Eric Chung

• MBBS, FRACS (Urol)
• Professor at The University of Queensland

Objective To contextualise the national population‐based temporal surgical trends in the management of benign prostatic hyperplasia (BPH) in Australia. Methods Google Trends (GT) was used to analyse the level of patients' online interest in various surgical options for the treatment of BPH. Analysis of variance was performed and the average rates...

Purpose: This study investigated 1) the frequency of quotation errors in multi-authored medical manuscripts in andrology, 2) analyzed common types of quotation errors and the methods used to rectify them, and 3) evaluated their impact on manuscript accuracy, credibility, and research conclusions. Materials and methods: Twelve manuscripts written...

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: There is increased interest in regenerative therapies (RTs) to treat erectile dysfunction (ED). However, the need for society's guidelines has led to varied practices. This study aims to investigate current global practices, address the heterogeneity in treatment protocols and evaluations, and establish expert recommendations in clinical...

Male factor infertility is a multifaceted problem that affects approximately 50% of couples suffering from infertility. Causes of male infertility include endocrine disturbances, gonadotoxins, genetic abnormalities, varicocele, malignancies, infections, congenital or acquired urogenital abnormalities, iatrogenic factors, immunological factors, and...

Purpose: The objective of this manuscript is to assess the effect of varicocele repair (VR) in patients with clinical varicoceles on serum total testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and inhibin B serum levels. Materials and methods: The study was performed in compliance with the Meta-Analysis and Systematic...

Vasectomy is a reliable male contraceptive method with a success rate exceeding 98%. Despite its efficacy, vasectomy is not foolproof, with potential early and late failures requiring careful postoperative monitoring via post-vasectomy semen analysis (PVSA). Published guidelines emphasize the necessity of conducting PVSA to ensure clinical sterilit...

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...

Background: Treatment for prostate cancer (PC) is associated with adverse effects, especially in patients receiving androgen deprivation therapy (ADT). The Australian Government, non-governmental organisations and pharmaceutical companies responsible for marketing ADT have initiated and sponsored various strategic support programs for patients dia...

Purpose: Surgical sperm retrieval (SSR) is used to extract spermatozoa for use with intracytoplasmic sperm injection in men with obstructive and non-obstructive azoospermia (NOA). The procedure may lead to segmental devascularization, postoperative fibrosis, and atrophy with a subsequent decrease in testosterone. The aim of the study is to investi...

Semen analysis remains the cornerstone of male infertility evaluation. The WHO “semen manual” is developed with the aim to standardize the procedures for the examination of human semen and provide guidance in the diagnosis and management of reproductive function in men. The sixth edition WHO manual functions both as an aid as well as a foundation f...

Purpose: This study aimed to examine current global practices in regenerative therapy (RT) for erectile dysfunction (ED) and to establish expert recommendations for its use, addressing the current lack of solid evidence and standardized guidelines.Materials and Methods: Materials and Methods: A 39-question survey was developed by senior Global Andr...

Summary Background Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injur...

Background Accurate assessments of current and future fertility-including overall trends and changing population age structures across countries and regions-are essential to help plan for the profound social, economic, environmental, and geopolitical challenges that these changes will bring. Estimates and projections of fertility are necessary to i...

This appendix provides detailed information on the methods for the paper “Global fertility in 204 countries and territories, 1950–2021 with forecasts to 2100: a comprehensive demographic analysis for the Global Burden of Disease Study 2021”

Background Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensiv...

Summary Background Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injur...

Background Recurrent urinary tract infections (rUTIs) can be debilitating for patients and pose an increasing challenge in the primary care setting. An efficient approach enables timely access and effective care for patients. Recent research and pharmaceutical developments have provided new avenues for treating this common condition.

Purpose of Review This paper evaluates the current evidence on the role of urodynamics in prostatectomy incontinence (PPI) and should male sling (MS) or artificial urinary sphincter (AUS) surgery be performed before or after patients receiving radiation therapy in terms of continence outcomes. Recent Findings The prevalence of PPI is more common i...

