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Testosterone replacement therapy and vascular thromboembolic events: a systematic review and meta-analysis

Asian Journal of Andrology 2024年第2期26卷 144-154页

作者： Rossella Cannarella Carmelo Gusmano Claudia Leanza Vincenzo Garofalo Andrea Crafa Federica Barbagallo Rosita A Condorelli Sandro La Vignera aldo e calogero Department of Clinical and experimental Medicine University of CataniaCatania 95123Italy Glickman Urological&Kidney Institute Cleveland Clinic FoundationClevelandOH44195USA

To evaluate the relationship between testosterone replacement therapy(TRT)and arterial and/or venous thrombosis in patients with pre-treatment total testosterone(TT)<12 nmol I^(-1),we performed a meta-analysis followi... 详细信息

To evaluate the relationship between testosterone replacement therapy(TRT)and arterial and/or venous thrombosis in patients with pre-treatment total testosterone(TT)e performed a meta-analysis following the Population Intervention Comparison Outcome model.Population:men with TTear mention of hypogonadism in the inclusion criteria of patients;intervention:TRT;comparison:placebo or no therapy;outcomes:arterial thrombotic events(stroke,myocardial infarction[MI],upper limbs,and lower limbs),VTe(deep vein thrombosis[DVT],portal vein thrombosis,splenic thrombosis,and pulmonary embolism),and mortality.A total of 2423 abstracts were assessed for eligibility.Twenty-four studies,including 14 randomized controlled trials(RCTs),were finally included,with a total of 4027 and 310288 hypotestosteronemic male patients,from RCTs and from observational studies,respectively.Based on RCT-derived data,TRT did not influence the risk of arterial thrombosis(odds ratio[OR]=1.27,95%confidence interval[CI]:0.47-3.43,P=0.64),stroke(OR=1.34,95%CI:0.09-18.97,P=0.83),MI(OR=0.51,95%CI:0.11-2.31,P=0.39),VTe(OR=1.42,95%CI:0.22-9.03,P=0.71),pulmonary embolism(OR=1.38,95%CI:0.27-7.04,P=0.70),and mortality(OR=0.70,95%CI:0.20-2.38,P=0.56).Meanwhile,when only observational studies are considered,a significant reduction in the risk of developing arterial thrombotic events,Ml,venous thromboembolism,and mortality was observed.The risk for DVT remains uncertain,due to the paucity of RCT-based data.TRT in men with TTe from the risk of adverse cardiovascular events.Further studies specifically assessing the risk of DVT in men on TRT are needed.

关键词： hypogonadism testosterone testosterone replacement therapy thromboembolism thrombosis TRT

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FSH dosage effect on conventional sperm parameters:a meta-analysis of randomized controlled studies

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Asian Journal of Andrology 2020年第3期22卷 309-316页

作者： Rossella Cannarella Sandro La Vignera Rosita A Condorelli Laura M Mongioi aldo e calogero Department of Clinical and experimental Medicine University of CataniaCatania 95123Italy.

Follicle-stimulating hormone(FSH)represents a therapeutic option in normogonadotropic patients with idiopathic oligozoospermia.The aim of this review was to evaluate the possible dose-and drug-dependent efficacy of FSH treatment on conventional sperm parameters.We performed a comprehensive systematic review via a meta-analysis of all available randomized controlled trials,in which FSH administration was compared with placebo or no treatment when administered to normogonadotropic patients with idiopathic oligozoospermia.Of the 971 articles that were retrieved,5 were fin ally included,in eluding a total of 372 patie nts and 294 controls.Overall,FSH treatment was effective in ameliorating the sperm concentration,total count,progressive motility,but not normal forms.On the basis of the weekly dosage,the studies were classified into those using low(175-262.5 IU per week),intermediate(350-525 IU per week),and high(700-1050 IU per week)doses.At low doses,FSH improved only sperm motility.At intermediate doses,FSH ameliorated sperm concentration and morphology.Total sperm count and progressive motility showed a trend toward the increase.At high doses,FSH increased sperm concentration,total sperm count,and progressive motility.Sperm morphology showed a trend toward the increase.Finally,both highly purified FSH(hpFSH)and recombinant human FSH(rhFSH)improved sperm concentration,total sperm count,progressive motility,but not morphology.No different efficacy was observed between these two preparations.This meta-analysis provides evidence in favor of high FSH doses.The FSH efficacy was not related to the preparation type(recombinant vs highly purified).Further studies are needed to evaluate the effectiveness of Iong-standing treatment regimes.

