Factors affecting the success of microdissection testicular sperm extraction in men with non-obstructive azoospermia

OBJECTIVE:To determine the sperm retrieval rates (SRRs) and predictive factors of patients with non-obstructive azoospermia (NOA) after testicular sperm extraction (TESE)MATRERIAL and METHODS:A total of 311 patients who were diagnosed with non-obstructive azoospermia (NOA) and underwent TESE were included in this study. Physical examination, hormone values, testicular volumes, and the medical history of all patients were recordedRESULTS:The mean sperm retrieval rates (SRRs) were 46.7%. These SRRs were 34.2%, 33.3%, 71.4%, 100%, and 100% for Sertoli Cell Only, late maturation arrest, early maturation arrest, hypospermatogenesis, and normal spermatogenesis, respectively (p<0.001). While the mean FSH values were significantly lower in patients with positive mTESE (19.7±12.8 mL/U vs. 25.3±15.5 mL/U, p: 0.001), the mean testicular volumes were larger in patients with positive TESE compared to patients with negative mTESE (p: 0.004).CONCLUSION:The testicular histopathology, level of FSH and testicular volume were identified as independent predictors of SRRs for men with NOAKeywords:Azoospermia, male infertilite, testicular sperm extractio

Late-Onset Hypogonadism in Male Patients Over 60 Years of Age with Metabolic Syndrome

Purpose: The aim of the study was to determine serum androgen levels and the frequency of late-onset hypogonadism (LOH) in patients over 60 years of age with metabolic syndrome (MS) and its correlation with parameters of MS. Material and Method: Men over 60 years of age who were diagnosed with MS according to the Adult Treatment Panel III (ATP III) criteria in the internal medicine outpatient clinics at Cerrahpasa Medical School (n=30) and healthy controls (n=30) were included in the study. Total testosterone and sex hormone binding globulin (SHBG) levels were analysed. Bioavailable and free testosterone levels were calculated. The participants filled up the Beck Depression Inventory (BDI) and Aging Male Symptoms (AMS) questionnaire forms themselves without any help of the physician. Results: LOH rates were 30% and 13.3% in the MS group and healthy control group, respectively (p=0.11). Serum total testosterone and SHBG levels were significantly lower in the MS group compared to controls (p=0.004 and p=0.003, respectively). A negative correlation was found between total testosterone and MS components. BDI and AMS questionnaire scores in the two groups were not significantly different.Discussion: Serum total testosterone and SHBG levels were lower in the MS group, and inversely proportional to this, insulin resistance and intensity of MS components were increased. Turk Jem 2013; 17: 22-

Testis mikrobiyotasının erkek infertilitesi ile ilişkisi

In recent years, substantial findings have been reported about the effects of microbiota on human health. In our study, we aimed to compare the outcomes of microbiota assays of testicular tissue obtained by testicular sperm extraction (TESE) from 2 patients with male infertility. In the first patient who had azoospermia, Illumina sequencing detected the following bacterial flora in the collected tissue homogenates: Firmicutes (53%), Bacteroidetes (12%), Actinobacteria (12%), Proteobacteria (8%), Fusobacteria (8%), SR1 (7%), TM7-3 (3%) and OD-1 (1%). In the second patient who had oligozoospermia, Firmicutes (13%), Bacteroidetes (15%), Actinobacteria (7%) and Proteobacteria (64%) were detected in the testicular tissue. Our preliminary study confirmed that certain types of bacteria exist in testicular tissues of infertile men. Future studies with more infertile and healthy men are required to understand the importance of these microorganisms in the pathophysiology of male infertility.Son yıllarda mikrobiyotanın insan sağlığı üzerindeki etkileri hakkında önemli bulgular rapor edilmiştir. Çalışmamızda erkek infertilitesi olan 2 hastadan testiküler sperm ekstraksiyonu (TESE) ile elde edilen testis dokusunun mikrobiyota analizinin sonuçlarını karşılaştırmayı amaçladık. Azospermik olan ilk hastada, toplanan doku homojenatlarında Illumina dizilemesi ile şu bakteri florasına saptandı: Firmicutes (%53), Bacteroidetes (%12), Actinobacteria (%12), Proteobacteria (%8), Fusobacteria (%8), SR1 (%7), TM7-3 (%3) ve OD-1 (%1). Oligozoospermi olan ikinci hastanın ise testis dokusunda Firmicutes (%13), Bacteroidetes (%15), Actinobacteria (%7) ve Proteobacteria (%64) bakterileri saptandı. Ön çalışmamızda, infertil erkeklerin testis dokusunda belirli bakteri türlerinin bulunduğu doğrulandı. Erkek infertilitesinin patofizyolojisinde bu mikroorganizmaların önemini anlamak için infertil ve sağlıklı erkeklerle yapılacak ileri çalışmalara ihtiyaç vardır

Alternative solution for cross-ply laminated composite thick plates

The structural analysis of orthotropic and linear elastic cross-ply laminated composite thick plates is made by considering complete effects of transverse shear and normal stresses. The solutions are obtained using the functional analysis method in conjunction with the Gâteaux differential. A new functional with boundary condition terms is developed for the analysis. A four-node serendipity element with eight degrees of freedom is used. To ensure the accuracy of the developed mixed finite element (MFE), numerical results are compared with those of the published solutions. It has been proven that the developed MFE is highly accurate and efficient

Genito-Üriner Hastalıklarda Fitoterapinin Yeri

Erektil disfonksiyon (ED) tatmin edici cinsel birliktelik için ereksiyonun tam sağla-namaması yada devam ettirilememesi olarak tanımlanmaktadır(1). Yapılan preva-lans çalışmalarında ABD’de 40-70 yaş arası erkeklerde ED görülme oranı %52 olarak saptanırken, Türk Androloji Derneğinin yaptığı çalışmada ise Türkiye ED prevalansı %33 olarak bildirilmiştir (2, 3). ED patofizyolojisinin net olarak anlaşılmasından son-ra tedavide önemli gelişmeler kaydedilmiştir. Farmakoterapideki gelişmeler özellikle etkinliği ve tolere edilebilir olması nedeniyle fosfodiesteraz inhibitörlerinin (PDE 5-I) birinci basamak yöntem olarak kullanıma girmesini sağlamıştır. Ancak bu ilaçların bazı hastalarda kontrendike olması, başarı oranın diyabetik hastalarda veya radikal prostatektomi cerrahisinden sonra daha düşük olması, tedaviyi bırakma nedeni ola-bilecek yan etkilerin görülebilmesi ve bu tedavi yönteminin küratif olmaması nede-niyle alternatif tedavi yöntemleri gündeme gelmektedir (4)