Background Detailed, comprehensive, and timely reporting on population health by underlying causes of disability and premature death is crucial to understanding and responding to complex patterns of disease and injury burden over time and across age groups, sexes, and locations. The availability of disease burden estimates can promote evidence-base...

Objective To assess the re‐intervention rates of new surgical benign prostatic hyperplasia (BPH) interventions, as the clinical durability of new surgical interventions for BPH is not widely known. Methods A critical review of new surgical BPH therapies namely ‘UroLift®’, ‘Aquablation’, ‘Rezum’, ‘prostatic artery embolisation (PAE)’ and ‘temporary...

Background Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important follow...

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...

Background Accurate assessments of current and future fertility-including overall trends and changing population age structures across countries and regions-are essential to help plan for the profound social, economic, environmental, and geopolitical challenges that these changes will bring. Estimates and projections of fertility are necessary to i...

Background Disorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditio...

Background Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of D...

Introduction Understanding and addressing sexual dysfunction is of paramount importance to enhance the overall well-being and quality of life of individuals worldwide. While significant progress has been made in the field of sexual medicine, variability in practice patterns among healthcare professionals remains a potential barrier to optimal patie...

Purpose: Varicocele has been associated with high seminal oxidative stress (OS), impaired semen quality, and reduced male fertility potential. However, the exact mechanism(s) underlying the development of varicocele-mediated infertility and the cause-effect relationship between varicocele and testicular dysfunction are not fully understood. The ai...

Introduction Understanding and addressing sexual dysfunction is of paramount importance to enhance the overall well-being and quality of life of individuals worldwide. While significant progress has been made in the field of sexual medicine, variability in practice patterns among healthcare professionals remains a potential barrier to optimal patie...

Background and Objective Basic semen analysis is the first step in the evaluation of male infertility. It includes an assessment of sperm morphology which is believed to reflect on overall spermatogenesis and sperm function. Teratozoospermia, defined as abnormal sperm morphology, is frequently present in association with severe oligoasthenozoosperm...

There have been many significant scientific advances in the diagnostics and treatment modalities in the field of male infertility in recent decades. Examples of these include assisted reproductive technologies, sperm selection techniques for intracytoplasmic sperm injection, surgical procedures for sperm retrieval, and novel tests of sperm function...

Background Semen analysis is the cornerstone for male fertility evaluation. In 2021, the World Health Organization (WHO) released its 6th edition of semen analysis manual. Methods We highlight the main changes in the latest 6th edition of the WHO manual of semen analysis and their possible interpretations. Results The manual is highly comprehensi...

The COVID‐19 pandemic led to a major disruption to health services across the world. The aim of this population‐based study was to assess the downstream effects of the pandemic on diagnostic tests and treatment activities related to prostate cancer (PC). The Australian Government Department of Health Medicare Benefits Schedule and the Pharmaceutica...

Purpose: Prostate cancer (PC) is more common in the older population and the use of hormonal therapy in PC can increase medical frailty and cognitive decline. This narrative review examines the impact of androgen deprivation therapies (ADTs) and next-generational hormonal therapies (NGHT) on cognitive function outcomes amongst patients with hormon...

For patients with large calcified tunical plaque or severe corporal fibrosis which are likely to have a pronounced and persistent residual curvature which may not be correct by penile prosthesis implantation alone, other adjunctive manoeuvres such as penile plication and/or plaque incision with grafting may be necessary. The sequence between penile...

Male infertility (MI) and male sexual dysfunction (MSD) can often coexist together due to various interplay factors such as psychosexual, sociocultural and relationship dynamics. The presence of each form of MSD can adversely impact male reproduction and treatment strategies will need to be individualized based on patients' factors, local expertise...

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...

Objectives To characterise cases of spontaneous rupture of the urinary bladder in the context of bladder cancer. Methods A systematic review was performed to characterise cases of spontaneous bladder rupture in patients with bladder cancer. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) system was utilised, with da...

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...

