Paolo Capogrosso

San Raffaele Scientific Institute | OSR · Dipartimento di Urologia

Objectives To investigate which infertile men with semen parameters above WHO reference limits at first semen analysis deserve a second semen test. Materials and methods Data from 1358 consecutive infertile men were analysed. Patients underwent two consecutive semen analyses at the same laboratory. Descriptive statistics and logistic regression mo...

Background: Recurrent pregnancy loss (RPL) and unexplained infertility are the current indications to test sperm DNA fragmentation (SDF) according to the EAU Guidelines on sexual and reproductive health. Objective: To identify a novel and better performing model to diagnose primary infertile men presenting with altered SDF and to outlie its pred...

Since the beginning of the coronavirus disease 19 (COVID-19) pandemic, efforts in defining risk factors and associations between the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), clinical, and molecular features have initiated. After three years of pandemic, it became evident that men have higher risk of adverse outcomes. Such evide...

The interrelationship between male sexual desire and erectile dysfunction (ED) has been scantly investigated. Thus, we aimed at investigating the prevalence of and the predictors of unrecognised low sexual desire/interest (uLSD/I) in a cohort of men with new onset ED. Complete data from 1587 men seeking for first medical help for ED between 2010 an...

Background: Peyronie's disease (PD) has a huge impact on patients' physical and psychological wellbeing. Objectives: To investigate whether patients' age has an impact on PD symptomatic burden at first presentation. Materials & methods: Data from 129 consecutive heterosexual patients seeking first medical attention for PD at a single andrologi...

Recreational drug intake may be associated with a range of medical untoward consequences, including male infertility. However, as the related evidence is still limited, the main outcome of this review is to provide a better understanding of the existence of any association between recreational drug misuse and male fertility levels’ decline. Whilst...

Radical prostatectomy (RP) represents the treatment of choice to manage clinically-localized prostate cancer (PCa). However, the risk of postoperative functional side effects including urinary incontinence (UI) and erectile dysfunction (ED) remains non-negligible. The pathophysiology of post-RP ED primarily involves three factors which almost inevi...

Background: The identification of biomarkers correlated with COVID-19 outcomes is a relevant need for clinical management. SARS-CoV-2 infection is characterized by elevated IL-6, IL-10, and HLA-G and impaired testosterone production. Objectives: We aimed at defining the combined impact of sex hormones, IL-10, and HLA-G on COVID-19 pathophysiolog...

Objectives Patients with low urinary tract symptoms (LUTS) frequently complain some sexual dysfunction and sometimes even episodes of bothersome urinary incontinence (UI). We aimed to assess the relationship between UI (as measured with the ICIQ-UI-SF), and sexual disfunction (as measured with the IIEF), in men presenting with LUTS at a tertiary-re...

Objectives The interrelationship between sexual desire and erectile dysfunction (ED) has been variously investigated. We aimed to investigate the prevalence of and the predictors of unrecognized low sexual desire (LSD) in the real-life setting. Methods Data from 1509 men seeking first medical help for new-onset ED at a single andrology centre were...

Objectives The Masturbation Erection Index (MEI) has been recently validated in the setting of men presenting with erectile dysfunction (ED). We sought to analyze the correlation between MEI and the International Index for Erectile Function (IIEF) in a cross-sectional study in men with ED. Methods Data of 87 men presenting for ED at a tertiary ref...

Objectives Erectile dysfunction (ED) has been demonstrated to be reasonably prevalent among young men (≤40 yr). We aimed to i) assess changes in patterns of reported ED in men ≤ 40 yr and ii) compare the sociodemographic and clinical characteristics of ED men ≤ 40 yr vs. > 40 yr of age over a 8-yr period at a single academic centre. Methods 1179 p...

Objectives The Masturbation Erection Index (MEI) has been recently validated in the setting of men presenting with erectile dysfunction (ED). We sought to analyze the correlation between MEI and the International Index for Erectile Function (IIEF) in a cross-sectional study in men with ED. Methods Data of 87 men presenting for ED at a tertiary ref...

Objectives High estrogens levels have been associated with higher rates of heart attacks, strokes, and prostate cancer. Moreover, hyperestrogenism is believed to be harmful to male sexuality. We aimed to investigate the impact of hyperestrogenism on sexual functioning in the real-life setting. Methods Data from 481 men seeking first medical help f...

