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Human Andrology
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This is an Open Access Journal

Open Access journal
ISSN (Print) 2090-6048 - ISSN (Online) 2090-6056
Published by Cairo Univeristy

[5 journals]

The validated Arabic version of sexual health inventory for men
questionnaire as a screening method for erectile dysfunction in outpatient
clinic patients
- Abstract: Background: Erectile dysfunction affects an estimated 20% of men older than 40 years, and the risk is increased withincreasing age and comorbidities. Sexual Health Inventory for Men (SHIM) Arabic version is a validated abbreviated version of International Index of Erectile Function.Aim: To evaluate the benefit of using the validated Arabic version of SHIM questionnaire as a screening tool for ED in KasrAlAiny outpatient clinics’ patients with main complaints other than ED.Patients and Methods: A cross sectional study included outpatients of Kasr AlAiny Clinic with complaints other thanED. 550 patients were interviewed, 415 of them agreed to be enrolled in the study after an informed written consent. After answering the validated Arabic version of the SHIM questionnaire, workup for definite diagnosis and proper management have been offered to those with score less than 21.Results: Among studied cases, 112 (27%) had no ED, 128 (30.8%) mild, 98 (23.6%) mild to moderate, 48 (11.6%) moderate,and 29 (7%) severe ED. Responders had a mean age 49.1±12.8 years, mean age for sexual partner 44.4±12.2 years and mean duration of marriage 21.2±12.4 years. Higher severity of ED was more commonly reported among older age groups, older age of sexual partner, and longer duration of marriage (P = 0.0001 for all). There was a strong negative correlation between age, age of partner and duration of marriage with total SHIM indicating ED severity (r=-0.66, -0.66 and -0.62 respectively, P = 0.0001 in all). Smoking index had a significant impact on ED severity (P =0.0001) where non-smokers reported no or mild ED while heavy and moderate smokers had higher prevalence of severe ED.Conclusion: Estrogen receptor alpha gene polymorphism has a role in the female sexual function by affecting certain domains in the sexual function.
The impact of ultrastructural tail abnormalities on sperm motility among
infertile men
- Abstract: Background: Asthenozoospermia is a status of low or absent sperm motility in fresh ejaculate. Absoluteasthenozoospermia, i.e., 100% immotile sperms, is reported in one of 5000 men. Many factors are involved in impaired sperm motility and in turn male factor infertility. The ultrastructure defects of sperm tail are considered the most important factors that cause severe asthenozoospermia.Aim: To evaluate the ultrastructure abnormalities of the sperm tail in infertile men with severe asthenozoospermia.Patients and Methods: This study was conducted on 22 asthenozoospermic (total motility < 5%) infertile patients and 10matched fertile controls. Sperm motility was evaluated by Computer-Aided Semen Analysis (CASA). Ultrastructural defects of the sperm tail were evaluated using transmission electron microscope (TEM).Results: Sperm tail defects were evident in 100% of the examined cases in this order of frequency : microtubular disturbance (91%), mitochondrial anomalies (45%), and fibrous sheath dysplasia (9%). Most of the cases showed more than one anomaly.  Patients with mitochondria anomalies had the least total motility (1.93±1.73), while patients with microtubular disturbance had the highest total motility (3.02±0.53). Moreover, patients with complex anomalies revealed the least total motility (1.5%).Conclusion: Transmission electron microscope is a vital step that should be performed in infertile men with severeasthenozoospermia who are resistant to medical treatment.
COVID-19 survivors: Women regained their ability to breathe, but did they
regain their ability to make love'
- Abstract: Background: Lately, the widespread outbreak of the coronavirus disease known as COVID-19 has been responsible forconsiderable economic and social devastation.  Aim: The current study aimed to assess the effect of COVID-19 on sexual function in a sample of sexually active married Egyptian women.Patients and Methods: April 2021 to August 2021, 300 sexually active married women who attended the outpatient clinicsat Benha University Hospital voluntarily participated in a survey to gather information regarding their sexual health. Ofthese, 150 had previously been infected with COVID-19, and 150 were healthy women with neither close contact with aninfected family member nor a history of COVID-19. This study used two indices Arabic validated form of the female sexual functioning index (FSFI) and the Arabic-validated form of depression, anxiety, and stress score (Depression Anxiety Stress Scales; DASS).  Results: In the present study, mean desire, arousal, lubrication, orgasm, satisfaction levels as well as FSFI-6 total score showed a significant gradual decrease between healthy and previously infected subjects, respectively (P<0.001 for each). However, pain frequency did not differ significantly among the studied groups. FSFI showed significant negative correlations with age, children number, and age of youngest. Mean depression, anxiety, stress, and DASS significantly increased in healthy and infected subjects, respectively (P<0.001 for each). DASS showed a significant negative correlation with FSFI.  Conclusion: The present findings suggested that COVID-19 negatively impacted all female sexual functions and increased depression, anxiety, and stress among most participants. These two indices (sexuality and psychological state) affect one another, and COVID-19 increases these affections. Most women recovered their capacity to breathe adequately after COVID-19 but did not recover their sexual abilities properly.