关键词： follicle-stimulati ng hormone male in fertility oligozoospermia sperm concen tration sperm count

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efficacy and limits of sildenafil citrate in patients with arterial erectile dysfunction： role of peripheral arterial disease and cardiovascular comorbidities

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Asian Journal of Andrology 2008年第6期10卷 847-853页

作者： enzo Vicari Mariano Malaguarnera Sandro La Vignera Fabio Calzavara Carmelo Battiato aldo e. calogero Section of endocrinology Andrology and Internal Medicine and Master in Andrological and Human Reproduction Sciences Department of Biomedical Sciences University of Catania Catania 95123 Italy Department of Senescence Urological and Neurological Sciences University of Catania Catania 95021 Italy

Aim： To evaluate whether the response to sildenafil administration in patients with arterial erectile dysfunction （eD） was related to their peak systolic velocity （PSV）, peripheral atherosclerosis, cardiovascular risk factors （RF） and/or comorbidities at low cardiovascular risk. Methods： We enrolled 97 patients with 1-2 RF and comorbidities, combined with arterial eD alone （group A, n = 27）, eD plus atherosclerotic carotid artery （group B, n = 23）, eD plus lower limb artery abnormalities （group C, n = 25）, and eD plus carotid and lower limb artery abnormalities （group D, n = 22）. Sildenafil efficacy （100 mg twice a week for 12 weeks） was also examined in patients with ≥ 3 RF, peripheral a（herosclerosis and no cardiovascular comorbidities （group e, n = 20）. Results： Median PSV was 24.1, 21.0, 19.3, 14.5 and 17.5 cm/s in groups A, B, C, D and e, respectively. Sildenafil response was higher in group A patients （77.8%）, intermediate in groups B and C （65.2% and 56%） and lowest in groups D （45.4%） and e （50%）, and the response in latter two groups was significantly lower than in the other three groups. In addition, sildenafil response was nega- tively influenced by：〉 3 RF, peripheral atherosclerosis and no systemic comorbidity, or presence of 1-2 RF associated with extended atherosclerosis and comorbidities. The number of comorbidifies was positively related to atherosclerosis localization or extension （25, 35, 38 and 47 in groups A, B, C and D, respectively）. Conclusion： Low sildenafil efficacy in patients with arterial eD was associated with extended atherosclerosis. These patients should undergo extensive ultrasonography and a full cardiovascular examination.

关键词： arterial erectile dysfunction cardiovascular comorbidities peripheral atherosclerosis sildenafil efficacy

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Persistence of ultrasound alterations after antibiotic treatment with levofloxacin in patients with male accessory gland infection

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Asian Journal of Andrology 2012年第6期14卷 879-883页

作者： Sandro La Vignera Rosita A Condorelli aldo e calogero Salvatore Bellanca Mario Salmeri enzo Vicari Section of endocrinology Andrology and Internal Medicine Department of Medical and Paediatric Sciences University of Catania Policlinico 'G. Rodolico' Catania 95123 ItalY Operative Unit of Marital Infertility Department of Medical Surgical Specialities University of Catania Policlinico 'G. Rodolico' Catania 95123 Italy Section of Microbiology Department of Biomedical Sciences University of Catania Policlinico 'G. Rodolico' Catania 95123 Italy

