Patients with congenital unilateral absence of the vas deferens(CUAVD)manifest diverse symptoms from normospermia to azoospermia.Treatment for CUAVD patients with obstructive azoospermia(OA)is complicated,and there is...Patients with congenital unilateral absence of the vas deferens(CUAVD)manifest diverse symptoms from normospermia to azoospermia.Treatment for CUAVD patients with obstructive azoospermia(OA)is complicated,and there is a lack of relevant reports.In this study,we describe the clinical features and evaluate the treatments and outcomes of CUAVD patients with OA.From December 2015 to December 2020,33 patients were diagnosed as CUAVD with OA in Shanghai General Hospital(Shanghai,China).Patient information,ultrasound findings,semen analysis,hormone profiles,and treatment information were collected,and the clinical outcomes were evaluated.Of 33 patients,29 patients were retrospectively analyzed.Vasoepididymostomy(VE)or cross VE was performed in 12 patients,the patency rate was 41.7%(5/12),and natural pregnancy was achieved in one of the patients.The other 17 patients underwent testicular sperm extraction as the distal vas deferens(contralateral side)was obstructed.These findings showed that VE or cross VE remains an alternative treatment for CUAVD patients with OA,even with a relatively low rate of patency and natural pregnancy.展开更多
Structural alterations in fibroelastic compone nts of the penile corpus caver no usum(CC)may impair its compliance,resulting in venous leakage and erectile dysfunction(ED).Our study evaluated the effectiveness of noni...Structural alterations in fibroelastic compone nts of the penile corpus caver no usum(CC)may impair its compliance,resulting in venous leakage and erectile dysfunction(ED).Our study evaluated the effectiveness of noninvasive two-dimensional shear-wave elastography(2-D SWE)in quantifying penile CC lesions in rabbits with hyperlipidemia-induced ED.A total of 12 New Zealand white rabbits were randomly divided into two groups.Six were fed a high-cholesterol diet containing 2%cholesterol and 8.5%lard for 10 weeks and the other six were fed normal diet as controls.We measured the shear-wave elastic quantitative(SWQ)value of penile CC by 2-D SWE.Erectile function was inv estigated by intracavernous injecti on of pa pa ver i ne,and immunohistochemical(IHC)stain inga nd the wester n blot analysis to determine the penile CC lesions.After 10 weeks,the SWQ values obtained from penile CC were remarkably higher in the high-cholesterol-fed compared with the control group,and the AICP(ICP plateau minus ICP baseline)/MAP(ICP:intracavernous pressure,MAP:mean arterial pressure)was markedly decreased.The IHC staining and western blot revealed extracellular matrix(ECM)accumulation in penile cavernous tissues,and the smooth muscle cell(SMC)phenotypic transition was affected,as indicated by reduced alpha-smooth muscle actin and calponinexpression and increased phospho-myosin light chain?。(p-MLC20)/MLC20 and osteopontin expression.Hyperlipidemia resulted in ECM accumulation accompanied with SMC phenotypic transition in penile CC and impaired the erectile function eventually.These might,in turn,lead to variations in the SWQ values.It suggests that 2-D SWE may be a novel,noninvasive and effective approach that distinguishes penile CC lesions secondary to hyperlipidemia from normal.展开更多
Erectile dysfunctio n attributable to testosterone deficiency is less comm on in young males,and the effect of estradiol on erectile function in eug on adal young males is un clear.We an a lyzed data from 195 male par...Erectile dysfunctio n attributable to testosterone deficiency is less comm on in young males,and the effect of estradiol on erectile function in eug on adal young males is un clear.We an a lyzed data from 195 male participa nts,including 143 eug on adal patients with erectile dysfunction and 52 healthy men.To distinguish psychogenic and organic erectile dysfunction,penile rigidity was measured using the nocturnal penile tumescenee rigidity test.Serum levels of sexual hormones were quantified by electrochemiluminescence,and penile vascular status was assessed by penile color Doppler ultrasound.Both serum estradiol levels and the ratio of estradiol to testosterone were higher in patients with organic erectile dysfunction than in patients with psychogenic erectile dysfunction or healthy controls.Organic erectile dysfunction was negatively associated with estradiol levels and the ratio of estradiol to testosterone,and estradiol was the only sign ifica nt risk factor for orga nic erectile dysf un ction(odds ratio:1.094;95%con fide nee interval:1.042-1.149,P=0.000).Moreover,serum estradiol levels were negatively correlated with penile rigidity.Serum estradiol levels were higher and penile rigidity was lower in patients with venous erectile dysfunction than in patients with nonvascular erectile dysf unction.We con elude that elevated serum estradiol levels may impair erectile function and may be involved in the pathoge nesis of organic erectile dysfunction in eugonadal young men.展开更多
基金supported by grants from the Shanghai Science and Technology Innovation Action Plan Project (20Y11907600)National Natural Science Foundation of China (82001530)+1 种基金Shanghai Key Laboratory of Molecular Andrology (SLMA-014)Strategic Priority Research Program of the Chinese Academy of Sciences (XDA16020701).