Objectives The interrelationship between sexual desire and erectile dysfunction (ED) has been variously investigated. We aimed to investigate the prevalence of and the predictors of unrecognized low sexual desire (LSD) in the real-life setting. Methods Data from 1509 men seeking first medical help for new-onset ED at a single andrology centre were...

Objectives The ASCVD (Atherosclerotic Cardiovascular Disease) risk score is a validated and standardised algorithm predicting the individual 10-year risk of developing acute cardiovascular events (CVs). Patients with erectile dysfunction (ED) are at greater risk of CVs; we aimed to i) apply the ASCVD score at a homogenous cohort of men undergoing d...

Objectives Laser enucleation of the prostate is associated with an invariable risk of retrograde ejaculation which could affect patient’ sexual life with negative impact on orgasmic function (OF). We investigated OF outcomes after Holmium Laser Enucleation of the Prostate (HoLEP) in patients consecutively treated at a single center. Methods The Ex...

Objectives Surgery remains the most effective treatment for Peyronie Disease (PD), despite different conservative therapies have been suggested. However, surgical procedures are associated with a non-negligible risk of complications and failures. We investigated patients’ willingness of being operated for PD. Methods Data were prospectively collec...

Objectives Testosterone therapy (TT) is commonly prescribed in men with androgen deficiency. TT has several common side effects. Moreover, the effect of TT on serum prostate specific antigen (PSA) levels has been a matter of debate over the last decade. We aimed to investigate the effect of TT on PSA and haematocrit levels in a cohort of men with a...

Objectives Patients with low urinary tract symptoms (LUTS) frequently complain some sexual dysfunction and sometimes even episodes of bothersome urinary incontinence (UI). We aimed to assess the relationship between UI (as measured with the ICIQ-UI-SF), and sexual disfunction (as measured with the IIEF), in men presenting with LUTS at a tertiary-re...

Objectives High estrogens levels have been associated with higher rates of heart attacks, strokes, and prostate cancer. Moreover, hyperestrogenism is believed to be harmful to male sexuality. We aimed to investigate the impact of hyperestrogenism on sexual functioning in the real-life setting. Methods Data from 481 men seeking first medical help f...

Objectives To investigate whether patients’ age has an impact in terms of Peyronie's disease (PD) clinical characteristics at presentation. Methods Data from a group of 110 consecutive patients aged >18 and <70 years with PD and seeking first andrological attention, with a complete clinical assessment and who completed the IIEF-15 and PDQ question...

Objectives Testosterone therapy (TT) is commonly prescribed in men with androgen deficiency. TT has several common side effects. Moreover, the effect of TT on serum prostate specific antigen (PSA) levels has been a matter of debate over the last decade. We aimed to investigate the effect of TT on PSA and haematocrit levels in a cohort of men with a...

Objectives To investigate whether patients’ age has an impact in terms of Peyronie's disease (PD) clinical characteristics at presentation. Methods Data from a group of 110 consecutive patients aged >18 and <70 years with PD and seeking first andrological attention, with a complete clinical assessment and who completed the IIEF-15 and PDQ question...

Context The outcomes and morbidity following treatment for persistent or varicocele recurrence remain controversial. Objective To conduct a systematic review relating to the outcomes following treatment (any surgical or radiological) for varicocele persistence/recurrence. Evidence acquisition A systematic review was conducted in accordance with t...

Prostate cancer (PCa) accounts as the most common non-cutaneous disease affecting males, and as the first cancer, for incidence, in male. With the introduction of the concept of immunoscore, PCa has been classified as a cold tumor, thus driving the attention in the development of strategies aimed at blocking the infiltration/activation of immunosup...

Penile prosthesis implantation continues to represent a reliable solution to address erectile dysfunction when oral medications fail, are not tolerated or are contraindicated, and most typically is associated with excellent satisfaction rates and durable results. Despite the dramatic improvements in the prostheses’ design, in the surgical instrumen...

Background: Male patients with COVID-19 have been found with reduced serum total testosterone (tT) levels and with more severe clinical outcomes. Objectives: To assess total testosterone (tT) levels and the probability of recovering eugonadal tT levels during a minimum 12-mo timespan in a cohort of men who have been followed over time after the...