No studies have evaluated the ultrasound features of the male sex accessory glands in infertile patients with bacterial male accessory gland infection （MAGI） according to the microbiological outcomes of bacterial cultures （absent, partial or complete） following antibiotic therapy administration. Therefore, the aim of this study was to evaluate the ultrasound characteristics of the prostate, seminal vesicles, and epididymal tracts after treatment with levofloxacin （a common quinolone antibiotic）, in patients with infections caused by escherichia coil （a Gram-negative bacterium） according to the Naber＇s classification, which includes the following categories： eradication, eradication with superinfection, persistence and persistence with superinfection. The study was conducted in 100 patients aged 25±8 years （range： 20-40 years） with bacterial MAGI and bacterial cultures positive only for e. coil（colony forming units ≥ 106 per ml）. Retrospective analysis was conducted only on patients treated with oral levofloxacin （500 mg） administered once daily for 28 days who were recruited over the last 5 years. Following antibiotic treatment, patients with microbiological persistence or persistence with superinfection had a significantly higher percentage of ultrasound abnormalities suggestive of prostato-vesiculitis （PV）（30.2% and 36.0%, respectively） or prostato-vesiculo-epididymitis （PVe）（60.2% and 70.0%, respectively） compared with patients with microbiological eradication （PV= 10.2% and PVe=8.2%, respectively） or eradication with superinfection （PV= 18.8% and PVe=21.2%, respectively）. In conclusion, patients with microbiological persistence or persistence plus superinfection showed the highest prevalence of complicated forms of MAGI （PV and PVe）, compared with patients with microbiological eradication or eradication with superinfection.

关键词： eradication rate male accessory gland infection microbiological response semen analysis ultrasound changes

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Acquired premature ejaculation and male accessory gland infection： relevance of ultrasound examination

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Asian Journal of Andrology 2016年第5期18卷 769-772页

作者： Sandro La Vignera Rosita A Condorelli enzo Vicari Vincenzo Favilla Giuseppe Morgia aldo e calogero Section of Andrology Endocrinology and Internal Medicine Department of Clinical and Experimental Medicine Department of Urology Policlinico 'G. Rodolico'University Hospital University of Catania Catania Italy

We have previously demonstrated a high frequency of premature ejaculation （Pe） among patients with male accessory gland infection （MAGI）. The aim of this study was to evaluate the ultrasound （US） features of patients with MAGI and acquired premature ejaculation （APe） associated （MAGI-APepos）. US evaluation of 50 MAGI-APepos patients compared to 50 patients with MAGI without Pe （MAGI-Peneg） which represent the control group. The diagnosis of APe was made through the evaluation of Intravaginal ejaculation latency time （IeLT） and confirmed with the questionnaire PeDT （Premature ejaculation Diagnostic Tool）. The main outcome measure was represented by the frequency of US criteria suggestive of P （prostatitis）, V （vesiculitis）, and e （epididymitis） in MAGI-APepos and MAGI-Peneg patients. MAGI-APepos patients showed a total number of US criteria significantly higher compared to MAGI-Peneg patients. MAGI-APepos showed a higher frequency of US criteria of V and e （complicated forms of MAGI）. Finally, in MAGI-APepos group, it was found a positive relationship between the anteroposterior diameter （APD） of the caudal tract of the epididymis and the APD of the seminal vesicles, as well as between both diameters and the PeDT score. MAGI-APepos patients have a peculiar US characterization compared to MAGI-Peneg patients. According to these results, US evaluation of the epididymal and of the prostato vesicular tract should be considered in the practical clinical approach of patients with MAGI and APe. In particular, it could be a SUDDort for a possible Dathoahysiological interpretation of this clinical problem in these patients.

关键词： male accessory gland infection premature ejaculation ultrasound examination

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Transrectal ultrasonography in infertile patients with persistently elevated bacteriospermia

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Asian Journal of Andrology 2008年第5期10卷 731-740页

作者： Sandro La Vignera aldo e. calogero Alessandro Arancio Roberto Castiglione Gaetano De Grande enzo Vicari Section of endocrinology Andrology and Internal Medicine Department of Biomedical Sciences University of Catania 95123 Catania Italy Urology Unit Ospedale Umberto L 96100 Syracuse ltaly

