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Progres En Urologie : Journal de... Nov 2023The role of urogenital infections in male infertility has long been the subject of debate. (Review)
Review
BACKGROUND
The role of urogenital infections in male infertility has long been the subject of debate.
METHODS
A bibliographic search limited to English-language literature on human subjects published before 5/2023 resulted in the selection of 189 articles.
RESULTS
Male infertility is often of multifactorial aetiology, and to optimise the prognosis it is important to manage all the factors that can be corrected, including infectious causes, which represent one of the most frequent aetiologies. The infectious agents involved in urogenital infections are most often bacterial or viral, and more rarely parasitic. They can infect the seminal tract, male accessory glands and/or testicles, and usually result in inflammation and increased oxidative stress. These infections reduce male fertility, in particular by altering spermogram parameters and increasing sperm DNA fragmentation. For these reasons, the search for a urogenital infection should be systematic, involving a careful history and clinical examination, ultrasound and systematic bacteriological tests guided by clinical findings. Aetiological treatment may be proposed depending on the picture and the germ involved.
CONCLUSION
This review should help the urologist to establish an accurate diagnosis of the form and extent of the infection, and enable him to define an appropriate therapeutic strategy, tailored to the patient, in order to obtain the best chances of improving male fertility.
Topics: Humans; Male; Semen; Infertility, Male; Inflammation; Spermatozoa; Testis; Urinary Tract Infections; Bacterial Infections
PubMed: 38012909
DOI: 10.1016/j.purol.2023.09.015 -
Biomolecules Feb 2022It has been a long-standing debate in the research and medical societies whether alcohol consumption is linked to the risk of prostate cancer (PCa). Many comprehensive... (Review)
Review
It has been a long-standing debate in the research and medical societies whether alcohol consumption is linked to the risk of prostate cancer (PCa). Many comprehensive studies from different geographical areas and nationalities have shown that moderate and heavy drinking is positively correlated with the development of PCa. Nevertheless, some observations could not confirm that such a correlation exists; some even suggest that wine consumption could prevent or slow prostate tumor growth. Here, we have rigorously analyzed the evidence both for and against the role of alcohol in PCa development. We found that many of the epidemiological studies did not consider other, potentially critical, factors, including diet (especially, low intake of fish, vegetables and linoleic acid, and excessive use of red meat), smoking, family history of PCa, low physical activity, history of high sexual activities especially with early age of first intercourse, and sexually transmitted infections. In addition, discrepancies between observations come from selectivity criteria for control groups, questionnaires about the type and dosage of alcohol, and misreported alcohol consumption. The lifetime history of alcohol consumption is critical given that a prostate tumor is typically slow-growing; however, many epidemiological observations that show no association monitored only current or relatively recent drinking status. Nevertheless, the overall conclusion is that high alcohol intake, especially binge drinking, is associated with increased risk for PCa, and this effect is not limited to any type of beverage. Alcohol consumption is also directly linked to PCa lethality as it may accelerate the growth of prostate tumors and significantly shorten the time for the progression to metastatic PCa. Thus, we recommend immediately quitting alcohol for patients diagnosed with PCa. We discuss the features of alcohol metabolism in the prostate tissue and the damaging effect of ethanol metabolites on intracellular organization and trafficking. In addition, we review the impact of alcohol consumption on prostate-specific antigen level and the risk for benign prostatic hyperplasia. Lastly, we highlight the known mechanisms of alcohol interference in prostate carcinogenesis and the possible side effects of alcohol during androgen deprivation therapy.
Topics: Alcohol Drinking; Androgen Antagonists; Ethanol; Humans; Male; Prostate; Prostatic Neoplasms; Risk Factors
PubMed: 35327568
DOI: 10.3390/biom12030375 -
Oncogene Jul 2023Tuft cells are chemosensory epithelial cells that increase in number following infection or injury to robustly activate the innate immune response to alleviate or...
Tuft cells are chemosensory epithelial cells that increase in number following infection or injury to robustly activate the innate immune response to alleviate or promote disease. Recent studies of castration resistant prostate cancer and its subtype, neuroendocrine prostate cancer, revealed Pou2f3+ populations in mouse models. The transcription factor Pou2f3 is a master regulator of the tuft cell lineage. We show that tuft cells are upregulated early during prostate cancer development, and their numbers increase with progression. Cancer-associated tuft cells in the mouse prostate express DCLK1, COX1, COX2, while human tuft cells express COX1. Mouse and human tuft cells exhibit strong activation of signaling pathways including EGFR and SRC-family kinases. While DCLK1 is a mouse tuft cell marker, it is not present in human prostate tuft cells. Tuft cells that appear in mouse models of prostate cancer display genotype-specific tuft cell gene expression signatures. Using bioinformatic analysis tools and publicly available datasets, we characterized prostate tuft cells in aggressive disease and highlighted differences between tuft cell populations. Our findings indicate that tuft cells contribute to the prostate cancer microenvironment and may promote development of more advanced disease. Further research is needed to understand contributions of tuft cells to prostate cancer progression.
