| 1. |
- Elzanaty, Saad, et al.
(författare)
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Advances in male reproductive surgery : robotic-assisted vasovasostomy
- 2013
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Ingår i: Current Urology. - : Ovid Technologies (Wolters Kluwer Health). - 1661-7649. ; 6:3, s. 7-113
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Forskningsöversikt (refereegranskat)abstract
- It is estimated that 3-6% of all vasectomised men request vasectomy reversal for different reasons. Microsurgical vasovasostomy is the gold standard technique of vasectomy reversal. However, the microsurgical technique is time-consuming and challenging to most urological surgeons. Therefore, alternative methods of vasal anastomosis have been studied including robotic-assisted vasovasostomy. This review discusses the feasibility and practice of robotic-assisted vasovasostomy. Based on the available studies robotic-assisted vasovasostomy is feasible. The reported rate of vasal patency associated with this new technique is similar to that of microsurgical vasovasostomy. There is no clear difference between the 2 approaches in terms of operating time. Robotic-assisted vasovasostomy does not appear to afford significant advantages in the era of vasectomy reversal.
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| 2. |
- Elzanaty, Saad
(författare)
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Association between age and epididymal and accessory sex gland function and their relation to sperm motility
- 2007
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Ingår i: Archives of Andrology. - : Informa UK Limited. - 0148-5016. ; 53:3, s. 149-156
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Tidskriftsartikel (refereegranskat)abstract
- Increased male age has been associated with significant reduction in pregnancy rates. This study investigated the association between age, the function of epididymal and accessory sex glands, and their relation to sperm motility. Ejaculates from 498 men assessed for infertility were analysed according to WHO [1999] guidelines. Seminal markers of epididymal (neutral alpha-glucosidase (NAG)), prostatic (prostate-specific antigen (PSA) and zinc), and seminal vesicle function (fructose) were measured. Four groups according to age were defined: G(21-30) (21-30 years), G(31-40) (31-40 years), G(41-50) (41-50 years), and G(> 50) (51-66 years). Percentage progressive motility was significantly lower in G(> 50) compared with G21-30. NAG, PSA, zinc, and fructose were significantly lower in G(> 50) compared with G21-30. In a multiple regression analysis model, NAG and PSA showed positive significant association with percentage progressive motility. The opposite trend was found regarding zinc. No association between fructose and percentage progressive motility was shown. In this cross-sectional study, declined sperm motility observed in men over 50 years of age might be due to age-dependent changes in epididymal and accessory sex gland function.
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| 3. |
- Elzanaty, Saad, et al.
(författare)
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Association between Erectile Function and Biomarkers of Subclinical Atherosclerosis : A Study Based on Middle-Aged Healthy Men from the General Population
- 2016
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Ingår i: Current Urology. - : Ovid Technologies (Wolters Kluwer Health). - 1661-7649. ; 9:3, s. 119-123
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Epidemiological studies suggest atherosclerosis as a common risk factor between cardiovascular diseases and erectile dysfunction (ED). We aimed to determine the association between erectile function and the biomarkers of subclinical atherosclerosis in 119 middle-aged healthy men from the general population. Methods: Erectile function was assessed using the International Index of Erectile Function-5 (IIEF-5). Serum levels of biomarkers of atherosclerosis: Apolipoprotein A, Apolipoprotein B, fibrinogen, and C-reactive protein (CRP) were measured. In addition, demographic data was collected. Results: The mean (SD) of age was 55 years (± 4.0). The prevalence of ED was 50%. There was a negative significant correlation between IIEF-5 and CRP levels (r = -0.20, p = 0.02), and BMI (r = -0.20, p = 0.03), respectively. No significant correlations between IIEF-5 and serum levels of Apolipoprotein A, Apolipoprotein B, and fibrinogen were found (p > 0.05). A positive significant correlation was found between BMI and fibrinogen (r = 0.20, p = 0.01), CRP (r = 0.30, p = 0.001). In a multivariate logistic regression model with IIEF-5 as the dependent variable, CRP was the only biomarker that predicted ED (odds ratio = 1.350; 95 % CI: 1.044-1.754). Conclusions: These results indicate that CRP is a biomarker of subclinical atherosclerosis associated with ED. This association seems to be linked to greater BMI among such men.
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| 4. |
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| 5. |
- Elzanaty, Saad, et al.
(författare)
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Association between PSA Levels and Biomarkers of Subclinical Systemic Inflammation in Middle-Aged Healthy Men from the General Population
- 2016
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Ingår i: Current Urology. - : Ovid Technologies (Wolters Kluwer Health). - 1661-7649. ; 9:3, s. 148-152
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: This study was aimed to determine the association between PSA levels and biomarkers of subclinical systemic inflammation based on data from 119 middle-aged healthy men from the general population. Materials and Methods: Serum levels of PSA and biomarkers of systemic inflammation (CRP and fibrinogen) were measured. Demographic data were also collected. Subjects were divided into two groups according to PSA levels; < 2 ng/ml and ≥ 2 ng/ml. Results: The mean (SD) age of men was 55 ± 4.0 years. We found a positive significant correlation between PSA and fibrinogen levels (r = 0.20, p = 0.04), and between CRP and fibrinogen levels (r = 0.60, p = 0.01). On the other hand, no significant correlation between PSA and CRP levels was found. Men with PSA values ≥ 2 ng/ml had significantly higher levels of fibrinogen as compared to those with PSA < 2 ng/ml (2.9 ng/ml vs. 2.4 ng/ml, p = 0.01). In a multivariate regression analysis model adjusted for the age of subjects, BMI, marital status, smoking, snuff, and alcohol intake with serum levels of PSA as a dependent variable, serum level of fibrinogen predicted higher PSA-values (odds ratio = 3.30, 95% CI = 1.05-10.20, p = 0.042). Conclusions: The present results indicate that serum fibrinogen is a biomarker of subclinical systemic inflammation associated with PSA elevation among middle-aged healthy men from the general population.