Aim： To identify and define prostate and seminal vesicle abnormalities in patients with chronic male accessory gland infection （MAGI） who failed to respond to antibacterial treatment. Methods： We selected 67 consecutive patients with MAGI and persistently elevated bacteriospermia （≥ 10^6 colony forming units [CFU]/mL） after three antibiotic courses. Fourteen infertile patients with initial chronic microbial （≥ 10^6 CFU/mL） MAGI who responded to antibacterial treatment （〈 10^3 CFU/mL） served as a control group. All patients and controls underwent transrectal ultrasonography （TRUS） scans and semen analysis. Patients with low seminal plasma volume （〈 1.5 mL） underwent both preejaculatory and post-ejaculatory TRUS examination. Results： TRUS revealed multiple abnormalities indicative of：（i） bilaterally extended prostato-vesiculitis （group A： 52 cases, 77.6%）（nine of these patients also had micro-emphysematous prostate abscess）; and （ii） prostato-vesiculitis with unilateral or bilateral sub-obstruction of the ejaculatory ducts （group B： 15 cases, 22.4%）. Mean sperm concentration, total sperm number, ejaculate volume and pH value were significantly higher in group A than in group B. In addition, sperm forward motility and the percentage of normal forms were significantly worse than in controls, whereas leukocyte concentration was significantly higher in group A. Group B patients had all sperm parameters, but their pH values, significantly different from those of controls. Conclusion： Although antibiotic therapy is considered suitable when microbial MAGI is suspected, it is impossible to account for a poor response to antibiotics merely on the basis of conventional criteria （clinical history, physical and ejaculate signs）. Thus, TRUS may be helpful in the follow-up of these patients.

关键词： persistent bacteriospermia prostato-vesiculitis sub-obstruction of the ejaculatory ducts micro-emphysematous prostate abscess sperm parameters ultrasound features

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Next-generation sequencing:toward an increase in the diagnostic yield in patients with apparently idiopathic spermatogenic failure

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Asian Journal of Andrology 2021年第1期23卷 24-29页

作者： Rossella Cannarella Rosita A Condorelli Stefano Paolacci Federica Barbagallo Giulia Guerri Matteo Bertelli Sandro La Vignera aldo e calogero Department of Clinical and experimental Medicine University of CataniaCatania 95123Italy MAGI eUReGIO Bolzano 39100Italy

A large proportion of patients with idiopathic spermatogenic failure(SPGF;oligozoospermia or nonobstructive azoospermia[NOA])do not receive a diagnosis despite an extensive diagnostic workup.Recent evidence has shown that the etiology remains undefined in up to 75%of these patients.A number of genes involved in germ-cell proliferation,spermatocyte meiotic divisions,and spermatid development have been called into play in the pathogenesis of idiopathic oligozoospermia or NOA.However,this evidence mainly comes from case reports.Therefore,this study was undertaken to identify the molecular causes of SPGF.To accomplish this,15 genes(USP9Y,NR5A1,KLHL10,ZMYND15,PLK4,TeX15,TeX11,MeIOB,SOHLH1,HSF2,SYCP3,TAF4B,NANOS1,SYCe1,and RHOXF2)involved in idiopathic SPGF were simultaneously analyzed in a cohort of 25 patients with idiopathic oligozoospermia or NOA,accurately selected after a thorough diagnostic workup.After next-generation sequencing(NGS)analysis,we identified the presence of rare variants in the NR5A1 and TeX11 genes with a pathogenic role in 3/25(12.0%)patients.Seventeen other different variants were identified,and among them,13 have never been reported before.eleven out of 17 variants were likely pathogenic and deserve functional or segregation studies.The genes most frequently mutated were MeIOB,followed by USP9Y,KLHL10,NR5A1,and SOHLH1.No alterations were found in the SYCP3,TAF4B,NANOS1,SYCe1,or RH0XF2 genes.In conclusion,NGS technology,by screening a specific custom-made panel of genes,could help increase the diagnostic rate in patients with idiopathic oligozoospermia or NOA.

关键词： azoospermia next-generation sequencing oligozoospermia spermatogenetic failure

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Anejaculation in a patient with Charcot-Marie-Tooth

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Asian Journal of Andrology 2018年第5期20卷 529-530页

作者： Rossella Cannarella Giovanni Burgio Sandro La Vignera enzo S Vicari aldo e calogero Department of Clinical and experimental Medicine University of Catania Catania95123 Italy

Dear editor,The occurrence of delayed ejaculation or ane）aculation has been previously suggested in patients with Charcot-Marie-Tooth （CMT） syndrome.1 Despite this, such disorder is rarely investigated and may be underestimated in patients with this disease. We report the case of a 20-year-old men with CMT 1B due to the presence of a punctiform mutation in the exon 2 of the myelin protein zero （MPZ） gene （ 1 q23.3）（Ser78Leu）, complaining for life-long anejaculation. He inherited this mutation from the mother and it has also been detected in his grandmother. No other components of his family were positive at the genetic testing.