Topics: Male; Mice; Humans; Animals; Prostate; Protein Serine-Threonine Kinases; Signal Transduction; Prostatic Neoplasms; Epithelial Cells; Tumor Microenvironment; Doublecortin-Like Kinases
PubMed: 37386128
DOI: 10.1038/s41388-023-02743-1 -
Urology Nov 2019Sepsis following transrectal prostate biopsy occurs in 2%-5% of cases and the risk is increasing. We performed a comprehensive literature search for the cost of... (Review)
Review
Sepsis following transrectal prostate biopsy occurs in 2%-5% of cases and the risk is increasing. We performed a comprehensive literature search for the cost of post-prostate biopsy sepsis to define the potential cost savings of reducing infectious complications. Reporting of cost is varied and presents a challenge to interpretation. Length of hospitalization ranged from 1.1 to 14 days and the percent admitted to an ICU ranged from 1.1% to 25%. The estimated cost of sepsis post-prostate biopsy, adjusted for inflation, ranged from $8,672 to $19,100. Healthcare costs of treating post-biopsy infection are substantial. Our findings should guide payers and policymakers, especially in value-based care models.
Topics: Biopsy; Health Care Costs; Humans; Male; Postoperative Complications; Prostate; Sepsis
PubMed: 31229516
DOI: 10.1016/j.urology.2019.06.011 -
Asian Journal of Andrology 2020For more than nine decades, transurethral resection of the prostate remains the gold standard for the surgical treatment of lower urinary tract symptoms due to benign... (Review)
Review
For more than nine decades, transurethral resection of the prostate remains the gold standard for the surgical treatment of lower urinary tract symptoms due to benign prostatic obstruction. The occurrence of urethral strictures after transurethral resection of the prostate is one of the major late complications and has been reported as the leading cause of iatrogenic urethral strictures in patients older than 45 years who underwent urethroplasty. Although several postulations have been proposed to explain the urethral stricture after transurethral resection of the prostate, the exact etiology of urethral stricture after TURP is still controversial. Suggested etiological factors of urethral stricture formation after transurethral resection of the prostate include infection, mechanical trauma, prolonged indwelling catheter time, use of local anesthesia, and electrical injury by a stray current. One single treatment option is not appropriate for all stricture types. The management of urethral stricture following transurethral resection of the prostate includes minimally invasive endoscopic methods, including urethral dilation and direct visual incision, or open surgical procedures with varying urethroplasty techniques. Although scientific studies focusing on urethral strictures after transurethral resection of the prostate are relatively limited and sparse, we can apply the principles of urethral stricture management before making decisions on individual stricture treatment.
Topics: Humans; Male; Middle Aged; Prostate; Prostatic Hyperplasia; Transurethral Resection of Prostate; Urethra; Urethral Stricture
PubMed: 31898584
DOI: 10.4103/aja.aja_126_19 -
World Journal of Urology Sep 2021Sepsis after prostate biopsy is a costly and potentially lethal complication. We sought to assess whether enhanced antibiotic prophylaxis regimens combining oral and...
PURPOSE
Sepsis after prostate biopsy is a costly and potentially lethal complication. We sought to assess whether enhanced antibiotic prophylaxis regimens combining oral and parenteral antibiotics may decrease the risk of post-biopsy urinary tract infection and sepsis compared to regimens with only oral antibiotics.
METHODS
We identified men with commercial insurance who underwent prostate biopsy (2009-2015) with prophylactic antibiotic coverage. Our primary exposure of interest was antibiotic regimen: enhanced, oral-only, and parenteral-only. Post-biopsy outcomes of interest included urinary tract infections and sepsis/bacteremia after prostate biopsy. We used bivariate testing to assess associations between outcomes, exposures, and other covariates of interest. Multivariable regression was used to estimate adjusted odds of infectious outcomes based on antibiotic regimen.
RESULTS
We identified 163,831 men who underwent prostate biopsy. The proportion of men with infectious complications (5.5% in 2009 to 6.9% in 2015, p < 0.001) and sepsis (0.24% in 2009 to 0.30% in 2015, p = 0.327) increased over the timeframe of our analysis. Use of fluoroquinolones was associated with a decreased risk of infectious outcomes (5.8 vs 7.3% without, OR 0.83, 95% CI 0.79-0.88). Use of enhanced antibiotic regimens was associated with an increased risk of infectious outcomes (6.8 vs 5.7% oral, OR 1.23, 95% CI 1.16-1.31) and sepsis (0.34 vs 0.24% oral, OR 1.40, 95% CI 1.08-1.82) among our cohort.
CONCLUSION
We did not observe a significant reduction in infectious complications among men who received enhanced antibiotics regimens before prostate biopsy. This may be due to increased antibiotic resistance or unmeasured risk factors among those receiving enhanced regimens.