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| 6. |
- Elzanaty, Saad, et al.
(författare)
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Association between Serum Testosterone and PSA Levels in Middle-Aged Healthy Men from the General Population
- 2017
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Ingår i: Current Urology. - : Ovid Technologies (Wolters Kluwer Health). - 1661-7649. ; 10:1, s. 40-44
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The aim of the present study was to evaluate the association between serum testosterone and PSA levels in middle-aged healthy men from the general population. Materials and Methods: Based on 119 healthy men from the general population, total testosterone and PSA levels were measured. Demographic data regarding BMI, waist-to-hip ratio, smoking, and alcohol consumption were also collected. Men were classified into two groups according to testosterone levels; hypogonadal (testosterone ≤ 12 nmol/l), and eugonadal (testosterone > 12 nmol/l). Results: The mean age of the subjects was 55 years (range 46-60 years). No significant correlation between serum testosterone and PSA levels was found (p = 0.60). PSA levels were similar when compared between hypogonadal and eugonadal men (1.4 μg/l vs. 1.4 μg/l, p = 0.90).When using a multivariate analysis model adjusted for the age of the subjects, BMI, waist-to-hip ratio, smoking, and alcohol consumption, a positive significant association between testosterone and PSA levels was found (β = 0.03, 95 % CI = 0.003-0.062, p = 0.03). Conclusion: Only after adjusted multivariate analysis, our results indicated that testosterone was associated with PSA levels in middle-aged healthy men.
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| 7. |
- Elzanaty, Saad, et al.
(författare)
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Comparison of semen parameters in samples collected by masturbation at a clinic and at home
- 2008
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Ingår i: Fertility and Sterility. - : Elsevier BV. - 1556-5653 .- 0015-0282. ; 89:6, s. 1718-1722
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate differences in semen quality between samples collected by masturbation at a clinic and at home. DESIGN: Cross-sectional study. SETTING: Fertility center. PATIENT(S): Three hundred seventy-nine men assessed for infertility. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Semen was analyzed according to World Health Organization guidelines. Seminal markers of epididymal (neutral alpha-glucosidase), prostatic (prostate-specific antigen and zinc), and seminal vesicle (fructose) function were measured. Two patient groups were defined according to sample collection location: at a clinic (n = 273) or at home (n = 106). RESULT(S): Compared with clinic-collected semen, home-collected samples had statistically significantly higher values for sperm concentration, total sperm count, rapid progressive motility, and total count of progressive motility. Semen volume, proportion of normal sperm morphology, neutral alpha-glucosidase, prostate-specific antigen, zinc, and fructose did not differ significantly between groups. An abnormal sperm concentration (<20 x 10(6)/mL) was seen in statistically significantly fewer of the samples obtained at home (19/106, 18%) than at the clinic (81/273, 30%), and the same applied to proportions of samples with abnormal (< 25%) rapid progressive motility (68/106 [64%] and 205/273 [75%], respectively). CONCLUSION(S): The present results demonstrate superior semen quality in samples collected by masturbation at home compared with at a clinic. This should be taken into consideration in infertility investigations.
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| 8. |
- Elzanaty, Saad, et al.
(författare)
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Duration of sexual abstinence: epididymal and accessory sex gland secretions and their relationship to sperm motility.
- 2005
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Ingår i: Human Reproduction. - : Oxford University Press (OUP). - 0268-1161 .- 1460-2350. ; 20:1, s. 221-225
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The data on the association between the abstinence period and sperm motility are conflicting. METHODS: Ejaculates from 422 men assessed for infertility were analysed according to the World Health Organization (WHO) guidelines. Seminal plasma neutral alpha-glucosidase (NAG), prostate-specific antigen (PSA), zinc and fructose were measured. Three groups were defined according to the length of sexual abstinence: G(2-3) (2-3 days), G(4-5) (4-5 days) and G(6-7) (6-7 days). RESULTS: The total percentage of progressively motile spermatozoa was significantly higher in G(4-5) compared with G(2-3) and G(6-7) (medians 55 versus 47 and 42%: P = 0.039 and P < 0.001, respectively). The percentage of spermatozoa with tail defects was significantly higher in G(6-7) compared with G(2-3) and G(4-5) (medians 14 versus 10 and 10%; P = 0.011 and P = 0.002. respectively). NAG was significantly lower in G(2-3) compared with G(4-5) and G(6-7) (medians 23 versus 34 and 34mU/ejaculate; P < 0.001 and P = 0.001, respectively). The same trend was found regarding zinc (medians 6 versus 8 and 8 mumol/ejaculate; P = 0.001 and P = 0.005, respectively). CONCLUSIONS: Within the time interval recommended by the WHO (2-7 days), the length of the abstinence period is associated with sperm characteristics and should be taken into consideration when interpreting results of semen analysis.