Male sexual dysfunction and liver fibrosis : Are there other secret
Players'
- Abstract: Background: The effect of advanced liver disease on male sexual health is wellestablished, yet data on sexual disturbancesin liver fibrosis are scant.Aim: This work aimed to investigate the sexual dysfunctions in male participants with varying stages of fibrosis.Patients and Methods: A sample of 400 male patients with varying grades of liver fibrosis were subjected to noninvasivetransient elastography (FibroScan) and evaluation of sexual functions using International Index of Erectile Functions (IIEF)and its short form.Results: Among studied participants, 57.75% had sexual dysfunction, with a significantly reduced IIEF score accompanyingrising stage of fibrosis (r=0.513, P<0.001). The IIEF score was significantly positively correlated with elevated serum albumin levels (r=0.433, P< 0.001) and hemoglobin levels (r=0.334, P=0.009).Conclusion: A high percent of patients with liver fibrosis were found to have erectile dysfunction, the severity of which was directly proportional to the stage of fibrosis. Lower serum albumin and hemoglobin levels appear to be attributes.
COVID-19-induced seminal alterations in Qalyubbia Governorate, Egypt
- Abstract: Background: A variety of viruses, including influenza and mumps virus can disrupt male reproductive function and potentially infect the testes. The pandemic COVID-19 has the ability to damage multiple organ systems. The male genitalia could be one of its targets.Aim: The purpose of this study was to determine how COVID-19 affected sperm characteristics.Patients and Methods: A cross-sectional case control study with 100 fathers who had recovered from COVID-19 threemonths before starting the study and 100 fathers of similar age who were healthy served as controls. Semen of all participants was analyzed utilizing computer-assisted semen analysis.Results: Patients who had recovered from COVID 19 had significantly lower sperm parameters than controls includingsperm concentration, progressive and total motility (P<0.001). There was no correlation between sperm count, motility,morphology index, or teratozoospermia with illness severity. Abnormal semen analysis could be predicted from the duration of COVID-19 infection..Conclusion: COVID-19 negatively impacts the male reproductive system, at least temporarily.
Evaluation of the Role of estrogen receptor alpha gene polymorphism in
female sexual function : A case controlled study
- Abstract: Introduction: Female sexual dysfunction is a common problem with serious effects on women’s quality of life. The biological effects of estrogens are mediated primarily through high-affinity binding to estrogen receptors. The association between estrogen receptor genes and sexual desire and arousal in women has not yet been specifically studied.Aim: To assess estrogen receptor alpha gene polymorphism in females with sexual dysfunction and to detect its relationship with sexual dysfunction in females.Methods: A case-control study was conducted on 48 women divided into two groups: 24 women with sexual dysfunction and 24 healthy women as a control group. Sexual function of all participants was evaluated using The Female Sexual Function Index. Estrogen receptor alpha gene polymorphism was assessed using polymerase chain reaction and Horizontal gel electrophoresis. Results: The largest percent of cases aged from 25 to less than 30 years old (79%) while in controls, the largest percentages aged from (20-
Adverse sexual effects of COVID-19 in a sample of Egyptian male patients
- Abstract: Background: COVID-19 is a pandemic caused by the SARS-CoV-2 virus, which causes severe acute respiratory syndrome.By the end of November 2022, numbers issued by the WHO indicate that over 600 million persons were infected by thedisease and more than 6 million deaths occurred due to it.Aim: The purpose of this study was to evaluate sexual functions in freshly recovered COVID-19 male patients.Patients and Methods: A case-control study was undertaken on two groups of age-matched males: Group 1: 120 men onemonth after recovering from COVID-19 infection, and Group 2: 120 normal men as a control group. All subjects underwenta thorough clinical examination and full history taking. The 15-item International Index of Erectile Function (IIEF-15) wasused to assess sexual functions. Total testosterone and prolactin levels in the blood were evaluated..Results: Cases compared with controls exhibited significantly greater prolactin (19.9±13.9, 7.7±4.4, respectively,P < 0.001) and much lower testosterone levels (3.91 ± 2.31, 5.04 ± 2.22, respectively, P < 0.001), and their meanerectile function (EF) was significantly lower(22.5±3.7, 25.8±2.7, respectively, P < 0.001). EF 14-25 was present in themajority of the cases (n=83, 69.2%), with only two cases having EF less than 14. When compared to the control group,cases had significantly reduced mean orgasmic function, sexual desire, intercourse satisfaction, total sexual satisfaction,and overall IEF.Conclusion: COVID-19 infection has a negative impact on male sexual functions.
