Yang Y.,Shanghai JiaoTong University |
Yang Y.,Shanghai Institute of Andrology |
Hu J.-L.,Shanghai JiaoTong University |
Hu J.-L.,Shanghai Institute of Andrology |
And 12 more authors.
Journal of Urology | Year: 2011
Purpose: We prospectively compared clinical response and penile color duplex ultrasound results of oral tadalafil 20 mg plus low dose intracavernous injection of vasoactive agents with those of intracavernous injection and oral tadalafil 20 mg alone. We also observed the best approach to facilitate penile color duplex ultrasound and that most preferred by patients. Materials and Methods: All 56 patients with erectile dysfunction underwent penile color duplex ultrasound 3 times at an interval of at least 1 week using different pharmacological induction methods, including tadalafil mode (20 mg tadalafil), intracavernous injection mode (30 to 60 mg papaverine) and mixed mode (15 mg papaverine plus 20 mg tadalafil). Ultrasound parameters included peak systolic and end diastolic velocity, resistance index and acceleration time. Clinical response was assessed by the erection hardness score. Patient preference was determined when all tests were finished. Results: For penile color duplex ultrasound parameters no significant difference was observed between intracavernous injection and mixed modes. However, for tadalafil mode peak systolic velocity of the 2 cavernous arteries measured 15 minutes after induction were significantly lower than for intracavernous injection and mixed modes. Also, acceleration time of the right cavernous artery measured 5 minutes after induction and left cavernous artery measured 15 minutes after induction in tadalafil mode were significantly shorter than those in intracavernous injection and mixed modes. No severe side effect occurred in tadalafil and mixed modes but 2 patients experienced priapism in intracavernous injection mode. Of the patients 55.4% preferred tadalafil mode, an incidence significantly higher than intracavernous injection (16.1%) and mixed (28.5%) modes. Conclusions: Oral tadalafil plus low dose vasodilator led to a significantly better clinical response than high dose vasodilator. Penile color duplex ultrasound parameters showed no difference between the 2 modes. Thus, this mixed mode emerges as a possible alternative to high dose vasodilator injection. © 2011 American Urological Association Education and Research, Inc.
PubMed | Shanghai Institute of Andrology and Shanghai JiaoTong University
Type: Journal Article | Journal: SpringerPlus | Year: 2016
Over the past two decades, Snodgrass tubularized incised plate (TIP) urethroplasty has become one of the dominant surgical techniques with wide applications and excellent cosmetic results. However, TIP has many limitations. We performed a retrospective study at our department and assessed the outcome of the inlay internal preputial graft for extending the applications of TIP.Between January 2009 and December 2013, we performed a retrospective study consisting of approximately 508 primary distal and moderate cases. Patients with primary distal hypospadias who had mild or no chordee and good penile development were divided into the following 3 groups based on their procedures: (1) classic TIP hypospadias repair group (n=198); (2) inlay buccal mucosa graft group (n=150); and (3) inlay internal preputial graft group (n=160). The median age was 1.6years (range 1-4years). Our data were analyzed statistically by the Chi square test with The mean follow-up period was 18months (range 624months). In the classic TIP group, the incidence of urinary fistula and meatal stenosis were both 3.0% (6/198); in the inlay buccal mucosal graft group, the incidence of urinary fistula was 3.3% (5/150), and the incidence of stenosis was 2.7% (4/150); and in the inlay internal preputial graft group, the incidence of urinary fistula was 3.1% (5/160), and the incidence of meatal stenosis was 4.4% (7/160). The success rates of each group were as follows: the classic TIP group has a success rate of 93.9% (186/198); the inlay buccal mucosa graft group had a success rate of 94.0% (141/150); and the inlay internal preputial graft group had a success rate of 92.5% (148/160). There were no statistically significant differences between the 3 groups with respect to complication rates.As the inner foreskin Snodgraft does not appear to be worse than the buccal mucosa graft, it is a good method for hypospadias repair, and this method is not inferior to TIP.
Wang X.-B.,Shanghai Institute of Andrology |
Hu H.-L.,Shanghai Institute of Andrology |
Liu Y.,Shanghai Institute of Andrology |
Cao X.-R.,Shanghai Institute of Andrology |
And 3 more authors.
Journal of Shanghai Jiaotong University (Medical Science) | Year: 2012
Objective: To analyse karyotype of chromosome in patients with infertility and sperm donors, and explore its clinical significance. Methods: A total of 967 infertile patients (infertility group) and 3 184 semen donors (donor group) were selected for analysis of karyotype of chromosome, and the incidence and types of abnormal karyotypes were compared between two groups. Results: The incidence of abnormal karyotypes in infertility group was significantly higher than that in donor group (14.06% vs 3.39%, P<0.01). The main type of abnormal karyotype in infertility group was non-polymorphic chromosomal abnormalities, whose incidence was significantly higher than that in donor group (9.62% vs 0.25%, P<0.05). The main type of abnormal karyotype in donor group was polymorphic chromosomal abnormalities, whose incidence was not significantly different from that in infertility group (3.14% vs 4.44%, P>0.05). Besides, two abnormal karyotypes [46, XY, t(3; 12)(p23; q24) and 46, XY, inv(20)(p13; q13.1)] were first reported worldwide in infertility group. Conclusion: Chromosome non-polymorphism abnormalities is one of the major causes for male infertility, and karyotype analysis for infertile patients and sperm donors is of great significance to reduce birth defects.
Ping P.,Shanghai Institute of Andrology |
Zhu W.-B.,Central South University |
Zhang X.-Z.,Zhejiang Institute |
Yao K.-S.,Zhejiang Institute |
And 3 more authors.
Asian Journal of Andrology | Year: 2010
Sperm banking can preserve male fertility effectively, but the current conditions of sperm cryopreservation in China have not been investigated. This retrospective investigation was based on data collected at multiple centres in China from January 2003 to December 2008. The collected data included urogenital history, indication for cryopreservation, semen parameters, use rate, type of assisted reproductive technique (ART) treatment and pregnancy outcome. The study population included 1 548 males who had banked their semen during the study period at one of the clinics indicated above. Approximately 1.9% (30/1 548) of the cryopreserved semen samples were collected from cancer patients; about 88.8% (1 374/1 548) of the patients had banked their semen for ART and 8.6% (134/1 548) had a male infertility disease (such as anejaculation, severe oligozoospermia and obstructive azoospermia). The total use rate of cryopreserved semen was 22.7% (352/1 548), with 119 live births. The cancer group use rate was 6.7% (2/30), with one live birth by intracytoplasmic single sperm injection (ICSI). The ART group use rate was 23.2% (319/1 374), with 106 live births. The reproductive disease group use rate was 23.1% (31/134), with 12 live births. The semen parameters in each category varied; the cancer patient and infertility disease groups had poor semen quality. In vitro fertilization (IVF) and ICSI were the most common ART treatments for cryopreserved sperm. Semen cryopreservation as a salvage method is effective, but in many conditions it is underutilized, especially in cancer patients. Lack of awareness, urgency of cancer treatment and financial constraints are the main causes of the low access rate. The concept of fertility preservation should be popularized to make better use of this medical service in China. © 2010 AJA, SIMM & SJTU All rights reserved.