文摘Patients with congenital unilateral absence of the vas deferens(CUAVD)manifest diverse symptoms from normospermia to azoospermia.Treatment for CUAVD patients with obstructive azoospermia(OA)is complicated,and there is a lack of relevant reports.In this study,we describe the clinical features and evaluate the treatments and outcomes of CUAVD patients with OA.From December 2015 to December 2020,33 patients were diagnosed as CUAVD with OA in Shanghai General Hospital(Shanghai,China).Patient information,ultrasound findings,semen analysis,hormone profiles,and treatment information were collected,and the clinical outcomes were evaluated.Of 33 patients,29 patients were retrospectively analyzed.Vasoepididymostomy(VE)or cross VE was performed in 12 patients,the patency rate was 41.7%(5/12),and natural pregnancy was achieved in one of the patients.The other 17 patients underwent testicular sperm extraction as the distal vas deferens(contralateral side)was obstructed.These findings showed that VE or cross VE remains an alternative treatment for CUAVD patients with OA,even with a relatively low rate of patency and natural pregnancy.
基金the National Natural Science Foundation of China(Grant No.81401195)Nature Science Foundation of Shanghai(Grant No.17ZR1422400).
文摘Structural alterations in fibroelastic compone nts of the penile corpus caver no usum(CC)may impair its compliance,resulting in venous leakage and erectile dysfunction(ED).Our study evaluated the effectiveness of noninvasive two-dimensional shear-wave elastography(2-D SWE)in quantifying penile CC lesions in rabbits with hyperlipidemia-induced ED.A total of 12 New Zealand white rabbits were randomly divided into two groups.Six were fed a high-cholesterol diet containing 2%cholesterol and 8.5%lard for 10 weeks and the other six were fed normal diet as controls.We measured the shear-wave elastic quantitative(SWQ)value of penile CC by 2-D SWE.Erectile function was inv estigated by intracavernous injecti on of pa pa ver i ne,and immunohistochemical(IHC)stain inga nd the wester n blot analysis to determine the penile CC lesions.After 10 weeks,the SWQ values obtained from penile CC were remarkably higher in the high-cholesterol-fed compared with the control group,and the AICP(ICP plateau minus ICP baseline)/MAP(ICP:intracavernous pressure,MAP:mean arterial pressure)was markedly decreased.The IHC staining and western blot revealed extracellular matrix(ECM)accumulation in penile cavernous tissues,and the smooth muscle cell(SMC)phenotypic transition was affected,as indicated by reduced alpha-smooth muscle actin and calponinexpression and increased phospho-myosin light chain?。(p-MLC20)/MLC20 and osteopontin expression.Hyperlipidemia resulted in ECM accumulation accompanied with SMC phenotypic transition in penile CC and impaired the erectile function eventually.These might,in turn,lead to variations in the SWQ values.It suggests that 2-D SWE may be a novel,noninvasive and effective approach that distinguishes penile CC lesions secondary to hyperlipidemia from normal.
基金This work was supported by grants from the National Key Research and Development Program(No.2017YFC1002003)the National Science Foundation for Young Scientists of China(No.81701428).
文摘Erectile dysfunctio n attributable to testosterone deficiency is less comm on in young males,and the effect of estradiol on erectile function in eug on adal young males is un clear.We an a lyzed data from 195 male participa nts,including 143 eug on adal patients with erectile dysfunction and 52 healthy men.To distinguish psychogenic and organic erectile dysfunction,penile rigidity was measured using the nocturnal penile tumescenee rigidity test.Serum levels of sexual hormones were quantified by electrochemiluminescence,and penile vascular status was assessed by penile color Doppler ultrasound.Both serum estradiol levels and the ratio of estradiol to testosterone were higher in patients with organic erectile dysfunction than in patients with psychogenic erectile dysfunction or healthy controls.Organic erectile dysfunction was negatively associated with estradiol levels and the ratio of estradiol to testosterone,and estradiol was the only sign ifica nt risk factor for orga nic erectile dysf un ction(odds ratio:1.094;95%con fide nee interval:1.042-1.149,P=0.000).Moreover,serum estradiol levels were negatively correlated with penile rigidity.Serum estradiol levels were higher and penile rigidity was lower in patients with venous erectile dysfunction than in patients with nonvascular erectile dysf unction.We con elude that elevated serum estradiol levels may impair erectile function and may be involved in the pathoge nesis of organic erectile dysfunction in eugonadal young men.