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| 9. |
- Elzanaty, Saad, et al.
(författare)
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Effect of microsurgical subinguinal varicocele repair on chronic dull scrotal pain in men with grade II-III lesions
- 2017
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Ingår i: Current Urology. - : Ovid Technologies (Wolters Kluwer Health). - 1661-7649. ; 9:4, s. 188-191
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: We aimed to evaluate the effectiveness of microsurgical subinguinal varicocele repair in patients with grade II-III lesions and chronic dull scrotal pain. Materials and Methods: A total of 29 patients with grade II-III varicocele and chronic dull scrotal pain that had a microsurgical subinguinal varicocele repair were included in the study. They were followed-up for 6-12 months including pain assessment and scrotal examination. Results: Of the 29 patients, 28 (97%) reported complete resolution of pain with no palpable varicocele on scrotal examination. No cases of testicular atrophy or hydrocele formation were reported. Conclusion: These results indicated that microsurgical varicocele repair should be considered in patients with grade II-III lesions and chronic dull scrotal pain.
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| 10. |
- Elzanaty, Saad, et al.
(författare)
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Effects of ejaculation-to-analysis delay on levels of markers of epididymal and accessory sex gland functions and sperm motility
- 2007
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Ingår i: Journal of Andrology. - : Wiley. - 0196-3635. ; 28:6, s. 847-852
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to examine the association between the interval from ejaculation to analysis and epididymal and accessory sex gland function in relation to sperm motility. Ejaculates from 1079 men assessed for infertility were analyzed according to World Health Organization guidelines. Biochemical markers were measured in semen to assess the function of the epididymi;s (neutral alpha-glucosidase [NAG]), prostate (prostate-specific antigen [PSA] and zinc), and seminal vesicles (fructose). Three groups were defined according to time from ejaculation to analysis: G <= 30 (24 -30 minutes), G(31-60) (31-60 minutes), and G(>60) (63-80 minutes). The proportion of progressively motile sperm was significantly lower in G(>60) than in G(<= 30) (mean difference, 8.0%; 95% confidence interval [CI], 2.0%-13%) or G(31-60) (mean difference, 6.0%; 95% CI, 1.0%-12%). The proportion of rapid progressive sperm motility was significantly higher in G(<= 30) compared with G(31-60) (mean difference, 3.0%; 95% CI, 1.0%-5.0%) and 6160 (mean difference, 6.0%; 95% 3.0%; 95% 1.0%-10%). Sperm morphology and viability did not vary significantly between the groups. However, PSA levels in G(>60) were 29% and 31% significantly lower than in G(<= 30) (95% CI, 3.0%-54%) and G(31-60) (95% CI, 7.0%-58%), respectively. Moreover, men in G(>60) had 29% and 17% significantly lower zinc compared with those in G(<= 30) (95% CI, 4.0%-69%) and G(31-60) (95% CI, 4.0%-64%), respectively. Levels of NAG and fructose did not differ significantly between the groups. There were negative associations between the ejaculation-to-analysis interval and sperm motility and levels of PSA and zinc. In male infertility assessments, semen analysis should be performed within 60 minutes of ejaculation.
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| 11. |
- Elzanaty, Saad
(författare)
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Epididymal and accessory sex gland function and semen quality
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Infertility, defined as the inability to conceive after one year of unprotected regular intercourse, affects up to 15% of all couples of reproductive age. The infertility can originate from female, male or both partners. In up to 50% of the affected couples, a male factor is the cause of infertility. Semen analysis is the cornerstone of male infertility assessment and an abnormal result often triggers a referral for a specialist opinion. It has been hypothesized that epididymal and accessory sex gland dysfunction are involved in pathophysiologies affecting male fertility. However, our knowledge within this area is still very limited. The aims of this study were, therefore, 1) To examine the association between the markers of epididymal (neutral ?-glucosidase [NAG]), prostatic (prostate-specific antigen [PSA] and zinc), and seminal vesicles (fructose) function and the motility of spermatozoa; 2) To examine the association between the function of these organs and semen visco-elasticity, the length of sexual abstinence and the impact of these two factors on sperm motility in men under infertility assessment; 3) To assess the association between 5?-reductase type 2 gene (SD2R5A) polymorphisms and semen parameters in men from the general population; 4) Finally, to explore the association between exposure to persistent organohalogen pollutants (POPs) and epididymal and accessory sex gland function in a group of Swedish fishermen , fertile men from Greenland, Warsaw, (Poland) and Kharkiv, (Ukraine). Our study demonstrated a positive association between the epididymal marker NAG as well as the prostatic marker PSA and the motility of spermatozoa. Hyperfunction of seminal vesicles was associated with high visco-elasticity and lower proportion of motile spermatozoa. Compared to men delivering semen samples after 4?5 days, those having 2?3 days abstinence presented with lower NAG, zinc and proportion of motile sperm whereas those who delivered samples after 6?7 days exhibited higher percentage spermatozoa with tail defects and lower percentage motile sperm. SD2R5A polymorphism analysis showed, that subjects with the AT genotype had significantly higher sperm concentration compared to those having the AA genotype. Men bearing the V allele showed higher proportion of motile sperms compared to those being homozygotes for the L allele. We demonstrated a negative impact of POPs on the epididymal function, which might help us to understand the previously reported negative impact of POPs on sperm motility. Epididymis and accessory sex glands are potential targets for infertility assessment, therapy and for male contraception. Therefore, an insight into the function of these organs may help us to understand the mechanism behind male infertility and may lead to the development of new therapeutic and contraceptive modalities.
