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Journal of Pediatric Surgery Apr 2022Laparoscopic orchiopexy (LO) was recently described as superior to open orchiopexy (OO) for palpable undescended testes (UDT). We aimed to investigate the outcomes of LO... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND/PURPOSE
Laparoscopic orchiopexy (LO) was recently described as superior to open orchiopexy (OO) for palpable undescended testes (UDT). We aimed to investigate the outcomes of LO of palpable UDT in relation to high retroperitoneal dissection, Prentiss maneuver and intrascrotal testis fixation; also, to identify evidence for the safety, efficacy and cost of LO compared with OO in palpable UDT.
METHODS
Systematic search was performed for all studies on LO for palpable UDT, and for all comparative studies between LO and OO in palpable UDT. Fisher's test was used to assess associations between success/complications rates and different LO approaches and meta-analysis to compare LO and OO.
RESULTS
In LO, success rates were not affected by regular high dissection (p = 1.0), Prentiss maneuver (p = 1.0) or intrascrotal fixation (p = 1.0); in fact, higher complications rates were noticed with regular high dissection (p = 0.002) and Prentiss maneuver (p = 0.01). Meta-analysis showed no significant differences between LO and OO in success (p = 0.17) and complications (p = 0.14) rates, while LO cost was higher in all comparative studies.
CONCLUSIONS
Evidence shows higher benefit-cost ratio for OO and, therefore, the latter should remain the procedure of choice. LO can be alternatively used, as it shows comparable safety/efficacy, but it should not include high dissection, Prentiss maneuver and testis fixation, when unnecessary.
TYPE OF STUDY
Systematic review and meta-analysis LEVEL OF EVIDENCE: III.
Topics: Cryptorchidism; Dissection; Humans; Infant; Laparoscopy; Male; Orchiopexy
PubMed: 34304904
DOI: 10.1016/j.jpedsurg.2021.07.003 -
Physiological and pathological functions of βB2-crystallins in multiple organs: a systematic review.Aging Jun 2021Crystallins, the major constituent proteins of mammalian lenses, are significant not only for the maintenance of eye lens stability, transparency, and refraction, but...
Crystallins, the major constituent proteins of mammalian lenses, are significant not only for the maintenance of eye lens stability, transparency, and refraction, but also fulfill various physiopathological functions in extraocular tissues. βB2-crystallin, for example, is a multifunctional protein expressed in the human retina, brain, testis, ovary, and multiple tumors. Mutations in the βB2 crystallin gene or denaturation of βB2-crystallin protein are associated with cataracts, ocular pathologies, and psychiatric disorders. A prominent role for βB2-crystallins in axonal growth and regeneration, as well as in dendritic outgrowth, has been demonstrated after optic nerve injury. Studies in βB2-crystallin-null mice revealed morphological and functional abnormalities in testis and ovaries, indicating βB2-crystallin contributes to male and female fertility in mice. Interestingly, although pathogenic significance remains obscure, several studies identified a clear correlation between βB2 crystallin expression and the prognosis of patients with breast cancer, colorectal cancer, prostate cancer, renal cell carcinoma, and glioblastoma in the African American population. This review summarizes the physiological and pathological functions of βB2-crystallin in the eye and other organs and tissues and discusses findings related to the expression and potential role of βB2-crystallin in tumors.
Topics: Black or African American; Humans; Lens, Crystalline; Neoplasms; Organ Specificity; beta-Crystallin B Chain
PubMed: 34118792
DOI: 10.18632/aging.203147 -
Endocrine, Metabolic & Immune Disorders... 2021Coronaviruses are a big family of viruses that can infect mammalians and birds. In humans they mainly cause respiratory tract infections, with a large spectrum of...
Coronaviruses are a big family of viruses that can infect mammalians and birds. In humans they mainly cause respiratory tract infections, with a large spectrum of severity, from mild, self-limited infections to highly lethal forms as severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV) and Coronavirus Disease 2019 (COVID-19). Scanty data are reported for the involvement of endocrine glands in human coronaviruses, in particular SARS-CoV-2. In this review, we summarize endocrinological involvement in human coronaviruses, including data on animal coronaviruses. Avians, ferrets and bovine are affected by specific coronavirus syndromes, with variable involvement of endocrine glands. SARS-CoV and SARS-CoV-2 use angiotensin-converting enzyme 2 (ACE2) as a target receptor, so ACE2 plays a central role in viral transmission and initial organ involvement. Autoptic studies on SARS patients revealed that thyroid, parathyroid, pituitary gland, endocrine pancreas and especially adrenals and testis could be impaired by different mechanisms (direct damage by SARS-CoV, inflammation, vascular derangement and autoimmune reactions) and few clinical studies have evidenced functional endocrine impairment. Only few data are available for COVID-19 and gonads and endocrine pancreas seem to be involved. International endocrinological societies have brought some recommendations for the COVID-19 pandemic, but further studies need to be performed, especially to detect long-term hormonal sequelae.
