[Show abstract][Hide abstract] ABSTRACT: Objective:
To determine the exact location of the opening of the ejaculatory duct in men and provide some basic anatomical evidence for seminal vesiculoscopy and the treatment of ejaculatory duct obstruction.
We performed ureterocystoscopy for 21 male patients aged 26 - 47 years with hematuria (n = 12), hematospermia (n = 2), glandular cystitis (n = 6), and anejaculation after radical resection of rectal carcinoma (n = 1), and meanwhile, with the consent of the patients, massaged the prostate and ejaculatory duct and observed the outlet of the expelled fluid. Under the microscope, we described the fluid samples with sperm as the expulsion from the ejaculatory duct.
Ureterocystoscopy showed that the exact anatomical sites of the expulsion of prostatic fluid and semen in the patients were the side and lower side of the prostatic utricle opening above the verumontanum and the ventral side of the verumontanum. Quantities of sperm were found in the expulsion fluid of 13 of the patients, and no expulsion, including semen, was seen from the prostatic utricle opening.
Anatomically, the ejaculatory duct openings of males are located at the two sides of the verumontanum adjacent to the opening of the prostatic utricle, rather than in the prostatic utricle above the verumontanum.
No preview · Article · Apr 2014 · Zhonghua nan ke xue = National journal of andrology
[Show abstract][Hide abstract] ABSTRACT: To evaluate the impact of the factors of perceived male infertility on men's penile erectile function.
Using the 5-item version of the International Index of Erectile Function (IIEF-5), we investigated the penile erectile function among 245 infertile men (infertility group) and another 52 males having physical checkup for planned conception (checkup group), the former further divided into four subgroups according to the factors of infertility: male factor, female factor, bilateral factor, and unknown factor. We compared the total and item scores of IIEF-5 among different groups.
Mild or mild-moderate ED was found in 50.61% of the infertile men, with a total IIEF-5 score of 21.24 +/- 2.58. The total and item scores of IIEF-5 were markedly higher in the male factor than in the female factor subgroup (P < 0.01), but with no significant difference between the male factor subgroup and the bilateral and unknown factor subgroups (P > 0.05), except the score on confidence. The scores were significantly lower in the bilateral and unknown factor subgroups than in the female factor subgroup (P < 0.05), with no remarkable difference between the former two. In the infertility group, the total and item scores of IIEF-5 were markedly higher in those with education above high school than in those with high school or lower education (P < 0.01), but not correlated with age and infertility duration. After adjustment for education background, the total IIEF-5 score and the scores on confidence and satisfaction were significantly lower in the infertility than in the checkup group (P < 0.05), and 15.38% of the men in the latter group had mild ED, dramatically lower than in the former (P < 0.01).
Perceived infertility may cause ED in males, and a higher incidence rate is associated with lower education background of the men.
No preview · Article · Dec 2013 · Zhonghua nan ke xue = National journal of andrology
[Show abstract][Hide abstract] ABSTRACT: To sum up the experience in administering oral tadalafil on alternate days for the treatment of erectile dysfunction (ED) that fails to respond to on-demand medication.
We retrospectively analyzed the clinical data of 15 cases of ED treated with oral tadalafil on alternate days from September 2010 to March 2012. All the patients had failed to respond to on-demand medication of sildenafil previously.
After 4 weeks of tadalafil treatment, 11 (73.3%) of the cases were remarkably improved, with significant difference in IIEF-5 scores before and after treatment (P < 0.05). Transient adverse reactions were observed in the other 4 cases, including mild headache in 2, slight backache in 1, and facial flush in 1.
Oral tadalafil on alternate days is safe and effective in the treatment of ED that fails to respond to on-demand medication of sildenafil.
No preview · Article · Apr 2013 · Zhonghua nan ke xue = National journal of andrology
[Show abstract][Hide abstract] ABSTRACT: To investigate the impact of infertility on men's self-esteem, self-confidence, sexual satisfaction and overall relationship with their spouses.
Using Self-Esteem and Relationship questionnaire (SEAR), we conducted an investigation among 253 infertile men and 52 fertile male controls. We divided the infertile men into four subgroups according to their perceived causes of infertility: male (M) factors, female (F) factors, both M and F factors, and unknown factors, and compared the SEAR scores among different groups.