The Rigicon ContiClassic® is a new sphincteric device designed to treat male stress urinary incontinence. This study evaluates the surgical outcomes and safety profile of the first 116 patients who received the implant between September 2021 and April 2022. Data were collected from patient information forms completed at the time of the implant and...

Synthetic male sling (MS) is considered an effective surgical treatment to restore male stress urinary incontinence. The modern MS can be categorised into adjustable or non-adjustable types, while the surgical techniques can be divided into retropubic or transobturator approaches. This narrative review paper evaluates the contemporary MS devices in...

The malleable penile implant is often considered an inferior device to the three-piece inflatable penile prosthesis implant. Nonetheless, the malleable prosthesis has its unique advantages such as lower cost, easier to perform and fewer mechanical complications than inflatable prostheses. Furthermore, its role can be extended to patients with issue...

Purpose Sperm DNA fragmentation (SDF) testing was recently added to the sixth edition of the World Health Organization laboratory manual for the examination and processing of human semen. Many conditions and risk factors have been associated with elevated SDF; therefore, it is important to identify the population of infertile men who might benefit...

Background: At present, the only definitive treatment for adult phimosis is circumcision, which is a surgical removal of the prepuce. Novoglan is a novel device that could offer patients with phimosis an alternative to surgery. It is based on application of custom-moulded balloons for gradual skin remodelling and prepuce dilatation. This open-labe...

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 Management of malfunctioning inflatable penile prostheses (IPPs) is varied, with some patients undergoing complete exchange of the entire device and others undergoing exchange of non-functioning components only. The impact of partial component exchange versus complete device exchange on infectious and non-infectious complications is un...

Introduction A new three-piece inflatable penile prosthesis was introduced in 2019. The Rigicon Infla10® has been implanted in 26 centers by 103 physicians. Clinical investigation for FDA approval in United States will begin in late 2022. Objective We report initial survival from explantation and revision rates for infection, mechanical failure an...

We aimed to understand the risks and benefits of post-inflatable penile prosthesis (IPP) implantation drainage and optimal duration. Our patients were divided into 3 groups: Group 1 (n = 114) had no drain placed, Group 2 had a drain placed for 24 h (n = 114) and Group 3 had a drain placed for 72 h (n = 117). Postoperative scrotal hematoma and prost...

Objectives: To collate available data via systematic review considering aetiology, presentation and treatment of Uro-Symphyseal Fistula (USF) in order to inform a contemporary management framework. Materials and methods: A systematic review was performed according to the Cochrane Handbook and registered in PROSPERO (CRD42021232954). MEDLINE and...

Introduction Penile reconstructive and prosthetic surgery remains a highly specialized field where potential complications can be devastating, and unrealistic patient expectations can often be difficult to manage. Furthermore, surgical practice can vary depending on locoregional expertise and sociocultural factors. Methods The Asia Pacific Society...

Objective To analyse data from patient information forms (PIFs) submitted to the manufacturer of a new three‐piece inflatable penile prosthesis (IPP), the Rigicon Infla10®, to summarize early outcomes. Methods A retrospective review of PIFs from 319 patients implanted with the IPP between 6 January 2019 and 31 December 2021 was performed to assess...

5-alpha reductase inhibitors (5-ARIs) are commonly used and widely available, with benefits observed from their effect on androgen signalling. Their effect relies on the inhibition of the 5-alpha reductase enzyme which aids in the conversion of testosterone to dihydrotestosterone. 5-ARIs have increasing clinical relevance outside of benign prostati...

Background: Male sexual dysfunction (MSD) can affect males of all ages. The most common problems associated with sexual dysfunction include low sexual desire, erectile dysfunction, Peyronie's disease and disorders of ejaculation and orgasm. Each of these male sexual problems can be difficult to treat, and some males may have more than one form of...

Objective: To describe the infectious and non-infectious complications in men undergoing Inflatable penile prosthesis (IPP) revision with partial and complete component exchange for mechanical malfunction. Methods: We performed a multicenter retrospective cohort study of patients who underwent IPP revision. Men undergoing procedures for implant...

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...