Topics: Antibiotic Prophylaxis; Bacterial Infections; Biopsy; Humans; Male; Middle Aged; Postoperative Complications; Prostate; Risk Assessment; Sepsis; Urinary Tract Infections
PubMed: 33772321
DOI: 10.1007/s00345-021-03674-w -
Scientific Reports Sep 2022Trichomonas vaginalis infection is one of the most widespread sexually transmitted infections in the world. There are approximately 276 million cases worldwide. Most men...
Trichomonas vaginalis infection is one of the most widespread sexually transmitted infections in the world. There are approximately 276 million cases worldwide. Most men remain undiagnosed and untreated because they are asymptomatic. The chronic inflammation induced by persistent infection may increase the risk of developing genitourinary cancers. In this study, we aimed to investigate the association between trichomoniasis and benign prostate hyperplasia (BPH), prostate cancer (PCa), and bladder cancer (BC) in Taiwan. We designed a case-control study by using the database of the National Health Insurance program in Taiwan. We used the International Classification of Diseases, 9th Revision classifications to classify all the medical conditions in the case and control groups. All odds ratios (ORs) and 95% confidence intervals (CIs) were analyzed using multivariable logistic regression to adjust for all comorbidities and variables. From 2000 to 2015, we enrolled a total of 62,544 individuals as the case group and 187,632 as the control group. Trichomoniasis exposure had a significant association with BPH and PCa (adjusted OR: BPH = 2.685, 95% CI = 1.233-4.286, P = 0.013; PCa = 5.801, 95% CI = 1.296-26.035, P = 0.016). The relative risk was much higher if patients had both trichomoniasis and depression (adjusted OR = 7.682, 95% CI = 5.730-9.451, P < 0.001). Men with trichomoniasis had a significantly higher risk of developing BPH and PCa than those without. Healthcare professionals should not only pay more attention to disease treatment, but also to public health education.
Topics: Case-Control Studies; Humans; Male; Prostate; Prostatic Hyperplasia; Trichomonas Infections; Urinary Bladder Diseases
PubMed: 36100630
DOI: 10.1038/s41598-022-19561-2 -
European Urology Focus Jan 2020
Topics: Anti-Bacterial Agents; Anti-Infective Agents; Biopsy; Humans; Male; Prostate; Sepsis
PubMed: 30177401
DOI: 10.1016/j.euf.2018.08.011 -
APMIS : Acta Pathologica,... Feb 2020Chronic inflammation can create a microenvironment that can contribute to the formation of prostate pathologies. Far less well understood is the origin of inflammation... (Review)
Review
Chronic inflammation can create a microenvironment that can contribute to the formation of prostate pathologies. Far less well understood is the origin of inflammation in the prostate. One potential source is microbial infections of the prostate. This review summarizes recent findings regarding the presence of bacteria in the prostate and the dysbiosis of bacterial populations in the urinary tract and the gastrointestinal tract related to prostate cancer, thereby focusing on next-generation sequencing (NGS)-generated data. The current limitations regarding NGS-based detection methods and other difficulties in the quest for a microbial etiology for prostate cancer are discussed. We then focus on a few bacterial species, including Cutibacterium acnes and Escherichia coli that are often NGS-detected in prostatic tissue specimens, and discuss their possible contribution as initiator or enhancer of prostate inflammation and prostate carcinogenesis.
Topics: Animals; Bacterial Infections; Humans; Inflammation; Male; Prostate; Prostatic Neoplasms
PubMed: 31990107
DOI: 10.1111/apm.13021 -
Reviews on Environmental Health Jun 2021All men, almost, suffer from prostatic disorders in average life expectancy. In the year of 1950s, the first autopsy of prostate gland discovered the link between Benign... (Review)
Review
All men, almost, suffer from prostatic disorders in average life expectancy. In the year of 1950s, the first autopsy of prostate gland discovered the link between Benign prostatic hyperplasia (BPH) and Prostate Cancer (PCa). After that, many histology, biochemistry, epidemiology studies explained the association and associated risk factor for the same. From the various scientific evidence, it is proved that both diseases share some common transcription factors and signalling pathways. Still, BPH cannot be considered as the first step of PCa progression. To define, the relationship between both of the diseases, a well-defined large epidemiological study is needed. Along with androgen signalling, imbalanced apoptosis, oxidative stress, and microbial infection also crucial factors that significantly affect the pathogenesis of BPH. Various signalling pathways are involved in the progression of BPH. Androgen signalling is the driving force for the progress of PCa. In PCa androgen signalling is upregulated as compared to a healthy prostate. Some dominant Androgen-regulated genes and their functions have been discussed in this work.
Topics: Humans; Male; Oxidative Stress; Prostate; Prostatic Hyperplasia; Prostatic Neoplasms; Risk Factors
PubMed: 32960781
DOI: 10.1515/reveh-2020-0051