关键词： DISeASe

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SOX13 gene downregulation in peripheral blood mononuclear cells of patients with Klinefelter syndrome

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Asian Journal of Andrology 2021年第2期23卷 157-162页

作者： Rossella Cannarella Michele Salemi Rosita A Condorelli Laura Cimino Giorgio Giurato Giovanna Marchese Angela Cordella Corrado Romano Sandro La Vignera aldo e calogero Department of Clinical and experimental Medicine University of CataniaCatania 95123Italy Oasi Research Institute-IRCCS Troina(EN)94018Italy Genomix4Life Srl Department of MedicineSurgery and Dentistry“Schola Medica Salernitana”University of SalernoBaronissi(SA)84081Italy

Klinefelter syndrome(KS)is the most common sex chromosome disorder in men.It is characterized by germ cell loss and other variable clinical features,including autoimmunity.The sex-determining region of Y(SRY)-box 13(Sox13)gene is expressed in mouse spermatogonia.In addition,it has been identified as islet cell autoantigen 12(ICA12),which is involved in the pathogenesis of autoimmune diseases,including type 1 diabetes mellitus(DM)and primary biliary cirrhosis.SOX13 expression has never been investigated in patients with KS.In this age-matched,case-control study performed on ten patients with KS and ten controls,we found that SOX13 is significantly downregulated in peripheral blood mononuclear cells of patients with KS compared to controls.This finding might be consistent with the germ cell loss typical of patients with KS.However,the role of SOX13 in the pathogenesis of germ cell loss and humoral autoimmunity in patients with KS deserves to be further explored.

关键词： germ cells intellectual disability Klinefelter syndrome rare disease sex-determining region of Y-box 13(SOX13)

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迟发性性腺功能减退症与骨化二醇的关系

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Asian Journal of Andrology 2015年第2期17卷 236-238,I0008页

作者： Carlo Foresta aldo e calogero Francesco Lombardo Andrea Lenzi Alberto Ferlin Department of Medicine and Centre for Human Reproduction Pathology University of Padova Padova 35128 Italy Department of Medical and Pediatric Sciences Section of Endocrinology Andrology and Internal Medicine University of Catania Catania 95123 Italy Department of experimental Medicine Section of Medical Pathophysiology and Endocrinology Sapienza University of Rome Rome 00185 Italy

男性迟发性性腺功能减退症是指具有血清睾酮（T）水平降低和典型临床症状的综合征。而血清睾酮浓度是否总能真实反应Leydig细胞的功能目前仍不确定。轻度睾丸改变只有通过检测额外的生化标记物如黄体生成素（LH）和25．羟维生素D才能确... 详细信息

男性迟发性性腺功能减退症是指具有血清睾酮（T）水平降低和典型临床症状的综合征。而血清睾酮浓度是否总能真实反应Leydig细胞的功能目前仍不确定。轻度睾丸改变只有通过检测额外的生化标记物如黄体生成素（LH）和25．羟维生素D才能确诊。这些标记物可以帮助诊断称之为“亚临床”型的性腺功能减退（血清睾酮正常，LH升高）。性腺功能减退患者通常由于睾丸中CYP2Rt羟化酶受损而具有较低水平的25．羟维生素D。然而，目前仍无证据阐释维生素D3亦或骨化二醇是治疗此类病人的最佳选择。因此我们分析了26位具有典型性腺功能减退患者（总T[TT]〈12nmol 1^-1，LH≥8IU 1^-1）及46位亚临床型性腺功能减退患者（TT≥12nmol 1^-1，LH≥8IU 1^-1）以及低25-羟维生素D患者（〈50nmol 1^-1）。其中20名患者接受每周5000IU的维生素D3治疗，46名患者接受每周4000IU的骨化二醇治疗。治疗3个月后，患者25-羟维生素D及甲状旁腺激素升高。在两组患者中（原发型16人，亚临床型30人）补充骨化二醇可以显著提高25-羟维生素D水平并显著降低甲状旁腺激素水平，而补充维生素D3的患者，其25-羟维生素D和甲状旁腺激素水平并无明显变化。本研究首次阐述服用骨化二醇而非维生素D3，可以提高男性迟发性性腺功能减退患者25-羟维生素D水平。

关键词：胰岛素样因子3 迟发性性腺功能减退症男性性腺功能减退症睾酮维生素D

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