Purpose Varicocele is a common problem among infertile men. Varicocele repair (VR) is frequently performed to improve semen parameters and the chances of pregnancy. However, there is a lack of consensus about the diagnosis, indications for VR and its outcomes. The aim of this study was to explore global practice patterns on the management of varico...

Background and Objective The ideal candidate for a male sling (MS) should have a mild to moderate degree of stress urinary incontinence (SUI). This narrative review article evaluates the current MS devices in the commercial market and examines the role of MS as an effective and safe alternative treatment option for male SUI. Methods The available...

The modern AMS 800 artificial urinary sphincter (AUS) is often considered the standard of care for the treatment of moderate to severe stress urinary incontinence in male patients. Nonetheless, the AMS 800 device has several inherent limitations, and these factors can potentially impact its clinical utility and impede excellent clinical outcomes. T...

Objective This study evaluates the evolving surgical management of renal stones in Australia over the past 15 years. Methods The National Australian Medicare and Australian Institute of Health and Welfare (AIWH) data were used to obtain the annual number of hospital presentations for urolithiasis and surgical procedures for upper urinary tract sto...

This Asia‐Pacific (AP) AMS 800™ artificial urinary sphincter (AUS) consensus statement aims to provide a set of practical recommendations to assist surgeons with the AMS 800 device surgery. The AP consensus committee consisted of key opinion leaders with extensive experience with AMS 800 surgery across several AP countries. The panel reviewed and d...

Until 2019, the European Association of Urology guidelines recommended the implantation of a penile prosthesis as a third-line therapy, which has since then changed to “if other treatments fail or depending on the patient’s preference”. Primary endpoint was to assess whether patients with a penile prosthesis and their partner would have preferred e...

Purpose: Seminal oxidative stress (OS) is a recognized factor potentially associated with male infertility, but the efficacy of antioxidant (AOX) therapy is controversial and there is no consensus on its utility. Primary outcomes of this study were to investigate the effect of AOX on spontaneous clinical pregnancy, live birth and miscarriage rates...

Introduction: These clinical practice recommendations by the Urological Society of Australia and New Zealand (USANZ) and the Australasian Chapter of Sexual Health Medicine (AChSHM) for the Royal Australasian College of Physicians (RACP) provide evidence-based clinical guidelines on the management of erectile dysfunction (ED) in Australia. Main re...

Purpose: To compare clinical outcomes and patient satisfaction rates between intralesional verapamil (ILV) and collagenase Clostridium histolyticum (CCH) injections in males with Peyronie's disease (PD). Materials and methods: Following ethics approval, PD patients were prospectively enrolled in this open-label non-blinded study. Patients were r...

Objective: To evaluate the national trends in minimally invasive surgical therapies (MIST) for overactive bladder (OAB) in Australia over the past decade. Methods: Annual MIST data were extracted using the Australian Medicare Benefit Schedule (MBS) on intravesical botulinum toxin (BTX), sacral nerve modulators (SNM) and percutaneous tibial nerve...

Objective. The aim of the study is to investigate improvements in lower urinary tract symptoms in men with benign prostatic hyperplasia (BPH) treated with prostatic Aquablation. Materials and methods. We performed a literature search of clinical trials using the MEDLINE, Embase, and Cochrane Library databases and retrieved published works on Aquabl...

Purpose: There is a growing concern regarding the impact of SARS-CoV-2 infection on the male reproductive tract due to ACE2 receptor expression, however, its impact remains unclear. We performed this review to evaluate whether SARS-CoV-2 infection affects the male reproductive system. Materials and methods: We conducted a search in the Embase, S...

Men with erectile dysfunction (ED) have high patient satisfaction after placement of inflatable penile prostheses (IPP). The impact on satisfaction and quality of life has never been studied in men who have sex with men (MSM). This study sought to assess the satisfaction rates and quality of life of MSM after placement of IPP for ED. This study was...

Background Transvaginal pelvic mesh surgery has been shown to cause female sexual dysfunction. Aim To evaluate the sexual function impact of AdVance male sling (MS) on erectile and orgasmic domains. Methods A review of a prospectively collected database was conducted in all sexually active men who underwent AdVance MS for postprostatectomy stress...