Disorders of ejaculations are among the most complex complaints of patients seeking first medical help for sexual dysfunction. Among these, premature ejaculation (PE), delayed ejaculation (DE), retrograde ejaculation, and anorgasmia are the most frequently reported, and their impact on patients’ quality of life can be major. Although numerous precl...

Objective: - To i) identify a novel risk stratification for patients complaining of haemospermia; and, ii) compare its predictive ability to select high-risk patients by retrospectively validating the EAU guidelines classification. Patients and methods: - Data from 283 consecutive patients complaining of a single episode/recurrent haemospermia w...

International guidelines suggest to use testosterone therapy (TTh) in hypogonadal men presenting symptoms of testosterone deficiency (TD), even if there is no fixed threshold level of T at which TTh should be started. We aimed to develop and validate a nomogram named TRACE (Testosterone ReplACEment) for predicting the need of TTh in patients with “...

Purpose: Overall, male factor infertility (MFI) accounts for up to 50% of etiologies of couple's infertility, with almost 30% of MFI cases being idiopathic in nature. Idiopathic MFI does not support a tailored treatment work-up in clinical practice. To investigate rates of and characteristics of men presenting for idiopathic versus unexplained pri...

Background: Penile prosthesis implantation has been associated with overall good functional outcomes. Of relevance, some patients reported higher level of satisfaction and quality of life. Aim: We investigated the profile of the patients who may benefit the most from penile prosthesis implantation. Materials and methods: Data from a national m...

Background: Alfa-fetoprotein (AFP) is a serum glycoprotein highly produced during fetal development. While AFP synthesis drops dramatically after birth, AFP production only persists or returns under specific pathological condition OBJECTIVE: : We sought to investigate the rate of and the potential meaning of high AFP serum levels in men seeking fi...

Context The benefits and harms of varicocele treatment versus observation in adult infertile males are still controversial. Objective To systematically pool the evidence on outcomes of varicocele treatment (any surgical or radiological) versus observation in adult infertile men. Evidence acquisition A systematic review and meta-analysis was condu...

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...

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...

Concomitant sexual disorders have progressively shown increased prevalence in men at first outpatient presentation. We sought to i) estimate the prevalence of unreported premature ejaculation (PE) in a homogenous cohort of 1258 men seeking first medical help for erectile dysfunction (ED) as their primary compliant; ii) compare the baseline sociodem...

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...

Background: Male factor contributes to up to 50% of cases of couples experiencing infertility. Cannabis is one of the most commonly used recreational drugs and its effects on the reproductive system have been largely debated in the literature. Objectives: The aim of this study is to evaluate the effect of recreational cannabis use on total T (tT...

Background: Erectile dysfunction aetiology (ED) has been historically identified as organic, psychogenic, and mixed. Objectives: To stratify and compare a cohort of patients seeking medical help for ED for the first time according to the newly proposed binary classification of the EAU guidelines: "primary organic" versus "primary psychogenic"....

Background: In 2021, the World Health Organization (WHO) has provided the latest update on processing and evaluating semen analysis. Objectives: To assess (i) the rate of discordance in semen parameters categorization across three different WHO reference values (namely WHO21, 2010 and 1999) and (ii) the clinical differences among discordant seme...

Resumen Objetivo La nefrectomía parcial laparoscópica off-clamp tras la embolización arterial superselectiva (NPLh) en un quirófano híbrido es un abordaje mínimamente invasivo prometedor. En este estudio comparamos los resultados quirúrgicos perioperatorios de esta técnica innovadora con los de la técnica estándar de nefrectomía parcial laparoscóp...

Background In the context of established male hypogonadism, testosterone therapy (TTh) has been employed to regain physiologic levels of circulating testosterone and improve sexual function and overall quality of life. Aim To assess the risk of cardiovascular disease and mortality as time-dependent outcomes in treated vs TTh untreated hypogonadal...

Background: Peyronie's disease (PD) is a fibrosing disorder of the penis resulting in plaque formation and penile deformity, that negatively affect sexual and psychosocial function of patients. A multifactorial etiology of PD is assumed with diabetes mellitus (DM) being a potential risk factor. Objectives: The aim of this narrative review was to...

Purpose: In industrialized countries, air pollutants levels have been monitored closely for environmental and research issues. Using Italian data, we aimed to investigate the association between air pollutants levels and semen parameters in a cohort of non-Finnish white-European men presenting for couple's infertility. Materials and methods: Com...

