Ege Can Serefoglu

• Doctor of Medicine
• Urologist at Biruni University

Introduction Disorders of ejaculation and orgasm (DEO) in men are poorly understood and can pose a substantial burden to men and their sexual partners. Objectives Under the aegis of the International Consultation on Sexual Medicine, a multinational, multidisciplinary panel of experts was convened to review the world literature and generate a conse...

Ejaculatory dysfunction is a term that describes a spectrum of debilitating diseases that impacts the quality of life of men affected. This spectrum comprises a range of symptoms and the most common subtypes encountered can be summarized as premature ejaculation (PE), delayed ejaculation (DE), anejaculation, retrograde ejaculation (RE), painful eja...

Introduction Vasectomy is a widely used, safe, effective method of permanent contraception and contributes to healthy sexuality. Aims We have conducted a 3-step observational clinical study to develop a vasectomy regret risk score and guide patients and clinicians when discussing a vasectomy. Methods A 3-step approach has been followed. First, ex...

Purpose: Non-obstructive azoospermia (NOA) is a common, but complex problem, with multiple therapeutic options and a lack of clear guidelines. Hence, there is considerable controversy and marked variation in the management of NOA. This survey evaluates contemporary global practices related to medical and surgical management for patients with NOA....

Purpose of Review Artificial Intelligence (AI) has great potential in erectile dysfunction (ED) diagnosis and treatment. This review aims to summarize AI-based clinical decision-making in ED. Recent Findings Based on the literature search, forty-seven articles related to AI and ED were analyzed and their findings were summarized. AI may help diagn...

Introduction Hard-flaccid syndrome (HFS) is a condition of male sexual dysfunction (MSD) that has become a relatively new focus in online forums and urologic conferences. It is a poorly understood syndrome characterized by chronic pain, a partially rigid penis while in a flaccid state, and erectile dysfunction. HFS primarily affects men in their se...

Purpose: Non-obstructive azoospermia (NOA) represents the persistent absence of sperm in ejaculate without obstruction, stemming from diverse disease processes. This survey explores global practices in NOA diagnosis, comparing them with guidelines and offering expert recommendations. Materials and methods: A 56-item questionnaire survey on NOA d...

Purpose: This study aimed to examine the therapeutic effects of injection of conditioned medium of adipose-derived mesenchymal stem cells (ADMSC-CM) in a surgically created varicocele model in comparison with varicocelectomy. Materials and methods: Twenty-eight male Wistar Albino rats were randomly divided into four groups: sham group, varicocel...

Purpose This study aimed to explore the impact of psychological stress on erectile dysfunction (ED) in male patients following the Gaziantep-Kahramanmaras earthquake. The investigation aimed to establish correlations between earthquake-induced stress and changes in sexual function using International Index of Erectile Function (IIEF), Patient Healt...

Introduction Lifelong premature ejaculation (LPE) is a subtype of premature ejaculation. Genetic research on LPE has primarily focused on neurotransmitters such as serotonin, dopamine, and norepinephrine, whereas LPE treatment studies have focused on drugs such as selective serotonin reuptake inhibitors. However, findings from genetic association a...

Hard-flaccid syndrome (HFS) is a poorly understood condition of male sexual dysfunction (MSD) that has more recently become a new topic of discussion in online forums and sexual medicine conferences. There has been limited research looking into HFS and consequently there are no evidence-based guidelines for its work-up and management. In order to i...

Introduction Postorgasmic Illness Syndrome (POIS) describes a debilitating collection of flu-like or allergy-like symptoms experienced post-orgasm. The disorder can be divided into primary or secondary subtypes, and even further into seven clusters. POIS is considered a rare, poorly understood condition that largely affects people with penises. Ob...

Purpose: Non-obstructive azoospermia (NOA) represents the persistent absence of sperm in ejaculate without obstruction, stemming from diverse disease processes. This survey explores global practices in NOA diagnosis, comparing them with guidelines and offering expert recommendations. Materials and Methods: A 56-item questionnaire survey on NOA diag...

Introduction POIS is a rare, but debilitating cluster of symptoms, occurring after ejaculation with unknown mechanism. Unfortunately, limited information is available on POIS diagnosis, treatment, and disease management Objective To investigate the practice patterns of sexual medicine experts towards POIS Methods Worldwide sexual medicine experts...

Introduction Hard-flaccid syndrome (HFS) is a condition of male sexual dysfunction (MSD) that has become a relatively new focus in online forums and urologic conferences. It is a poorly understood syndrome characterized by chronic pain, a partially rigid penis while in a flaccid state, and erectile dysfunction. HFS primarily affects men in their se...