Topics: Angiotensin-Converting Enzyme 2; Animals; COVID-19; Endocrine Glands; Endocrine System; Endocrine System Diseases; Humans; Middle East Respiratory Syndrome Coronavirus; SARS-CoV-2
PubMed: 32888287
DOI: 10.2174/1871530320666200905123332 -
Journal of Pediatric Surgery Jul 2022Cryptorchidism associated with gastroschisis has been poorly investigated. We aimed to assess the prevalence of this association, and to address the management and... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Cryptorchidism associated with gastroschisis has been poorly investigated. We aimed to assess the prevalence of this association, and to address the management and outcome of cryptorchidism in this context.
MATERIALS AND METHODS
In this systematic review, we searched electronic databases (PubMed, Web of Science, and Google Scholar), without language restrictions from inception to March 31, 2021, for studies on cryptorchidism and gastroschisis co-occurrence. Random effects meta-analysis was used to calculate pooled prevalence estimates of cryptorchidism in gastroschisis and spontaneous testicular descent in this population.
RESULTS
Twenty-five studies were included for the systematic review. All were retrospective case reports or series for a total of 175 patients. Pooled prevalence estimate for cryptorchidism in gastroschisis was 19% (95% CI 13-26). Complete data sets for management and outcome analysis were available in 94 patients, involving 120 undescended testes [63 (52.5%) nonpalpable, 34 (28.3%) prolapsed outside the abdominal wall defect, and 23 (19.2%) palpable]. Fifty-five descended spontaneously, with a pooled prevalence estimate of 50% (95% CI 31-69). Twelve testes/remnants were primarily removed or absent, while 49 testes underwent orchiopexy (success rate, 63%). Excluding 4 testes still awaiting orchiopexy, 30 of the remaining 116 (25.8%) testes had a dismal outcome, including testicular loss (19), hypoplasia (8) or recurrent cryptorchidism (3).
CONCLUSION
Cryptorchidism in gastroschisis appears to occur more frequently than in the normal population. The overall mediocre testicular outcome seems to reflect the most unfavorable presentation of cryptorchidism in gastroschisis, which is represented by originally intrabdominal or prolapsed testis in the majority of cases.
LEVEL OF EVIDENCE
IV.
Topics: Cryptorchidism; Gastroschisis; Humans; Infant; Male; Orchiopexy; Prevalence; Retrospective Studies; Testis
PubMed: 34344532
DOI: 10.1016/j.jpedsurg.2021.07.006 -
Minerva Urology and Nephrology Aug 2021The prevalence of testicular tumor is constantly increasing, with an estimated incidence rate of about 3-10 new cases per 100,000 males/per year. Radical orchiectomy or...
INTRODUCTION
The prevalence of testicular tumor is constantly increasing, with an estimated incidence rate of about 3-10 new cases per 100,000 males/per year. Radical orchiectomy or testis sparing surgery (TSS) are recognized therapeutic approaches in these cases. However, the risk for hypogonadism and infertility is higher with the former compared with the latter. The aim of this systematic review is to evaluate the oncological outcome and testicular function (endocrine and reproductive aspects) in patients who had undergone TSS for small testicular lesions.
EVIDENCE ACQUISITION
To accomplish this, 684 articles were retrieved and screened; 24 retrospective and two prospective studies were selected and finally included in this systematic review.
EVIDENCE SYNTHESIS
Overall the TSS attempts were 1096 but TSS was definitively performed in 603 cases (55%). Frozen section examination was performed in 996 TSS attempts (22 out of the 26 studies selected) and showed a benign histology in 37-100% of cases, a malignant histology in 0-63%, and an inconclusive result in 0-16%, respectively. Five studies reported that a total of 22 patients were able to father after conservative surgery. None of these studies reported cases of hypotestosteronemia after surgery and a low prevalence (1.66%) of complications was associated with this type of surgery.
CONCLUSIONS
In conclusion, TSS showed to be safe and practicable if used according to the specific guidelines. It can be safely performed to treat recurrence eventually associated to local adjuvant radiotherapy when an intra-tubular neoplasia is present. Urologists can therefore consider TSS as an important means against testicular tumor in selected and well-informed patients.