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| 12. |
- Elzanaty, Saad, et al.
(författare)
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Microsurgical Subinguinal Varicocele Repair of Grade II-III Lesions Associated with Improvements of Testosterone Levels
- 2017
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Ingår i: Current Urology. - : Ovid Technologies (Wolters Kluwer Health). - 1661-7649. ; 10:1, s. 45-49
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The results of reports on the association between varicocele repair and testosterone levels were conflicting. The aim of the present study is, therefore, to investigate the impact of varicocele repair on testosterone levels. Materials and Methods: The study is based on 20 men who experienced microsurgical subinguinal varicoceles repair because of chronic dull scrotal pain. All hormonal profiles available in the clinical records were reviewed. Follow-up evaluation was done at 1 and 12 months after surgery. Men were classified into groups based on the preoperative testosterone levels: euogonadal (serum levels of testosterone > 12 nmol/l), hypogonadal men (serum levels of testosterone ≤ 12 nmol/l). Results: Microsurgical subinguinal varicocele repair was associated with a significant improvements of testosterone levels at 1 and 12 months after surgery as compared to the preoperative levels (13 nmol/l vs. 18 nmol/l, p = 0.03; 13 nmol/l vs. 15 nmol/l, p = 0.01). The same trend was seen in men who were classified as being hypogonadal (7.0 nmol/l vs. 15 nmol/l, p = 0.01; 7.0 nmol/l vs. 10 nmol/l, p = 0.02). No significant improvements in testosterone levels were observed in euogonadal men (p > 0.05). Conclusion: Microsurgical subinguinal varicocele repair was associated with a significant improvements of testosterone levels in men with grade II-III lesions and low preoperative testosterone values.
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| 13. |
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| 14. |
- Elzanaty, Saad
(författare)
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Microsurgical vasovasostomy: An option for men with post vasectomy psychological distress
- 2021
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Ingår i: Discussion of Clinical Cases. - : Sciedu Press. - 2375-8473 .- 2375-8449. ; 8:4, s. 5-7
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Tidskriftsartikel (refereegranskat)abstract
- Vasectomy is a practical and straightforward approach to birth control. This paper presented a 31-year-old patient who desired torestore his fertility five years after being vasectomized. He met several obstacles. He developed severe psychological distress withsymptoms of stress, anxiety, and aggression. He underwent microsurgical vasovasostomy, and vassal patency was confirmedby return of spermatozoa in semen samples 6 and 10 weeks after surgery, and symptoms of psychological distress disappeared.Preoperative vasectomy counseling should include information about vasectomy reversal. At the most, vasectomy reversal can beconsidered in selected men with psychological problems due to vasectomy. Microsurgical training should be offered to moreurological surgeons, especially those who are interested in andrology.
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| 15. |
- Elzanaty, Saad
(författare)
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Non-obstructive azoospermia and clinical varicocele: therapeutic options.
- 2013
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Ingår i: International Urology and Nephrology. - : Springer Science and Business Media LLC. - 1573-2584 .- 0301-1623. ; 45:3, s. 669-674
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Forskningsöversikt (refereegranskat)abstract
- Ten to fifteen percent of infertile men are azoospermic, and sixty percent of these men have been classified as having non-obstructive azoospermia (NOA). NOA results from testicular failure, and one of the causes of this is the presence of varicocele. Varicocele is observed in 5-10 % of men with NOA. This review discusses the impact of varicocele repair on semen quality and pregnancy rate among men with NOA. Based on the best available evidence, varicocele repair of men with NOA is associated with an improvement in semen quality and pregnancy rate. Thus, it appears to be an effective therapeutic option for this group of men, particularly for those with a female partner who is younger than 35 years of age, before an assisted reproductive technique (ART) is initiated. Semen cryopreservation is recommended once the patient has spermatozoa in the ejaculate. In addition, varicocele repair seems to improve the rate of spermatozoa recovery in testicular sperm extraction for those who requested ART.
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| 16. |
- Elzanaty, Saad, et al.
(författare)
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Seminal plasma albumin: origin and relation to the male reproductive parameters.
- 2007
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Ingår i: Andrologia. - : Hindawi Limited. - 0303-4569 .- 1439-0272. ; 39:2, s. 60-65
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Tidskriftsartikel (refereegranskat)abstract
- We wanted to investigate the origin of seminal plasma albumin and its relation to the male reproductive parameters. Semen samples from 916 men, under infertility assessment, were analysed according to guidelines of the World Health Organization. Seminal plasma constituents, i.e. albumin, markers of the epididymal (neutral alpha-glucosidase, NAG), prostatic (prostate-specific antigen, PSA, and zinc) and seminal vesicle function (fructose), as well as levels of reproductive hormones in plasma were measured. The sperm chromatin structure assay (SCSA) was applied on 267 of the 916 samples. A negative correlation was seen for seminal albumin and plasma follicle-stimulating hormone (r = -0.1, P = 0.02) and a positive correlation for seminal albumin and serum inhibin B (r = 0.2, P = 0.004). Albumin exhibited positive correlations with the epididymal marker, NAG (r = 0.5, P < 0.001) and with the prostatic markers, PSA and zinc (r = 0.1, P = 0.001; r = 0.2, P < 0.001 respectively) as well as with age (r = 0.2, P < 0.001). A negative significant association was seen for seminal albumin and semen volume (beta = -0.60; 95% CI -0.80 to -0.30). The opposite trend was found regarding sperm concentration (beta = 0.34; 95% CI 0.30-0.40), total sperm count (beta = 0.30; 95% CI 0.20-0.40), and percentage morphologically normal spermatozoa (beta = 0.70; 95% CI 0.10-1.0). No association was found between albumin and sperm motility, SCSA parameters, or fructose, the marker of seminal vesicles. Our results suggest testicular, epididymal and prostatic origin of seminal plasma albumin, in addition to the contribution from blood. This is the first study to demonstrate an association between seminal plasma albumin and sperm morphology. Further studies are needed to elucidate the role of seminal albumin in sperm morphology.