In the infertile men, the total SEAR score was significantly higher in those with < 3 years than in those with > or = 3 years of infertility duration (75.50 +/- 17.05 vs 68.66 +/- 17.19, P < 0.05) and so was it in those with above-high-school than in those with high-school or lower education background (81.42 +/- 13.99 vs 67.61 +/- 17. 8, P < 0.01), but showed no significant difference between the > or = 30- and < 30-year-olds (71.77 +/- 17.42 vs 72.74 +/- 18.38, P > 0.05). The total SEAR scores in the M factor, M & F factor, unknown factor and F factor groups were 65.69 +/- 18.68, 68.52 +/- 17.68, 74.85 +/- 15.19 and 83.21 +/- 12.61, respectively, with significant differences between the first two and the latter two groups (P < 0.05), as well as between the unknown factor and F factor groups (P < 0.05). In the fertile male controls, the total SEAR score and subdomain scores on sexual relationship, self-confidence, self-esteem and overall relationship were 90.04 +/- 9.85, 88.40 +/- 10.74, 92.23 +/- 9.41, 91.95 +/- 10.67 and 90.38 +/- 14.14, respectively, all remarkably higher than in the M factor, M&F factor and unknown factor groups of the infertile men after adjustment of their infertility duration and education levels (P < 0.05).
Infertility reduces men's self-esteem, self-confidence, sexual satisfaction and relationship with their spouses, and the degree of its impact is correlated with the patients' infertility duration and education level.
No preview · Article · Mar 2013 · Zhonghua nan ke xue = National journal of andrology
[Show abstract][Hide abstract] ABSTRACT: To assess the necessity of detecting the gene of cystic fibrosis transmembrane conductance regulator factor (CFTR) in Chinese men with congenital bilateral absence of the vas deferens (CBAVD).
We detected the mutation of all the 27 exons of the CFTR gene in 9 patients with CBAVD by DNA sequencing, and compared the results using NCBI and Cystic Fibrosis Mutation Database.
Four novel missense mutations/variants were found in the CFTR gene of the CBAVD patients, which were submitted and accepted in the Cystic Fibrosis Mutation Database.
There are mutations or variants in the CFTR gene in Chinese men with CBAVD, and the mutational distribution is different from that in Westerners.
No preview · Article · Nov 2012 · Zhonghua nan ke xue = National journal of andrology
[Show abstract][Hide abstract] ABSTRACT: To summarize the experience in the treatment of erectile dysfunction (ED) with no successful intercourse at the baseline with tadalafil.
We retrospectively analyzed 21 cases of ED with no successful intercourse at the baseline treated with tadalafil on alternate days combined with sex guidance.
After 4 weeks of tadalafil treatment, 19 of the patients achieved successful sexual intercourse, and the IIEF-5 score was remarkably improved as compared with pre-medication (3.24 +/- 1.55 vs 18.95 +/- 3.02, P<0.0001). Mild adverse reactions were observed in 6 cases, including 2 cases of mild headache and 4 cases of facial blush.
Tadalafil on alternate days combined with sex guidance can significantly improve ED with no successful intercourse at the baseline.
No preview · Article · Jan 2012 · Zhonghua nan ke xue = National journal of andrology
[Show abstract][Hide abstract] ABSTRACT: To sum up the experience in the treatment of obstructive azoospermia by intracytoplasmic sperm injection (ICSI).
We retrospectively analyzed 107 cases of obstructive azoospermia treated by ICSI in our center from Jan. 2006 to Dec. 2008, and compared the rates of fertilization, cleavage and pregnancy between the patients with congenital bilateral absence of vas deferens (CBAVD) and those with non-CBAVD.
A total of 949 oocytes were injected for the 107 patients undergoing ICSI, of which 678 (71.4%) were fertilized and 605 (89.2%) cleaved, with 44 pregnancies (41.4%). Of the 442 oocytes injected for the 49 patients with CBAVD, 308 (69.6%) were fertilized and 279 (90.6%) cleaved, with 27 pregnancies (55.1%), and of the 507 oocytes injected for the 58 cases induced by inflammation or surgery, 370 (72.9%) were fertilized and 326 (88.1%) cleaved, with 17 pregnancies (29.3%). The rate of pregnancy was significantly higher in the CBAVD than in the non-CBAVD group (P < 0.01), but there were no significant differences in the rates of fertilization and cleavage between the two groups (P > 0.05).
PESA or TESE combined with ICSI is an effective approach to the treatment of male infertility induced by obstructive azoospermia, which may achieve a higher rate of pregnancy in patients with CBAVD than in those with non-CBAVD. Inflammation or surgery may not only cause the obstruction of the deferent duct, but also affect sperm quality, and consequently reduce the potentiality of embryonic development.
No preview · Article · Oct 2010 · Zhonghua nan ke xue = National journal of andrology