateral ureteral reimplantation for 2 cases (4.9%) and end-to-end anastomosisin 1 case (2.4%). The postoperative period was uneventful in 29 cases and we observed 7 cases of surgical site infection. The overall success rate was 87.8%. Conclusion: Urological complications following gynecologic surgeries managed at the urologic department of teaching hospital of Coto-nou had an even higher incidence. Early diagnosis especially during the operative procedure would save the patients’ serious complications and open surgery due to the lack of endo-urological facilities. The most important factor in prevention is good knowledge of pelvicanatomy and good knowledge of the surgical techniques of caesarean operation section and trans-abdominal hysterectomy.

Afterword to Semen Analysis in 21st Century Medicine special issue in Asian Journal of Andrology

We summarise and comment on the topics discussed by the contributors to this Special Issue. As an introduction, Ann Jequier＇s [ 1 ] generally positive assessment of the new-look manual was tempered with her res- ervations about reference values, on which other chapters dwelt at length. Aspects of laboratory technique were discussed by Charlene Brazil [2], whose offering gives a rare insight into the actual workings of andrology laboratories and highlights the need for greater involvement of laboratory directors （often clinicians） in assessing the quality of data provided.

Foreword to Semen Analysis in 21st Century Medicine special issue in Asian Journal of Andrology

Semen analysis as an integral part of infertility investigations has a surprisingly long history, emerging only slowly, from under a cloud of disrepute and occupying a solitary niche outside conventional pathology tests, until relatively recently. From origins in the 19th century when spermatozoa were only identified as present or absent in cervical mucus samples from postcoital tests, even then a practice deemed ＂... dabbling incompatible with decency and self-respect...＂ （cited in [1]）.

Clinico-Biological Profile of the Azoosperm Patient at the Urology and Andrology Department, Conakry University Hospital

Objective: Azoospermia is one of the most important causes of couple infertility. The objective of our study is to report the clinical-biological profile of the azoosperm patient to the Urology-Andrology Department of the Conakry University teaching Hospital. It aims to take stock of the diagnostic management of azoospermia at this time where the world scientific community seems to be turned towards the intracytoplasmic sperm injection in the treatment of men with severe spermiological dysfunction. Patients and Method: This was a descriptive retrospective study lasting 12 months from January 1 to December 31, 2015. It collected 151 patients out of a set of 544 follow-ups for desire to have children. Were included the patients whose files contained all the information of the clinical observation (general information, reason for consultation, evolution, history, data of the physical examination) and a paraclinical assessment consisting of the FSH level and two spermograms spaced three months, confirming the diagnosis of azoospermia. Results: The mean age was 36.4 years with extremes of 23 and 56 years old. Urogenital infections (36.4%) followed by a notion of inguinal surgery had been the main patients’ history. Primary infertility accounted for 76.8% of cases. The mean duration of infertility was 6.5 years with extremes of 2 and 19 years. Azoospermia affected 27.76% of patients who consulted for the desire to have a child. It was judged secretory in 59.6% of cases, excretory in 25.8% of cases, and undetermined in 14.6% of cases. Varicocele was the main associated abnormality (46.3%) followed by testicular hypotrophy (36.4%). Neisseria Gonorrhoeae was the most common germ in sperm culture (21.7%). Chlamydia serology was positive in 21.7% of patients. Conclusion: Azoospermia affects a non-negligible proportion of men admitted by consulting for desire to have a child in our context. Strengthening the diagnostic and therapeutic arsenal is necessary to improve the care of affected patients.

Endoscopic Internal Urethrotomy (EIU): Results of a Dynamic Study at the Urology-Andrology Department of the University Hospital Center (UHC) of Conakry

Introduction: Endoscopic internal urethrotomy (EIU) is a technique that consists of an incision of the stenosed urethra under visual control. Its indication is widespread since the first description in 1971 by Sachse. The objective was to analyze the results of EIU in the treatment of urethral stenosis (US) at the Andro-Urology Department of the UHC of Conakry. Methodology: It is a prospective descriptive study, lasting 18 months (January 2016-30 June 2017). It involved 102 patients. The variables were: age, etiology of US, type of catheter, duration of catheter wear and recurrences. After a 12-month follow-up, our results were considered good in the absence of recurrences. Results: The average age was 54.25 years with the extremes comprising between 16 and 96 years. The main reasons for medical checkup were chronic urine retention at 58.82%. Etiology infection was the most frequent with a ratio of 81.37%, while Escherichia coli was found at 51.29%. US was bulbar (71.57%), unique (67.64%) and less than 1 cm (60.78%). Surgical complication occurred with 9 patients (8.82%) with urethrorrhagia and the external genital organs infiltration in 4 cases. Results were good for 77 patients (75.49%). Stenosis post infection, long and multiple stenoses, urethral catheterization with latex catheter and urethral catheterization of more than 4 days were strongly associated with the recurrence occurrence. Conclusion: The EIU is a minimally invasive surgical technique that offers good results.

Afterword to men＇s health in Asia： special issue of Asian Journal of Andrology

As professor Tan, Guest Editor of the Special Issue on Men＇s Health in Asia, Asian Journal of Andrology, indicated in his foreword that this special issue reveals the many varied facets of men＇s health in Asia, including four papers on current status of men＇s health in different countries of Asia, four papers on men＇s sexual function, four on men＇s aging, one on prostate cancer and another four on male contraceptive, environmental impact and traditional medicine, respectively. After reading these papers carefully, we could reach the following common understanding：

Creating a ＂one-stop shop＂ for all the most interesting findings from across the field of andrology-Asian Journal of Andrology launches Research Highlights

Thumbing the pages of various scientific journals a researcher might wonder： how do I efficiently and accurately identify articles that invoke my enthusiasm while informing me of important breakthroughs across the field of andrology？ Skimming through an interesting article： how do I thoroughly and incisively comprehend the significance of the findings？ Closing the article pages： how do I integrate the conclusions derived from the findings into my own research？ Asian Journal of Andrology （AJA） would like to provide you an efficient information platform to address these questions through a brand new article type--Research Highlights.