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| 17. |
- Elzanaty, Saad, et al.
(författare)
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Significant impact of 5 alpha-reductase type 2 polymorphisms on sperm concentration and motility
- 2006
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Ingår i: International Journal of Andrology. - : Wiley. - 0105-6263 .- 1365-2605. ; 29:3, s. 414-420
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Tidskriftsartikel (refereegranskat)abstract
- Androgens, including 5 alpha-dihydrotestosterone (DHT), are known to play a role for spermatogenesis and accessory sex gland function. The enzyme 5 alpha-reductase (SRD5A) catalyses the conversion of testosterone to DHT. Our objective was to investigate whether polymorphisms in the SRD5A2 gene influence semen parameters in the general population. DNA from 182 Swedish military conscripts was examined for the A49T, V89L, and R227Q polymorphisms in the SRD5A type 2 gene. Ejaculates were analysed according to WHO guidelines. In addition, sperm motility was assessed using computer-aided sperm analysis (CASA). Seminal markers of epididymal (neutral alpha-glucosidase), prostatic (prostate specific-antigen and zinc), and seminal vesicles function (fructose) were measured. The A49TT-allele was associated with significantly higher sperm concentration compared with the wild type A-allele (mean: 102 x 10(6)/mL vs. 57 x 10(6)/mL, p = 0.02). The V89LV-genotype was correlated with significantly higher proportion progressive motile spermatozoa compared with the L-variant (mean: 55% vs. 48%, p = 0.04). The same trend was found regarding the CASA motile spermatozoa (mean: 52% vs. 41%, p = 0.02). No association between any of the polymorphisms and biochemical markers was found. SRD5A2 gene variants were associated with sperm concentration and motility, but not with epididymal and accessory sex gland markers. This effect on sperm parameters might therefore be exerted via a direct effect of DHT on spermatogenesis.
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| 18. |
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| 19. |
- Elzanaty, Saad
(författare)
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Time-to-Ejaculation and the Quality of Semen Produced by Masturbation at a Clinic.
- 2008
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Ingår i: Urology. - : Elsevier BV. - 1527-9995 .- 0090-4295. ; 71:5, s. 883-888
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To investigate the association between the length of time-to-ejaculation and semen parameters. METHODS: Ejaculates from 142 men under infertility assessment were analyzed according to the World Health Organization guidelines. Seminal neutral alpha-glucosidase (NAG), prostate-specific antigen (PSA), zinc, and fructose were also measured. Three groups according to the length of the time-to-ejaculation were defined: G(<10) (<10 minutes), G(10-15) (10 to 15 minutes), and G(>15) (greater than 15 minutes). RESULTS: Time to ejaculation showed negative significant correlation with sperm concentration (rho = -0.20, P = 0.02), total sperm count (rho = -0.20, P = 0.04), NAG (rho = -0.20, P = 0.01), and fructose (rho = -0.30, P = 0.02), respectively. No significant correlations existed among the time-to-ejaculation and age, sexual abstinence, semen volume, sperm motility, PSA, and zinc. There were negative significant associations among time-to-ejaculation and sperm concentration (beta = -3.0; P = 0.004), total sperm count (beta = -10; P = 0.02), total count of progressive motility (beta = -7.0; P = 0.02), and fructose (beta = -0.30; P = 0.02), respectively. No significant associations existed among the time-to-ejaculation and semen volume, motility grades, NAG, PSA, and zinc. G(<10) was characterized by higher sperm concentration, total sperm count, and total count of progressive motility compared with G(10-15) (mean difference = 33 x 10(6)/mL; P = 0.01), (mean difference = 96 x 10(6)/ejaculate; P = 0.50), (mean difference = 77 x 10(6)/ejaculate; P = 0.02), respectively, and G(>15) (mean difference = 50 x 10(6)/mL; P = 0.01), (mean difference = 176 x 10(6)/ejaculate; P = 0.02), (mean difference = 110 x 10(6)/ejaculate; P = 0.03), respectively. Fructose was significantly higher in G(<10) compared with G(>15) (mean difference = 5.0 mmol/L; P = 0.03). CONCLUSIONS: The time-to-ejaculation length was associated with semen parameters. These results might reflect the negative effect of acute stress during semen collection via masturbation at a clinic on semen parameters.
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| 20. |
- Elzanaty, Saad
(författare)
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Varicocele repair in non-obstructive azoospermic men: diagnostic value of testicular biopsy - A meta-analysis.