Recurrence after drug cessation is the biggest drawback of medical premature ejaculation (PE) treatments. Although these treatments are demonstrated to be safe and effective, most of the PE patients are interested in a more permanent solution. Despite the fact that currently available guidelines do not recommend surgical treatment for PE, some surg...

Purpose: Sperm DNA fragmentation (SDF) has been associated with male infertility and poor outcomes of assisted reproductive technology (ART). The purpose of this study was to investigate global practices related to the management of elevated SDF in infertile men, summarize the relevant professional society recommendations, and provide expert recom...

Conditions referred to as 'male sexual dysfunctions' usually include erectile dysfunction, ejaculatory disorders and male hypogonadism. However, some less common male sexual disorders exist, which are under-recognized and under-treated, leading to considerable morbidity, with adverse effects on individuals' sexual health and relationships. Such con...

Purpose: Sperm DNA fragmentation (SDF) is a functional sperm abnormality that can impact reproductive potential, for which four assays have been described in the recently published sixth edition of the WHO laboratory manual for the examination and processing of human semen. The purpose of this study was to examine the global practices related to t...

Post-orgasmic illness syndrome (POIS) is a rare, but debilitating cluster of symptoms, occurring after ejaculation with unknown mechanism and uncertain treatment. To the best of our knowledge, this study, which is thought to be the first in the literature, is aimed to investigate the practice patterns of sexual medicine experts towards POIS. Worldw...

Purpose: The purpose of this meta-analysis is to study the impact of varicocele repair in the largest cohort of infertile males with clinical varicocele by including all available studies, with no language restrictions, comparing intra-person conventional semen parameters before and after the repair of varicoceles. Materials and methods: The met...

Artificial intelligence (AI) in medicine has gained a lot of momentum in the last decades and has been applied to various fields of medicine. Advances in computer science, medical informatics, robotics, and the need for personalized medicine have facilitated the role of AI in modern healthcare. Similarly, as in other fields, AI applications, such a...

Introduction Hard flaccid syndrome (HFS) is characterized by chronic pain in the penis and perineum and firmness or rigidity of the penis even while not erect and may have a devastating impact on patient sexual quality of life. Although this syndrome has been discussed in myriad patient forums, there is no established evidence-based definition nor...

Introduction While Premature Ejaculation (PE) is a common and disturbing sexual dysfunction in men, currently available treatment modalities have limited efficacy and low treatment adherence. In this study, we assessed perineal Transcutaneous Electrical Stimulation (TES) as a new possibility to treat (PE) Objective To assess the feasibility, safet...

Objectives: Glucagon like peptide-1 (GLP-1) is a hormone released from intestinal L-cells following nutrient consumption. It potentiates secretion of insulin from pancreatic beta-cells thus GLP-1 analogues are used for the treatment of type-2 diabetes mellitus( T2DM). This study aims to evaluate impact of GLP-1 receptor agonist liraglutide on erect...

Background While premature ejaculation (PE) is a common and disturbing sexual dysfunction in men, current available treatment modalities have limited efficacy and low treatment adherence. Aim To assess the feasibility, safety, and efficacy of the vPatch, a miniaturized on-demand perineal transcutaneous electrical stimulation device for treating PE...

Infertility affects nearly 186 million people worldwide and the male partner is the cause in about half of the cases. Meta-regression data indicate an unexplained decline in sperm concentration and total sperm count over the last four decades, with an increasing prevalence of male infertility. This suggests an urgent need to implement further basic...

Objectives To investigate alterations in depicted penis size by evaluating nude male paintings from the 15th to 21st centuries. Materials and Methods Nude‐male paintings were identified from various art history websites and analysed to determine changes in penis size over time. Two observers organised the paintings according to the century in whic...

Objectives To assess the feasibility, safety, and efficacy of a miniaturized on-demand perineal Transcutaneous Electrical Stimulation (TES) Using the vPatch device, for the treatment of premature ejaculation (PE). Methods We designed a bi-center, international, prospective, randomized, double-blind, sham-controlled, clinical study. A total of 59 l...

Purpose: Despite the significant role of varicocele in the pathogenesis of male infertility, the impact of varicocele repair (VR) on conventional semen parameters remains controversial. Only a few systematic reviews and meta-analyses (SRMAs) have evaluated the impact of VR on sperm concentration, total motility, and progressive motility, mostly usi...

Larger penis size has been associated with a sign of strength, masculinity, and social standing. Little study has examined the relationship between men’s penis size and their partners’ sexual satisfaction. The purpose of the present study was to detail and evaluate the effect of penis size on partner sexual satisfaction with a design of narrative l...

Surgical treatments for ischemic priapism (IP) include shunts or penile implants. Non-ischemic priapism (NIP) is usually the result of penile/perineal trauma causing an arterial fistula and embolisation may be required. We conducted a systematic review on behalf of the EAU Sexual and Reproductive health Guidelines panel to analyse the available evi...