Topics: Frozen Sections; Humans; Male; Orchiectomy; Prospective Studies; Retrospective Studies; Testicular Neoplasms; Testis
PubMed: 33949185
DOI: 10.23736/S2724-6051.21.04330-5 -
Reproductive Biology and Endocrinology... Aug 2017The Catsper channel is a sperm-specific, Ca-permeable, pH-dependent, and low voltage-dependent channel that is essential for the hyperactivity of sperm flagellum,... (Review)
Review
The Catsper channel is a sperm-specific, Ca-permeable, pH-dependent, and low voltage-dependent channel that is essential for the hyperactivity of sperm flagellum, chemotaxis towards the egg, capacitation and acrosome reaction. All of these physiological events require calcium entry into sperm cells. Remarkably, Catsper genes are exclusively expressed in the testis during spermatogenesis, and are sensitive to ion channel-induced pH change, such as NHEs, CaATPase, K channel, Hv1 channel and HCO transporters. Furthermore, the Catsper channel is regulated by some physiological stimulants, such as progesterone, cyclic nucleotides (e.g., cAMP, cGMP), zona pellucida (ZP) glycoproteins and bovine serum albumin (BSA). All of these factors normally stimulate Ca entry into sperm through the Catsper channel. In addition, the Catsper channel may be a potential target for male infertility treatment or contraception. This review will focus on the structure, functions, regulation mechanisms and medicinal targets of the Catsper channel.
Topics: Animals; Calcium Channels; Calcium Signaling; Humans; Hydrogen-Ion Concentration; Infertility, Male; Male; Mice; Spermatozoa
PubMed: 28810916
DOI: 10.1186/s12958-017-0281-2 -
European Urology Oncology May 2024Mutations in the speckle-type POZ (SPOP) gene are frequently identified in prostate cancer (PC); yet, prognostic implications for affected patients remain unclear.... (Review)
Review
CONTEXT
Mutations in the speckle-type POZ (SPOP) gene are frequently identified in prostate cancer (PC); yet, prognostic implications for affected patients remain unclear. Limited consensus exists regarding tailored treatments for SPOP-mutant (SPOPmut) PC.
OBJECTIVE
To elucidate the prognostic and predictive significance of SPOP mutations across distinct PC stages and treatments.
EVIDENCE ACQUISITION
A systematic literature search of PubMed, Embase, and Scopus was conducted up to January 29, 2024. The meta-analysis included studies comparing survival outcomes between SPOPmut and SPOP wild-type (SPOPwt) PC.
EVIDENCE SYNTHESIS
From 669 records, 26 studies (including five abstracts) were analyzed. A meta-analysis of metastasis-free survival in localized (hazard ratio [HR]: 0.72, 95% confidence interval [CI]: 0.59-0.88; p < 0.01) and overall survival (OS) in metastatic PC (HR: 0.64, 95% CI: 0.53-0.76; p < 0.01) showed a favorable prognosis for patients with SPOPmut PC. In metastatic settings, SPOP mutations correlated with improved progression-free survival (PFS) and OS in patients undergoing androgen deprivation therapy ± androgen receptor signaling inhibitor (HR: 0.51, 95% CI: 0.35-0.76, p < 0.01, and HR: 0.60, 95% CI:0.46-0.79, p < 0.01, respectively). In metastatic castration-resistant PC, only abiraterone provided improved PFS and OS to patients with SPOP mutations compared with patients with SPOPwt, but data were limited. SPOP mutations did not correlate with improved PFS (p = 0.80) or OS (p = 0.27) for docetaxel.
CONCLUSIONS
Patients with SPOPmut PC seem to exhibit superior oncological outcomes compared with patients with SPOPwt. Tailored risk stratification and treatment approaches should be explored in such patients.
PATIENT SUMMARY
Speckle-type POZ (SPOP) mutations could be a favorable prognostic factor in patients with prostate cancer (PC) and may also predict better progression-free and overall survival than treatment with hormonal agents. Therefore, less intensified treatments omitting chemotherapy for patients with SPOP-mutant PC should be explored in clinical trials.
PubMed: 38704358
DOI: 10.1016/j.euo.2024.04.011 -
Robot-assisted retroperitoneal lymph node dissection: a systematic review of perioperative outcomes.BJU International Jul 2023To assess the safety and feasibility of robot-assisted retroperitoneal lymph node dissection (R-RPLND) and to compare the perioperative outcomes of R-RPLND with open... (Review)
Review
OBJECTIVE
To assess the safety and feasibility of robot-assisted retroperitoneal lymph node dissection (R-RPLND) and to compare the perioperative outcomes of R-RPLND with open RPLND (O-RPLND), as RPLND forms an integral part of the management of testis cancer and R-RPLND is a minimally invasive treatment option for this disease.