Background Penile cancer is rare among male malignancies. Various biomarkers have been used to predict the prognosis of cancer, one of which is the neutrophil to lymphocyte ratio (NLR). Therefore, we conducted this systematic review and meta-analysis to evaluate the prognostic value of NLR in penile cancer. Methods This review was conducted follow...

Objectives: To evaluate the clinical outcomes and patient satisfaction rate between men aged under and over 70 years who underwent artificial urinary sphincter (AUS) surgery. Methods: A prospective review of all men who received AUS between January 2008 and January 2018 was undertaken with a minimum 24-month review. All patient demographics and...

We would like to thank F. Pallotti and his colleagues for their positive comments [...].

Antisperm antibodies (ASA), as a cause of male infertility, have been detected in infertile males as early as 1954. Multiple causes of ASA production have been identified, and they are due to an abnormal exposure of mature germ cells to the immune system. ASA testing (with mixed anti-globulin reaction, and immunobead binding test) was described in...

Despite significant scientific advances in the modern three-piece inflatable penile prosthesis implant surgery, it is not without surgical risks and can carry additional cosmetic and psychosocial consequences in poorly selected and consented individuals. To address this problem, an international group of key opinion leaders and high-volume prosthet...

Purpose: To report a case series of 6 patients with penile glans necrosis (PGN) following prostatic artery embolization (PAE) and review the current literature relating to PAE and PGN, including the emerging role of hyperbaric oxygen therapy (HBOT) for PGN. Materials and methods: All patients have failed medical BPH therapy and chose to undergo...

Introduction Numerous non-invasive ways of managing distal ureteral stones have been recommended, such as administering treatments to inhibit receptors responsible for ureteral tone and peristaltic movement frequency. Nitric oxide, which is released during penile erection, causes smooth muscle relaxation by inhibiting the non-adrenergic non-choline...

Introduction Men with erectile dysfunction have high patient satisfaction after placement of inflatable penile prostheses (IPP), but the impact on satisfaction and quality of life has never been studied in men who have sex with men (MSM) with erectile dysfunction. Objective To assess the satisfaction rates and quality of life of MSM after placemen...

Introduction Prostate cancer (PC) treatments can cause significant cardiovascular and sexual dysfunctions. There is limited data on the effects of structured exercise interventions specifically on the improvements of erectile function (EF) in the context of cardiovascular health and PC survivorship. It is postulated that structured physical exercis...

Introduction The transvaginal pelvic mesh surgery has been shown to cause female sexual dysfunction. Given this pelvic mesh concern in women, there is similar concern whether men who received pelvic mesh for postprostatectomy stress incontinence (PPSI) may suffer from sexual dysfunction too. Objective To evaluate the sexual function impact of AdVa...

Sperm vitality testing is a basic semen examination that has been described in the World Health Organization (WHO) Laboratory Manual for the Examination and Processing of Human Semen from its primary edition, 40 years ago. Several methods can be used to test sperm vitality, such as the eosin-nigrosin (E-N) stain or the hypoosmotic swelling (HOS) te...

Background Orchialgia is not an uncommon complaint among men with varicocele, but postvaricocele embolization–related testicular pain has not been widely investigated. This study evaluates the phenomenon of postvaricocele embolization pain (PVEP) syndrome and examines the current strategies to treat this unusual complication. Methods and materials...

Introduction: Current clinical guidelines on Peyronie's disease (PD) advocate non-surgical treatment options as the first-line therapy despite inconsistent clinical outcomes when compared to definitive penile reconstructive surgery. Areas covered: This article examines the current understanding of established contemporary and emerging pharmacoth...

The objective of this study is to characterize the standard perioperative practices of penile prosthetic surgeons. A 24-question survey was sent to prosthetic urologists which assessed surgeon demographic and practice information, preoperative evaluation including assessment of sexual history, and postoperative assessment. The majority of surveyed...