Premature ejaculation (PE) is a prevalent male sexual dysfunction. Current standard treatment regimens include behavioural therapies, topical anaesthetics, dapoxetine and other selective serotonin reuptake inhibitors (SSRIs). Most of the pharmacotherapeutic options target neurotransmitters (such as serotonin and oxytocin) that have a role in the ej...

Sickle cell disease (SCD) is an inherited hemoglobin disorder characterized by the occlusion of small blood vessels by sickle-shaped red blood cells. SCD is associated with a number of complications, including ischemic priapism. While SCD accounts for at least one-third of all priapism cases, no definitive treatment strategy has been established to...

Conservative and medical treatments are considered the first step in ischemic priapism (IP) management, although there is no clear evidence regarding their efficacy. We conducted a systematic review on behalf of the EAU Guidelines panel on Sexual and Reproductive health to analyse the available evidence on the efficacy and safety of conservative an...

Measurement of blood flow velocity through the cavernosal arteries via penile color Doppler ultrasound (PDUS) is the most common objective method for the assessment of erectile function. However, in some clinical cases, this method needs to be augmented via the invasive intracavernosal pressure (ICP) measurement, which is arguably a more direct ind...

Context The European Association of Urology (EAU) has updated its guidelines on sexual and reproductive health for 2021. Objective To present a summary of the 2021 version of the EAU guidelines on sexual and reproductive health, including advances and areas of controversy in male infertility. Evidence acquisition The panel performed a comprehensi...

Peyronie’s disease treatments is changing again due the interruption of Xiapex® distrubution in Europe. There are many reasons that can be referred to this event. In this editorial we would like to shed light on the current cost items relating to treatment with collagenase clostridium histolyticum (CCH). The inaccessibility of the drug has seen bot...

Introduction Penile traction therapy (PTT) aims to non-surgically reduce curvature, enhance girth, and recover lost length. Available clinical practice guidelines however lack clear recommendations regarding their use. Aim To present a comprehensive review and recommendation regarding the available evidence to the use of PTT in Peyronie's disease...

Context: The present summary of the European Association of Urology (EAU) guidelines is based on the latest guidelines on male sexual health published in March 2021, with a last comprehensive update in January 2021. Objective: To present a summary of the 2021 version of the EAU guidelines on sexual and reproductive health. Evidence acquisition:...

Men’s Health is a urological subspecialty that is at the forefront of innovation, but little data exist evaluating the attitudes that andrologists have toward the current treatment modalities available for managing Men’s Health conditions. A survey of 37 questions asking what providers would choose as treatment for common conditions was distributed...

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Accumulating evidence has highlighted the contribution of oxidative stress and sperm DNA fragmentation (SDF) in the pathophysiology of male infertility. SDF has emerged as a novel biomarker of risk stratification for patients undergoing assisted reproductive technologies. Studies have also supported the use of testicular over ejaculated sperm at th...

Objective To systematically review the literature in order to investigate the efficacy and safety of surgical and non‐invasive penile enhancement procedures for aesthetic and therapeutic purposes. Methods A systematic search for papers investigating penile enhancement procedures was performed using the MEDLINE database. Articles published from Jan...

Hard flaccid (HF) syndrome is a complex symptom that significantly impacts a man’s sexual and social life. Since there is currently only one case series available in the literature regarding HF syndrome, it has not been recognized as a real medical condition. HF syndrome has mostly been reported in several patient forums and its exact definition, p...

Premature Ejaculation (PE) is a very common and disturbing sexual dysfunction in men. Currently available treatment modalities are associated with limited efficacy and low treatment adherence. In this prospective, single-blinded, self-controlled study, we evaluated the efficacy and safety of transcutaneous electrical stimulation (TES) for the treat...

Google Trends (GT) is a free, easily accessible search tool which can be used to analyze worldwide “big data” on the relative popularity of search terms over a specific period of time. To determine worldwide public interest in Peyronie’ disease (PD), erectile dysfunction (ED), premature ejaculation (PE) treatments, their penetrance, variation, and...

Research question Does the use of preimplantation genetic testing for aneuploidy (PGT-A) improve outcomes in couples with severe male factor infertility (SMFI)? Design : This retrospective cohort study included SMFI cases that underwent blastocyst transfer with/without PGT-A. Inclusion criteria were SMFI (azoospermia and sperm count<1 million/mL),...

Recent developments in the shockwave therapies have created a big excitement in the field of sexual medicine. Although the use of low-intensity shockwave therapy in erectile dysfunction became popular in many Men’s Health centers, its role in the treatment of Peyronie’s Disease (PD) has been a subject of debate. This chapter endeavors to perform a...

