Effects of 5-Year Treatment With Testosterone Undecanoate on Lower Urinary Tract Symptoms in Obese Men With Hypogonadism and Metabolic Syndrome

Objective To investigate the possible effects of testosterone undecanoate (TU) injections in a population of obese (mean age 57) hypogonadal men with lower urinary tract symptoms (LUTS) in a long-term observational study. Methods Twenty obese hypogonadal men with metabolic syndrome were treated with TU injections every 12 weeks for 60 months; also 20 matched subjects in whom TU was unaccepted or contraindicated were used as controls. LUTS severity and the impact of TU injections were assessed by differences in International Prostate Symptom Score (IPSS), maximum urinary flow (Qmax) rate in milliliters, post-void residual (PVR) volume, and prostate size every 12 months in a 5-year controlled study. Results TU injections did not produce differences in IPSS, Qmax, PVR, and prostate size in both groups. No modification in prostate-specific antigen (PSA) and hematocrit levels was also found between the 2 groups. Interestingly, controls showed increased incidence of prostatitis than TU-treated men (10% vs 30%, P <.01). Conclusion We showed that 5 years of TU treatment did not change IPSS, PVR, Qmax, or prostate size in obese hypogonadal men with metabolic syndrome and moderate LUTS at baseline. Therefore, long-term TU replacement therapy is a safe and effective treatment for reverting hypogonadal features related to metabolic syndrome and does not impact negatively on LUTS and prostate volume

Iperfunzione tiroidea nell’anziano

Sommario L’ipertiroidismo è una sindrome caratterizzata da un eccesso di sintesi e secrezione di ormoni tiroidei (OT). La forma conclamata è caratterizzata da aumento degli OT liberi circolanti con TSH soppresso; l’ipertiroidismo subclinico è invece definito dalla presenza di livelli di TSH inferiori ai limiti della norma e OT liberi entro il “range” di riferimento. Le cause più frequenti di ipertiroidismo nell’anziano sono il gozzo multinodulare (60%), specialmente nelle aree a carenza iodica, e l’adenoma (30%), più raro l’ipertiroidismo autoimmune. Nel paziente anziano è molto importante eseguire una corretta anamnesi e un attento esame obiettivo, poiché i segni e i sintomi di ipertiroidismo possono essere sfumati (ipertiroidismo apatetico). La tireotossicosi iodio-indotta è più frequente nell’anziano rispetto al giovane, spesso determinata dall’utilizzo di farmaci (amiodarone) o dall’esecuzione di esami radiologici con mezzo di contrasto iodato. I soggetti anziani sono più vulnerabili agli effetti dell’ipertiroidismo (subclinico e conclamato), soprattutto per ciò che attiene l’apparato cardiovascolare, il metabolismo osseo, il metabolismo intermedio e il sistema nervoso centrale. È generalmente opportuno trattare anche l’ipertiroidismo subclinico al fine di prevenire le complicanze cardiovascolari e metaboliche, soprattutto nel “grande anziano” (>80 anni) e nei pazienti con preesistente patologia cardiovascolare e/o metabolica. La strategia terapeutica da intraprendere deve essere sempre modulata sul singolo paziente considerando i potenziali rischi del trattamento oltre allo stato generale in termini di prognosi globale, complessità clinica e fragilit

Lifestyle and fertility: the influence of stress and quality of life on male fertility

Male infertility is a widespread condition among couples. In about 50% of cases, couple infertility is attributable to the male partner, mainly due to a failure in spermatogenesis. In recent times, the crucial role that modifiable lifestyle factors play in the development of infertility have generated a growing interest in this field of study, i.e. aging, psychological stress, nutrition, physical activity, caffeine, high scrotal temperature, hot water, mobile telephone use. Several studies have investigated associations between semen quality and the presence of lifestyle stressors i.e. occupational, life events (war, earthquake, etc.) or couple infertility; overall, these studies provide evidence that semen quality is impaired by psychological stress. In this review, we will discuss the impact of quality of life (modifiable lifestyle factors) and psychological stress on male fertility. In addition, the role that increased scrotal temperature along with inappropriate nutritional and physical exercise attitudes exert on male fertility will be presented

Effects of daily tadalafil on lower urinary tract symptoms in young men with multiple sclerosis and erectile dysfunction. a pilot study

Purpose: Men affected by multiple sclerosis (MS) often experience neurogenic overactive bladder (OAB), lower urinary tract symptoms (LUTS) and erectile dysfunction (ED). Aim of the study was to investigate modifications of urinary and sexual functions after administration of daily tadalafil (TAD) 5 mg. Methods: 30 men were enrolled in a single blind, 4-weeks prospective study while 10 men without treatment served as controls. Primary outcomes were changes from baseline of International Prostate Symptom (IPSS), OAB questionnaire (OAB-q) and International Index of Erectile Function (IIEF-5) scores. To evaluate the influence of bladder filling on somatic reflexes, we studied variations of the H-reflex evoked by electrical stimuli applied to the tibial nerve at the popliteal fossa and recorded from the soleus muscle. Also testosterone/estradiol (T/E) ratio was measured before and after treatment. Results: In TAD group, an improvement of IPSS (p<0.001), OAB-q (p<0.001) and IIEF-5 (p<0.001) scores were found. Also, an increase in Qmax (p<0.01) and T/E ratio (p<0.01) were found with a concomitant reduction of post-void residual volume (p<0.001) without any changes in the H-reflex. Conclusions: The study demonstrates for the first time that daily TAD in patients with multiple sclerosis improves storage symptoms, post-void residual volume, steroid hormone pattern and ED without urodynamic changes

Characterization of the Effects of a Six-Month Dancing as Approach for Successful Aging

Aging is accompanied by a decline in multiple domains. Positive effects of dance practice on several health issues have been evaluated in young adults, while the effects of regular social dance practice on physical fitness, sexual health, and cognitive functions have not been studied yet in older experienced dancers. Thus, the aim of this study has been to investigate whether a 6-month social dance practice might influence fitness performance, sexual health, and specific cognitive functions and/or mood characteristics in older experienced dancers. Thirty experienced dancers (age: 71.2±5.1 years, 18 females/12 males) were enrolled from the dance school “NonSoloLiscio” of Catanzaro. Body composition, physical fitness, sexual health, and cognitive functions were assessed before (T0) and after (T6) intervention. After 6 months of dance practice, percent of fat mass (%FM) significantly decreased (p&lt;0.01), while fat-free mass (FFM) significantly increased (p&lt;0.01) in both genders. Moreover, significant main effects of time on physical fitness tests, such as chair stand test (CST) (p&lt;0.01), gait speed (p&lt;0.05), and timed up and go (p&lt;0.05), were found. Sexual health was significantly higher in males than in females at T0 and no significant effects of dance on subjects’ sexual health were found. Interestingly, trait of anxiety significant decreased (p&lt;0.05) and perception of retrospective memory significantly increased (p=0.05) after training independently of gender. Our preliminary results suggest that, even in older intermediate-level dancer, the practice of social dance might positively influence body composition and also increase fitness performance, memory functions, and anxiety. In contrast, no effects on sexual health were observed after 6 months of dancing