- 2014
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Ingår i: Scandinavian Journal of Urology. - : Medical Journals Sweden AB. - 2168-1813 .- 2168-1805. ; 48:6, s. 494-498
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Forskningsöversikt (refereegranskat)abstract
- Abstract Azoospermia is observed in 10-15% of infertile men and 60% of these cases are classified as having non-obstructive azoospermia (NOA). NOA results from testicular failure, and one of the causes of this is the presence of varicocele. Varicocele is found in 5-10% of men with NOA and its repair is associated with the appearance of spermatozoa in the ejaculate in 21-55% of cases. This review discusses the diagnostic value of testicular biopsy on the outcome of varicocele repair in terms of appearance of spermatozoa in the ejaculate in men with NOA and normal genetic testing. Ninety men met the inclusion criteria and were thus included in the review. The histopathological assessment of testicular biopsies revealed hypospermatogenesis in 30 out of 90 (33%), maturation arrest in 26 out of 90 (29%) and Sertoli cell only in 34 out of 90 (38%). Following varicocele repair, spermatozoa were detected in the ejaculate in 18 of 30 (60%) of men with hypospermatogenesis; 12 of 26 (46%) of those with maturation arrest; and one of 34 (3%) of those with Sertoli cell only. Regarding men with maturation arrest, varicocele repair was successful only in those men who were classified as having arrest at the spermatid stage. In conclusion, based on the best available evidence, diagnostic testicular biopsy seems to be of great value before varicocele repair in men with NOA and normal genetic testing. The best results of varicocele repair are observed in those men with hypospermatogenesis revealed by testicular biopsy or maturation arrest at the spermatid stage.
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| 21. |
- Elzanaty, Saad, et al.
(författare)
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Vasovasostomy and predictors of vasal patency: A systematic review.
- 2012
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Ingår i: Scandinavian Journal of Urology and Nephrology. - : Informa UK Limited. - 1651-2065 .- 0036-5599. ; 46:4, s. 241-246
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Tidskriftsartikel (refereegranskat)abstract
- About 3-6% of vasectomized men requested vasectomy reversal, for various reasons. Vasal patency (VP) is an important surrogate outcome of vasectomy reversal. This article reviews the impact of surgical skills, surgical approaches, intraoperative vasal fluid characteristics and the length of obstructive interval on VP. Based on the best available evidence, the rate of patency is related to the operative frequency of the surgeons, with better results obtained by surgeons who perform the operations at least 10 times annually. Microsurgical vasovasostomy is the preferred technique for durable good results. One-layer vasovasostomy and two-layer vasovasostomy seem to be equal with regard to VP. The rate of patency following vasovasostomy in the convoluted vas and vasovasostomy in the straight vas is comparable. The patency rate is high in men with clear intraoperative vasal fluid in at least one vas. VP is still high among patients with a long obstructive interval. In conclusion, surgical skills and intraoperative vasal fluid characteristics are the most important predictors of VP. Postoperative semen quality and the age of the female partner determine the chance of spontaneous conception in these couples.
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| 22. |
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| 23. |
- Erenpreiss, Juris, et al.
(författare)
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Intra-individual variation in sperm chromatin structure assay parameters in men from infertile couples: clinical implications.
- 2006
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Ingår i: Human Reproduction. - : Oxford University Press (OUP). - 0268-1161 .- 1460-2350. ; 21:2006 May 9, s. 2061-2064
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Sperm DNA integrity is an important factor in the prognosis of male fertility. In this study, we investigated intra-individual variation of sperm chromatin structure assay (SCSA) parameters in infertility patients undergoing assisted reproductive techniques (ARTs). METHODS: Retrospective study of 282 consecutive patients referred for ART [intrauterine insemination (IUI), IVF or ICSI] with repeated (between 2 and 5) SCSA measurements. RESULTS: Mean coefficient of variation (CV) of DNA Fragmentation Index (DFI) for repeated SCSA measurements was 29%. A high proportion [37%; 95% confidence interval (CI): 27%, 49%] of patients with DFI > 30% in the first test had DFI < 30% in the second test. Also, a considerable proportion (27%; 95% CI : 16%, 40%) of patients with 21-30% DFI values in the first test had DFI > 30% in the second test. CONCLUSIONS: Intra-individual variability in DFI is significant, therefore repeated SCSA measurements are recommended. The biological mechanisms behind these variations remain to be elucidated.
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| 24. |
- Erenpreiss, Juris, et al.
(författare)
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Sperm DNA damage in men from infertile couples
- 2008
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Ingår i: Asian Journal of Andrology. - : Medknow. - 1008-682X .- 1745-7262. ; 10:5, s. 786-790
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To investigate the prevalence of high levels of sperm DNA damage among men from infertile couples with both normal and abnormal standard semen parameters. Methods: A total of 350 men from infertile couples were assessed. Standard semen analysis and sperm chromatin structure assay (SCSA) were carried out. Results: Ninety-seven men (28% of the whole study group) had a DNA fragmentation index (DFI) > 20%, and 43 men (12%) had a DFI > 30%. In the group of men with abnormal semen parameters (n = 224), 35% had a DFI > 20%, and 16% had a DFI > 30%, whereas these numbers were 15% and 5%, respectively, in the group of men with normal semen parameters (n = 126). Men with low sperm motility and abnormal morphology had significantly higher odds ratios (ORs) for having a DFI > 20% (4.0 for motility and 1.9 for morphology) and DFI > 30% (6.2 for motility and 2.8 for morphology) compared with men with normal sperm motility and morphology. Conclusion: In almost one-third of unselected men from infertile couples, the DFI exceeded the level of 20% above which, according to previous studies, the in vivo fertility is reduced. A significant proportion of men with otherwise normal semen parameters also had high sperm DNA damage levels. Thus, the SCSA test could add to explaining causes of infertility in cases where semen analysis has not shown any deviation from the norm. We also recommend running the SCSA test to choose the appropriate assisted reproductive technique (ART).