SOLICITATION FOR PAPERS—— Asian Journal of Andrology

Dear authors, Asian Journal ofAndrology （AJA） cordially invites original papers and reviews on all areas of andrology from every part of the world and is distributed worldwide.

Life science progress and andrology development

As requested by many participants, I would like to share with you the opening remark, which I made at the Third Asia-Pacific Forum on Andrology, in conjunction with the Celebration of the Tenth Anniversary of Asian Journal of Andrology, Nanjing, China, October 10, 2009. In my opening remark, I raised three questions about the development of Andrology, as well as highlighted three major trends of current progress of life science, which might be of great help in setting up our strategy for Andrology development in the coming years.

A grand meeting： paving the future of andrology

With the warm applause of all participants, the Third Asia-Pacific Forum on Andrology （3APFA）, in conjunction with the Tenth Anniversary Celebration of Asian Journal ofAndrology （AJA） was successfully and fruitfully completed at the International Conference Hotel Nanjing, Nanjing, China on October 10-13, 2009.

Asian Journal of Andrology is advancing towards a bright future

As time quickly passes, we once again have the opportunity to wave goodbye to last year and welcome the New Year. This is also an ideal point at which to reflect on the past and envision a brighter future for Asian Journal of Andrology （AJA）.

Current Situation and Reconsideration on Study of Integrated Chinese and Western Medicine Andrology

The development of Chinese medicine and Western medicine andrology is based on different social background and academic systems,either Chinese medicine or Western medicine andrology has their limitations,therefore,integration of Chinese and Western medicine(ICWM)andrology is in a great need.After more than 30 years of development,andrology has made great achievements in the construction of specialized academic association,holding academic conferences and publication of academic monographs,and the research progress on this field is mainly in the combination of disease and syndrome,microdifferentiation of symptoms and signs and basic research development.However,the comprehensive theoretic system of ICWM andrology has not yet established,and the related studies are still on the primary stage.In the future studies,great efforts still need to be made to expand the methods for the investigation of ICWM,and make innovations in the field of andrology.

Icariin plus curcumol enhances autophagy through the mTOR pathway and promotes cathepsin B-mediated pyroptosis of prostate cancer cells

Objective:To examine the effect of icariin plus curcumol on prostate cancer cells PC3 and elucidate the underlying mechanisms.Methods:We employed the Cell Counting Kit 8 assay and colony formation assay to assess cell viability and proliferation.Autophagy expression was analyzed using monodansylcadaverine staining.Immunofluorescence and Western blot analyses were used to evaluate protein expressions related to autophagy,pyroptosis,and the mTOR pathway.Cellular damage was examined using the lactate dehydrogenase assay.Moreover,cathepsin B and NLRP3 were detected by co-immunoprecipitation.Results:Icariin plus curcumol led to a decrease in PC3 cell proliferation and an enhancement of autophagy.The levels of LC3-Ⅱ/LC3-Ⅰand beclin-1 were increased,while the levels of p62 and mTOR were decreased after treatment with icariin plus curcumol.These changes were reversed upon overexpression of mTOR.Furthermore,3-methyladenine resulted in a decrease in inflammatory cytokines,pyroptosis-related protein levels,and lactate dehydrogenase concentration,compared to the icariin plus curcumol group.Inhibiting cathepsin B reversed the regulatory effects of icariin plus curcumol.Conclusions:Icariin plus curcumol demonstrates great potential as a therapeutic agent for castration-resistant prostate cancer by enhancing autophagy via the mTOR pathway and promoting pyroptosis mediated by cathepsin B.These findings provide valuable insights into the molecular mechanisms underlying the therapeutic potential of icariin and curcumol for prostate cancer treatment.

Prospective randomized study to evaluate and compare the post-procedural sexual function in patients undergoing semi-rigid ureterorenoscopy for distal ureteric stones in three different operating room settings

Objective:To evaluate and compare the effect of semi-rigid ureterorenoscopy on post-procedural sexual function with three different operating room settings.Methods:In this prospective randomized study,consecutive sexually active patients with normal pre-operative sexual function undergoing uncomplicated semi-rigid ureterorenoscopy for distal ureteric stones were randomized into three groups,with three different operating room settings.Procedure-related anxiety and sexual function were assessed pre-operatively using Amsterdam Preoperative Anxiety and Information Scale and Brief Sexual Function Inventory(in males)and Female Sexual Function Index-6(in females),respectively.All the participants were stented following the procedure,and the stent was removed after 3 weeks.Post-procedural sexual function and general discomfort were assessed and compared between three groups at 1 week,3 weeks,and 12 weeks.The effect of surgery-related anxiety,preoperative sexual function,age,and general discomfort(including stent-related discomfort)on post-procedural sexual function were analyzed using multiple regression analysis.A p-value of less than 0.05 was considered statistically significant.Results:Totally,327 eligible patients were randomized into three groups.The group of patients who underwent the procedural with a screen separating the operating area from the patient vision,while the patient could watch the endoscopy through a separate monitor,had better post-procedural sexual function compared to those who had total vision of the operating area as well as to those whose eyes were blocked.This difference was statistically significant.This post-procedural reduction in sexual function could not be attributed to in situ stent alone.Conclusions:Our study showed that semi-rigid ureterorenoscopy can have significant negative effect on sexual function,which can be reduced with proper preoperative counseling and an ideal operating room settings.