A range of drugs have a direct role in triggering ischaemic priapism. We aimed at identifying: a) which medications are associated with most priapism-reports; and, b) within these medications, comparing their potential to elicit priapism through a disproportionality analysis. The FDA Adverse Event Reporting System (FAERS) database was queried to id...

A limited number of studies have described patients on finasteride showing findings which were consistent with Peyronie’s disease (PD). We aimed to detect a pharmacovigilance signal of possible association between finasteride and PD-related clinical features. The Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) database was...

Background Several trials have reported on the impact of social restrictions due to SARS-CoV-2 (COVID-19) pandemic on sexual function and psycho-physical well-being. However, data showing modifications of these outcomes over time and at the end of lock-down are scant. Aim We investigated the longitudinal changes in sexual function during social re...

Introduction The routine use of dynamic duplex ultrasound of the penis (DDUP) to detect vasculogenic erectile dysfunction (V-ED) has been questioned because of a related patient’ discomfort and costs issues. Objective to investigate clinical factors which could guide the physician in selecting candidates for DDUP in routine practice. Methods Data...

Introduction High serum estrogens levels have been associated with higher rates of heart attacks, strokes, and prostate cancer. Moreover, hyperestrogenism is believed to be harmful to male sexuality. Objectives We aimed to investigate the prevalence of and the impact of hyperestrogenism on sexual functioning in a cohort of men seeking medical atte...

Introduction Peyronie's disease is a benign condition involving the tunica albuginea of the corpora cavernosa of the penis. Objectives To investigate whether patients’ age has an impact in terms of Peyronie's disease (PD) clinical characteristics at presentation. Methods Data from a group of 110 consecutive patients aged >18 and <70 years with PD...

Introduction The Sexual and Reproductive Health guidelines of the European Association of Urology (EAU) suggest stratifying patients complaining of haemospermia into low versus high-risk categories for treatable aetiologies. Objective To validate EAU guidelines in a homogeneous cohort of men with haemospermia and to identify a novel and better per...

Introduction Patients with low urinary tract symptoms (LUTS) frequently complain some sexual dysfunction and sometimes even episodes of bothersome urinary incontinence (UI). Objective We aimed to assess the relationship between UI (as measured with the ICIQ-UI-SF), and sexual disfunction (as measured with the IIEF), in men presenting with LUTS at...

Introduction There is a current lack of effective conservative treatments for Peyronie Disease (PD). Surgery represents an effective treatment, despite being associated with bothering complications, including erectile dysfunction (ED). Objective We investigated patients wish of being operated for PD at a single center. Methods Data were prospecti...

Introduction Erectile dysfunction (ED) is defined according to three different aetiological groups: organic, psychogenic and mixed. As most cases have mixed aetiology, EAU guidelines suggests using the terms "primary organic" or "primary psychogenic". Objectives We aimed to stratify a homogenous cohort of patients seeking medical help for ED for t...

Introduction The interrelationship between male sexual desire and erectile dysfunction (ED) has been variously investigated. Objectives We aimed to investigate the prevalence of and the predictors of unrecognized low sexual desire (LSD) in a cohort of men seeking medical help for new onset ED in the real-life setting. Methods Data from 1509 men s...

Introduction, The aim of this systematic review was to evaluate the current evidence for the effectiveness of ginseng, Rutin and Moringa for treating erectile dysfunction. Methods, A broad search of the Scopus, PubMed, Cochrane and Web of Science databases was performed in complicance with the Preferred Reporting Items for Systematic Reviews and Me...

In this narrative review we provide an overview of the current literature on male hypogonadism and related comorbidities, also depicting the role of testosterone therapy (TTh) in the various settings. Male hypogonadism has been associated with major comorbidities such as type 2 diabetes mellitus, obesity and cardiovascular diseases, promoting a vic...

Objective Off-clamp laparoscopic partial nephrectomy in a hybrid operating room after superselective arterial embolization (hLPN) is a promising minimally invasive approach. In this study, we compared the perioperative surgical outcomes of this innovative technique with the conventional standard of care laparoscopic partial nephrectomy (cLPN) techn...

Study question: we aimed to investigate the relationship between the tyg index and both semen and hormonal characteristics in a cohort of primary infertile men. Summary answer: almost one in two primary infertile men presented with a triglycerides/glucose index (tyg) suggestive of insulin resistance (ir). overall, patients with tyg suggestive of i...