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| 25. |
- Krzysztof, Stempel, et al.
(författare)
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True collision renal tumour of oncocytoma and papillary Renal cell carcinoma: Case Report and Review of the Literature
- 2020
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Ingår i: Archive of Urological Research. - : Peertechz Publications Private Limited. - 2692-4706. ; 4:1, s. 080-084
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Tidskriftsartikel (refereegranskat)abstract
- The clear cell, chromophobe and papillary carcinoma as well as oncocytoma are the most common renal tumours. While cases of hybrid renal tumours are well known, the true collision renal tumour of oncocytoma and Papillary Renal Cell Carcinoma (PRCC) is still rare. Herein, we present a case of a true collision renal tumour of an oncocytoma and a PRCC as well as a review of the literature.
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| 26. |
- Rezanezhad, Babak, et al.
(författare)
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Association between serum levels of testosterone and biomarkers of subclinical atherosclerosis
- 2018
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Ingår i: Aging Male. - : Informa UK Limited. - 1368-5538 .- 1473-0790. ; 21:3, s. 182-186
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the association between serum levels of testosterone and biomarkers of subclinical atherosclerosis based on data from 119 middle-aged men of the general population. Methods: Testosterone, Apolipoprotein A-1 (ApoA-1), Apolipoprotein B (ApoB), Apolipoprotein B-to-Apolipoprotein A-1 ratio (ApoB-to-ApoA-1), high-sensitive C-reactive protein (hsCRP), and fibrinogen levels were measured. Data were also gathered based on age, BMI, waist circumference, smoking, alcohol consumption, and family history of cardiovascular diseases. Men were classified into two groups based on testosterone levels: hypogonadal (testosterone ≤12 nmol/L) and eugonadal men (testosterone >12 nmol/L). Results: When compared to eugonadal, the hypogonadal men were significantly older (56 years vs. 55 years, p = .03), had greater BMI (28 kg/cm2 vs. 26 kg/cm2, p = .01), and higher waist circumference (104 cm vs. 100 cm, p = .01). Moreover, ApoB, ApoB-to-ApoA-1 ratio, and hsCRP were significantly higher in hypogonadal men compared to eugonadal men (1.1 g/L vs. 1.0 g/L, p = .03), (0.8 vs. 0.7, p = .03), (3.3 mg/L vs. 2.0 mg/L, p = .01), respectively. On the other hand, ApoA-1 and fibrinogen levels did not differ significantly between groups (p > .05). In an adjusted multivariate regression analysis model, only ApoB showed a significant negative association with testosterone levels (β = −0.01; 95% CI = −0.02, −1.50; p = .04). Conclusion: Testosterone levels showed an inverse relation to ApoB, a biomarker implicated in subclinical atherosclerosis. These findings support the hypothesis that low testosterone levels play a role in atherosclerosis.
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| 27. |
- Rezanezhad, Babak, et al.
(författare)
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Testosterone and coronary flow reserve: A study on Swedish men from the general population
- 2022
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Ingår i: Clinical Research and Trials. - 2059-0377. ; 8, s. 1-4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Coronary flow reserve (CFR) is an index of coronary microcirculation. No previous reports exist on the association between testosterone levels and CFR. Therefore, the aim of the present study is to explore the association between testosterone and CFR in a group of men from the general population.Material and Methods: The study consisted of 66 men with no history of cardiovascular disease (CVD). Clinical data included age, body mass index (BMI), smoking, alcohol consumption, family history of CVD, and systolic blood pressure (SBP) were collected. Serum levels of testosterone and HbA1c were measured, and ApoB-to-ApoA-1 ratio was calculated. CFR was assessed using transthoracic colour Doppler echocardiography. CFR was calculated as the ratio between mean hyperemic coronary flow velocity (CFV) to mean baseline CFV. The men were classified into 3 groups based on CFR : G1 (CFR ≤3), G2 (CFR = 3.1-4.0), and G3 (CFR >4).Results: Men in G1 had significantly lower testosterone levels compared to men in G3 (12nmol/L vs. 17nmol/L; p=0.021). On the other hand, no statistically significant differences were found between men in G1 and those in G2 (12nmol/L vs. 15nmol/L; p=0.299), as well as between men in G2 and G3 (15nmol/L vs. 17nmol/L; p=0.493). Age, BMI, smoking, alcohol consumption, family history of CVD, SBP, ApoB-to-ApoA-1 ratio, and HbA1c did not differ significantly between groups. In multivariate regression analysis adjusted for the age of subjects, BMI, smoking, alcohol consumption, family history of CVD, SBP, ApoB-to-ApoA-1 ratio, and HbA1c; a significant positive association was found between testosterone and CFR (β=0.035; 95% CI=0.011, 0.069; p=0.04).Conclusions: In men without symptomatic cardiovascular disease, there was a significant positive association between testosterone and CFR, which may indicate that testosterone levels could play a role for coronary microcirculation.
