https://doi.org/10.55788/d52d8060
On the topic of male infertility, Dr Jonathan Ramsay (London, United Kingdom) presented that sperm harvested directly from the testes of 63 men with evident infertility has the same DNA integrity/quality as ejaculated sperm of 76 healthy donor men. This is important to know because sperm from infertile men is often burdened by excessive DNA damage and this can cause troubles with the success rates of intracytoplasmic sperm injection and other forms of assisted reproduction techniques. In a comment from Prof. Maarten Albersen (Catholic University Leuven, Belgium) about this study, he warns: “However, we have to interpret these results with caution; certainly because they are now available in the lay press, association of course is not causation, and an adequate interventional design is needed to assess whether selection of certain patients with DNA damage with TESE [eds, Testicular/Epididymal Sperm Extraction] rather than using ejaculated sperm facilitates the success rates of assisted reproduction.”
Dr Cath Mercer et al. (University College London, United Kingdom) presented recent data supporting that serotonin is important in ejaculatory control in men [1]. We have long known from preclinical models that stimulation of serotonin 1A receptor 5-HT1A precipitates ejaculation [2]. However, despite data gathered from patients taking selective serotonin reuptake inhibitors (SSRIs) demonstrating modest effects on ejaculation latency time [3], interventional studies in humans have been lagging. At this conference, there was a new double-blind, placebo controlled phase 1 study presented with a new antagonist to this receptor (7 mg GSK958108 treatment group) that showed that intravaginal ejaculation latency time was shown to be 77% longer (95% CI 28%-144%). The main common adverse effect was headache, reported by 20%. Collectively, we can conclude that developments in premature ejaculation are finally translating to the clinic and we might see new drugs available in the near future.
Figure: Schematic overview of pathways controlling ejaculation
- Choi JB et al. J Urol. 2019 Jan;201(1):147-152.
- Arnone M et al. Behav Pharmacol. 1995 Apr;6(3):276-282.
- Sun Y et al. World J Urol. 2017 Dec;35(12):1817-1831.
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Table of Contents: EAU 2019
Featured articles
Prostate Cancer
Barentsz Trial – Bi-parametric MRI versus multi-parametric MRI
Enzalutamide plus ADT improves outcomes for metastatic hormone-sensitive prostate cancer
Prostate cancer active surveillance: Better patient risk stratification and use of imaging
The role of pelvic lymph node dissection in prostate cancer: Extended vs standard
When to use imaging and imaging-guided therapies
Radioguided surgery is the future?
Bladder Cancer
Largest safety study of its kind with atezolizumab in metastatic bladder cancer
Bladder cancer risk and early detection
Consensus treatment pathway for patients with limited pelvic lymph node involvement in otherwise localised bladder cancer
FGFR3 gene mutation: Favourable prognostic impact in bladder cancer
Bladder cancer in young patients
Spanish study directly links surgical volume with mortality in bladder cancer patients undergoing cystectomy
Updated interim results of phase 2 trial of pembrolizumab for high-risk NMIBC unresponsive to BCG
Robot-assisted radical cystectomy or open radical cystectomy?
Renal Transplantation and Renal Cell Carcinoma
Andrology
Microdissection testicular sperm extraction (microTESE)
Male infertility/Premature ejaculation
Testosterone replacement therapy: Safe and maybe even protective
Focus on treatment of erectile dysfunction and Peyronie’s disease
Penile prosthesis implantation
Functional Urology
Decision aids are too difficult for patients
Lower Urinary Tract Symptoms
The Urodynamics for Prostate Surgery Trial
Minimally invasive surgical techniques must compete against pharmacotherapy in benign prostate hyperplasia (BPH)
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