Although premature ejaculation (PE) is a common male sexual dysfunction, its pathophysiology has not been fully elucidated. Several medical problems such as erectile dysfunction, depression, anxiety, hormonal disorders and chronic prostatitis may play a role in the etiology of acquired PE. This study aims to evaluate the frequency of these etiologi...

Objectives: Although the association between 5 alpha reductase inhibitors used for the treatment of both androgenetic alopecia and benign prostatichy perplasia and their side effects is well established, the impact of dutasteride on testicular structure is not clear. To evaluate the alterations in spermatogenesis and serum FSH, LH, testosterone an...

Aim: To investigate the effect of tadalafil in rats administered with daily dutasteride. Methods: Twenty-four Sprague–Dawley male rats were allocated to three groups as control (group C), dutasteride (group D) and dutasteride plus tadalafil (group D + T). After a month of treatment, serum samples were obtained from rats to measure dihydrotestostero...

Hard flaccid (HF) is a group of symptoms that significantly affects a man’s sexual and social life. As this syndrome has only been reported in several patient forums, exact prevalence of this rare condition is unknown. Currently, no scientific literature exists of the syndrome. We, hereby, aimed to present four cases suffering from HF and compare t...

Introduction Radiofrequency (RF)-based treatment has been introduced as an esthetic alternative treatment for various medical indications without the scientific backup of a satisfactory body of evidence. Furthermore, the United States Food and Drug Administration issued a warning regarding the safety of energy-based technologies for indications suc...

Background Laser-based technologies have been commercially marketed as “wonder treatments” without a sufficient and adequate body of evidence. In addition, on July 30, 2018, the U.S. Food and Drug Administration issued a warning regarding the safety of the use of laser-based devices for the following indications: vaginal “rejuvenation” or cosmetic...

Purpose of Review Premature ejaculation (PE) is one of the most common forms of male sexual disorder. There are still different opinions and point of view regarding its definition, classification, prevalence, pathophysiology and treatment alternatives. For these reasons, we aim to recap the recently accumulated data on definition, classification, p...

Despite considerable public health initiatives in the past century, there remains a significant gender inequality in life expectancy. The Global Burden of Diseases study has highlighted that the life expectancy for men is 70.5 years, compared with 75.6 years for women. This discrepancy in mortality appears to be related to a disproportionately high...

Varicocele is defined as the dilation of the veins of the pampiniform plexus. It has been reported that at least 15% of adolescent males and more than 30% of infertile men suffer from varicocele. Although primary surgical intervention for varicocele is feasible, varicocele recurrence is not a rare complication of this procedure. The actual rates of...

Oxytocin antagonists seem to have potential as a treatment option for premature ejaculation (PE), but the parameters of their use are vague. Two recently published studies highlight the need for large-scale trials to elucidate the value of these drugs in the treatment of PE.

Introduction: Treatment options for erectile dysfunction (ED) have evolved over the last two decades, particularly after the introduction of phosphodiesterase type-5 inhibitors (PDE5Is). The path, however, has not been straightforward with issues raised regarding safety and toxicity following ED treatments. Areas covered: A literature review was co...

Premature ejaculation (PE) and erectile dysfunction (ED) are the most prevalent sexual disorders in men. ED is commonly reported among patients with PE. Although recent guidelines recommend to treat ED first in men with both PE and ED, this recommendation is not based on evidence and there are limited data about the efficacy and safety of dapoxetin...

Introduction: Medical treatment of Peyronie's disease (PD) in terms of intralesional therapy is still a matter of debate. Aim: To compare the efficacy of different classes of intralesional therapy with a network meta-analysis (NMA) method. Methods: The search was conducted using documents published in PubMed, Scopus, and Web of Science databas...

Introduction and objectives: Although nocturnal emission (NE) is an integral part of normal sexual function of males, little information has been documented in the literature. We aimed to assess masturbation habits and frequency of NE among virgin male religious Muslim teenagers. Materials and methods: A questionnaire was administered to student...

Objective: Paroxetine is a commonly prescribed SSRI that can impair erectile function in animal models via inhibition of nitric oxide synthase (NOS). Tadalafil potentiates nitric oxide (NO)-mediated responses in isolated trabecular smooth muscle and penile erection. The purpose of this study was to evaluate the impact of co-administering tadalafil...

IJIR: Your Sexual Medicine Journalhttps://doi.org/10.1038/s41443-018-0077-8REVIEW ARTICLENeurobiology of male sexual dysfunctions in psychiatric disorders:the cases of depression, anxiety, mania and schizophreniaJosé Nuno Trovão1●Ege Can Serefoglu2Received: 5 August 2018 / Revised: 16 August 2018 / Accepted: 3 September 2018© Springer Nature Limite...