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| 28. |
- Rezanezhad, Babak, et al.
(författare)
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Testosterone Level and Risk of Diabetes: Follow-Up Study
- 2023
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Ingår i: Medical Research Archives. - 2375-1916. ; 11:9
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Tidskriftsartikel (refereegranskat)abstract
- Background: Epidemiological studies have documented an inverse relationship between testosterone levels and risk of cardiovascular disease. The present study aimed to explore the association between testosterone levels and risk of developing diabetes mellitus from 108 middle-aged men with no history of medical diseases.Methods: Data regarding the age of subjects, smoking, alcohol consumption, waist-to-hip ratio, and family history of cardiovascular disease were collected at the time of inclusion. Testosterone levels were also measured. 15 years later the medical history of the men was reviewed to record the development of medical incidents with references to diabetes mellitus. Two groups of men were identified based on testosterone levels: hypogonadal (testosterone ≤12 nmol/L) and eugonadal (testosterone >12 nmol/L).Results: In total, 10 (9.0%) out of 108 men developed diabetes during the 15-year follow-up period, of whom 6 (16%) out of 37 and 4 (6%) out of 71 were men in the hypogonadal and eugonadal cohorts respectively (p=0.08). Using Cox proportional hazards regression analysis, the adjusted risk for diabetes was significantly lower in eugonadal men compared to hypogonadal men (adjusted hazard ratio=0.236; 95% CI=0.062–0.898; P=0.03).Conclusion: Our results showed a significant increased risk of diabetes in men with low testosterone levels compared to men with normal testosterone.
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| 29. |
- Rezanezhad, Babak, et al.
(författare)
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The Association between Serum Testosterone and Risk Factors for Atherosclerosis
- 2019
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Ingår i: Current Urology. - : Ovid Technologies (Wolters Kluwer Health). - 1661-7649. ; 13:2, s. 101-106
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To study the associations between serum testosterone and risk factors for atherosclerosis in 119 men from general population. Methods: Systolic pressure, body mass index (BMI), testosterone, fasting glucose, glucose tolerance test, apolipoprotein A-1 (ApoA-1), apolipoprotein B (ApoB), and ApoB/ApoA-1 ratio were assessed. Subjects classified into hypogonadal (testosterone ≤ 12 nmol/l), and eugonadal men (testosterone > 12 nmol/l). Results: BMI (28 vs. 26 kg/m2, p = 0.01), systolic pressure (129 vs. 123 mmHg, p = 0.03), fasting glucose (5.9 vs. 5.5 mmol/l, p = 0.03), ApoB (1.1 vs. 1.0 g/l, p = 0.03), and ApoB/ApoA-1 ratio (0.8 vs. 0.7, p = 0.03) were higher in hypogonadal compared to eugonadal men, respectively. In adjusted multivariate regression analysis model, testosterone showed negative associations with BMI (β =-1.832, p = 0.030, 95% CI =-3.485-0.180), fasting glucose (β =-0.394, p = 0.011, 95% CI =-0.696-0.091), glucose tolerance test (β =-0.957, p = 0.045, 95% CI =-1.892-0.022), ApoB (β =-0.157, p = 0.017, 95% CI =-0.286-0.029), and ApoB/ApoA-1 ratio (β =-0.118, p = 0.046, 95% CI =-0.234-0.002). Conclusions: These results suggest an inverse association between testosterone levels and risk factors for atherosclerosis.
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| 30. |
- Rezanezhad Zanjani, Babak, et al.
(författare)
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Association Between Testosterone Levels and Clinical Markers of Atherosclerosis
- 2020
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Ingår i: Journal of Clinical and Medical Images. - 2640-9615. ; 4:6
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Tidskriftsartikel (refereegranskat)abstract
- 1.1. Objectives: To investigate the association between testosterone levels and parameters obtainedfrom the clinical exercise stress test from 119 middle-aged Swedish men.1.2. Material and Methods: All subjects underwent a clinical exercise stress test and data on maximalheart rate, systolic pressure, diastolic pressure; and ST-segment levels in lead augmented vector foot(lead aVF) and lead left precordial voltage 5 (lead v5) were collected. Serum testosterone levels weremeasured. Data on age, body mass index (BMI), smoking, alcohol consumption, and family historyof cardiovascular diseases (CVD) were gathered. Men were classified into two groups: hypogonadal(testosterone ≤ 12 nmol/L), and eugonadal (testosterone > 12 nmol/L).1.3. Results: We found a significant negative correlation between testosterone and maximal systolicpressure (r= -0.30, P=0.01). Hypogonadal men had significantly higher systolic pressure and moredepressed ST-segment in lead V5 compared to eugonadal men (225mmHg vs. 210mmHg; p=0.01),(-0.13mm vs. 0.27mm; p=0.04), respectively. In a multivariate regression analysis test adjusted for theage of subjects, BMI, smoking, alcohol consumption, and family history of CVD, a significant negativeassociation was found only between testosterone and maximal systolic pressure (β= -0.829, p=0.04,95% CI= -1.636, -0.022).1.4. Conclusions: Our findings of an inverse relationship between testosterone levels and parametersof clinical stress test suggest that low testosterone may be a cardiovascular risk factor.
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