Heavy cigarette smoking and alcohol consumption are associated with impaired sperm parameters in primary infertile men

We assessed the concomitant impact of cigarette smoking and alcohol con sumption in men presenting for primary couple's infertility.Data from 189 in fertile men were an a lyzed.Semen analysis,serum hormones,and sperm DNA fragmentation(SDF)were obtained.Smoking status was categorized as follows:current nonsmoker(-S),moderate smoker(+MS),and heavy smoker(+HS).Alcohol consumption was categorized as follows:abstainer(-D),moderate drinker(+MD),and heavy drinker(+HD).Descriptive statistics and logistic regression models were applied.Among all the participants,132(69.8%),30(15.9%),and 27(14.3%)patients were-S,+MS,and+HS,respectively.In addition,67(35.4%),77(40.7%)and 45(23.8%)men were-D,+MD and+HD,respectively.Regarding concomitant habits,52(27.5%)patients were nonsmokers and abstainers(-S/-D:Group 1),91(48.1%)had at least one recreational habit(-S/+D or+S/-D:Group 2),and 46(24.3%)were both smokers and drinkers(+S/+D:Group 3).Sperm concentration and progressive motility were lower in+HS and+HD,compared with-S and-D(all P<0.05),respectively.Similarly,both parameters were significantly lower in Group 3 than Groups 1 and 2(all P<0.05).SDF values were higher in Group 3 than Groups 1 and 2(both P<0.05).In multivariate analysis,follicle-stimulating hormone(FSH)levels and concomitant+S/+D status were independent predictors of impaired sperm concentration and progressive motility(all P<0.05).Heavy smoking and heavy drinking were associated with worse seminal parameters than moderate smoking/drinking and nonsmoking/abstaining.When concomitant,+S/+D status has an even greater detrimental effect on semen parameters.

Substances of abuse consumption among patients seeking medical help for uro-andrological purposes:a sociobehavioral survey in the real-life scenario

Substances of abuse(SoA),as well as smoking and alcohol consumption,are well known for their impact on male fertility status,erectile function,and ejaculation.We assessed SoA consumption habits in a cohort of men seeking medical attention for uro-andrological purposes.Data from 7447 men seeking medical attention for the first time for uro-andrological purposes were analyzed.A complete medical and sexual history was collected for each patient.Smoking,alcohol,and SoA consumption were investigated.Descriptive statistics was used to describe the whole cohort.The primary motivations for their evaluation were lower urinary tract symptoms(LUTS),erectile dysfunction(ED),and infertility in 1912(25.7%),2944(39.5%),and 2591(34.8%)men,respectively.Previous use of SoA was reported by 378(5.1%)men,and 190(2.6%)individuals were current users.Patients seeking medical attention for infertility were more frequently current SoA users(107;4.1%)than men with ED(66;2.2%)and LUTS(17;0.9%)(both P<0.001).Current users of SoA were younger than those with past or no SoA history(P<0.001).Current SoA users were more frequently smokers(P<0.001)and alcohol consumers(P<0.001)than those with a previous history or those who had never tried SoA.In conclusion,approximately 3%of men seeking medical attention for uro-andrological purposes were current SoA consumers.Infertile men reported a higher use of SoA than those with ED or LUTS.Current SoA users were younger and more frequently concomitant smokers and alcohol consumers compared to those who did or had never used SoA.

Testicular volume in infertile versus fertile white-European men: a case-control investigation in the real-life setting

Testicular volume(TV)is considered a good clinical marker of hormonal and spermatogenic function.Accurate reference values for TV measures in infertile and fertile men are lacking.We aimed to assess references values for TV in white-European infertile men and fertile controls.We analyzed clinical and laboratory data from 1940(95.0%)infertile men and 102(5.0%)fertile controls.Groups were matched by age using propensity score weighting.TV was assessed using a Prader orchidometer(PO).Circulating hormones and semen parameters were investigated in every male.Descriptive statistics,Spearman's correlation,and logistic regression models tested potential associations between PO-estimated TV values and clinical variables.Receiver operating characteristic(ROC)curves were used to find TV value cutoffs for oligoasthenoteratozoospermia(OAT)and nonobstructive azoospermia(NOA)status in infertile men.The median testicular volume was smaller in infertile than that of fertile men(15.0 ml vs 22.5 ml;P<0.001).TV positively correlated with total testosterone,sperm concentration,and progressive sperm motility(all P≤0.001)in infertile men.At multivariable logistic regression analysis,infertile status(P<0.001)and the presence of left varicocele(P<0.001)were associated with TV<15 ml.Testicular volume thresholds of 15 ml and 12 ml had a good predictive ability for detecting OAT and NOA status,respectively.In conclusion,infertile men have smaller testicular volume than fertile controls.TV positively correlated with total testosterone,sperm concentration,and progressive motility in infertile men,which was not the case in the age-matched fertile counterparts.

Vascular occlusion to protect against intraoperative blood loss in liver surgeries: new perspectives on a traditional technique

The correlation between decreased blood loss and improved clinical and oncological outcomes has been described in liver surgery:considering that perioperative blood transfusions are associated with a higher rate of recurrence and lower survival after resection of colorectal liver metastases and hepatocellular carcinoma,any effort to address the task of bleeding control and reduce the need for blood transfusions is of outstanding importance(1).

Sexual dysfunction and prostate cancer risk： one more piece of a complex puzzle

In an era of personalized medicine where genetic, environmental, and biometric factors are considered as a whole throughout the diagnostic and therapeutic approach to a disease, the association between several clinical factors and prostate cancer risk （PCa） has been thoroughly investigated. In the study ofZapata et al.,