MATERIALS AND METHODS
The PubMed , Scopus , Cochrane Central Register of Controlled Trials, and Web of Science™ databases were searched for studies reporting perioperative outcomes of primary and post-chemotherapy R-RPLND and studies comparing R-RPLND with O-RPLND.
RESULTS
The search yielded 42 articles describing R-RPLND, including five comparative studies. The systematic review included 4222 patients (single-arm studies, n = 459; comparative studies, n = 3763). Of 459 patients in the single-arm studies, 271 underwent primary R-RPLND and 188 underwent post-chemotherapy R-RPLND. For primary R-RPLND, the operative time ranged from 175 to 540 min and the major complication rate was 4.1%. For post-chemotherapy R-RPLND, the operative time ranged from 134 to 550 min and the major complication rate was 8.5%. The conversion rate to open surgery was 2.2% in primary R-RPLND and 9.0% in post-chemotherapy R-RPLND. In comparison with O-RPLND, R-RPLND was associated with a lower transfusion rate (14.5% vs 0.9%, P < 0.001) and a lower complication rate (18.5% vs 7.8%, P = 0.002).
CONCLUSION
Robot-assisted RPLND has acceptable perioperative outcomes in both the primary and post-chemotherapy settings but a notable rate of conversion to open surgery in the post-chemotherapy setting. Compared with O-RPLND, R-RPLND is associated with a lower transfusion rate and fewer overall complications. Given the potential impact of selection bias, the optimal patient selection criteria for R-RPLND remain to be elucidated.
Topics: Male; Humans; Robotics; Retroperitoneal Space; Neoplasms, Germ Cell and Embryonal; Lymph Node Excision; Testicular Neoplasms; Retrospective Studies; Treatment Outcome
PubMed: 36754376
DOI: 10.1111/bju.15986 -
Andrologia Nov 2020Nonylphenol (NP) is known as an environmental pollutant that has adverse effects on the spermatogenesis process. In this review, we focus on (1999-2020) studies on the... (Review)
Review
Nonylphenol (NP) is known as an environmental pollutant that has adverse effects on the spermatogenesis process. In this review, we focus on (1999-2020) studies on the effect of this pollutant on the sperm parameters and the male reproductive system. Spermatogenesis is a process in which male spermatogonia (primary germ cells) is divided into meiosis and produce spermatozoa. NP and its isomers can cause oxidative stress and alter the production of sex hormones, and thereby disrupting this vital process. By searching in the scientific databases of PubMed, Google Scholar, Science Direct, Springer and Web of Science related articles were extracted. As a result, all observations have confirmed that NP can cause multiple damages to the spermatogenesis and male reproductive system.
Topics: Humans; Male; Phenols; Spermatogenesis; Spermatozoa; Testis
PubMed: 32662580
DOI: 10.1111/and.13748 -
Toxicology May 2023Eutrophication of water bodies can lead to cyanobacterial blooms, with the resultant release of microcystins (MCs), posing a threat to the ecosystem and human health.... (Review)
Review
Eutrophication of water bodies can lead to cyanobacterial blooms, with the resultant release of microcystins (MCs), posing a threat to the ecosystem and human health. MCs are environmental toxins with male reproductive toxicity. However, there is a dearth of reviews focusing on sperm or spermatogenesis. In this paper, studies on sperm toxicity caused by MCs in recent 20 years were collected and summarized, aiming at revealing the toxic effects and potential mechanisms of MCs on sperm. Based on the previous findings, MCs can decline sperm quality and count, and cause malformation in vertebrates and invertebrates. The reason might be that MCs cause indirect damage to sperm through impairing the structure and function of the testis. The mechanisms of MCs-induced sperm toxicity mainly result from alterations in genetic material, abnormalities in the structure and function of sperm. The epigenetic modifications such as miRNA and piRNA were also involved in MC-LR-induced sperm damage. In conclusion, MCs exposure is harmful to sperm, but its direct effects and mechanisms on sperm are still not known, which remains a significant research direction. Our review will provide a basis for the protection of male reproductive health damage caused by microcystins.
Topics: Animals; Male; Humans; Microcystins; Ecosystem; Semen; Testis; Spermatozoa
PubMed: 37030550
DOI: 10.1016/j.tox.2023.153507