Impact of COVID-19 pandemic on female sexual life among a sample of
Egyptian women
- Abstract: Aim: The pandemic of COVID-19 is caused by coronavirus 2(SARS-CoV-2) and leads to severe acute respiratory syndrome.  It has dominated people’s life including their psychosexual health. Consequently, we wanted to examine this pandemic effect on female sexual functions in a sample of Egyptian women.Patients and Methods: This cross-sectional study was conducted at the Department of Dermatology, Venereology, andAndrology of Benha University Hospitals. The study was conducted during the COVID-19 pandemic on 100 married females of 18–45 years’ old. Female Sexual Function Index (FSFI) was used to evaluate sexual function, while the psychological aspect was assessed using Beck Depression Inventory (BDI), social readjustment rating, Hamilton anxiety rating, and perceived stress scales. The participants were evaluated by answering retrograde questions about their sexual and psychological state before the pandemic. Then they reanswered the questionnaires about their present state during the pandemic.. Results: Total FSFI scores of the participants showed significant reduction during the pandemic when compared withprepandemic scores (P<0.001). Desire, arousal, lubrication, orgasm, and satisfaction scores reduced, but pain score increased (P<0.001). Concerning psychological evaluation, participants suffered from higher depression, stress, and anxiety levels as evidenced by Beck depression inventory (BDI), Hamilton anxiety rating, Social readjustment rating, and perceived stress scores that increased significantly during the pandemic (P<0.001).A negative correlation was observed between FSFI scores and BDI, Hamilton anxiety rating, social readjustment, and stress scores (P<0.01, r=-0.958, -0.956, -0.987, and-0.986, respectively).Conclusion: The COVID-19 pandemic seems to have a deleterious impact on female sexual behavior, which can be attributed to elevated stress, anxiety, and depression indices observed throughout the pandemic.
Coronavirus disease 2019-imposed multifaceted effect on male sexual
function: An online screening study
- Abstract: Background: Coronavirus disease (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV- 2) is a highly infectious viral disease. Cytokine storm, electrolytes imbalances, thromboembolism are the commonest signs and symptoms of the COVID-19 pandemic and are related to mitochondrial dysfunction. SARS-CoV-2 virus can affect testis directly through the ACE2, which is present on the cell surface of various testicular cells, and indirectly through the cytokine storm causing hypogonadism. COVID-19 infection may induce impairment of male sexual activity up to sexual dysfunction.Aim: The aim of this study was to evaluate the impact of COVID-19 pandemic on male sexual function (SF) in an Egyptiangovernorate "Kalyobia Governorate" using an online questionnaire.Patients and Methods: Participants included 420 married men.The protocol entails asking all patients attending thedermatology or andrology outpatient clinics to join the study through receiving an online link with identification number as a message using WhatsApp.Results: The widely-spread COVID-19 pandemic seriously affected male sexual function through varied organic affectionsor mood changes in a depressive direction. Vascular derangement was the most frequent (49.5%) organic effect of COVID-19 disease that necessitated surgical intervention in 13% of patients with ED. Genitourinary infections and hyperprolactinemia were problems inducing ED through ejaculatory problems or loss of desire in 6.7% and 4.9%, respectively. Depression was defined in 31.6% and could be a cause or a result of ED and required psychological intervention. 
Evaluation of sexual function following bipolar vaporization versus
monopolar transurethral resection of the prostate
- Abstract: Background: Little light has been shed on erectile functions following bipolar vaporization of the prostate.Patients and Methods: A prospective study was conducted that included 100 cases with a history of endoscopic prostaticsurgery. Cases were allocated into two groups: group I included 50 patients who were subjected to the conventional monopolartransurethral resection of the prostate (TURP), and group II included 50 patients who were subjected to bipolar vaporizationof the prostate. All patient were assessed 3 and 6months after the operation.Severity of benign prostatic hypertrophysymptoms and erectile function were reassessed using International Prostate Symptom Score and International Index ofErectile Function-5 (IIEF-5), respectively.Results: Although all patients in both groups demonstrated significantly lower IIEF-5 scores 3months postoperatively(P<0.0001), the percentage of IIEF-5 score reduction was insignificantly different between both groups. No significantdifferences were found at the 6-month follow-up. The erectile fraction (EF) in group II (bipolar vaporization group)was slightly better, yet insignificantly different from group I. The incidence of complications (TURP syndrome, bladderperforation, intraoperative bleeding, postoperative bleeding, and postoperative urinary tract infection) in group I (monopolarTURP) was significantly higher than the incidence in group II (bipolar vaporization). Among the study variables, it seemsthat diabetes mellitus and hypertension and development of postoperative complications (especially intraoperative bleeding,capsular perforation, and urinary tract infection) were significantly associated with development of postoperative erectiledysfunction (ED).Conclusion: No significant difference was found regarding sexual function following monopolar TURP and the bipolarvaporization of the prostate. However, the bipolar TURP is safer with less complications.
Assessment of ejaculatory function in men undergoing malleable penile
prosthesis implant surgery
- Abstract: Background: Penile prosthesis (PP), or penile implant, is one of the oldest effective treatments for the condition of erectiledysfunction and a Penile implant is always seen as a tool to provide rigidity in the penis with no other effects regarding the ejaculation.Aim of the study: To assess any change in ejaculatory function after penile prosthesis implantation (PPI)Patients and Methods: 40 male patients with erectile dysfunction scheduled for malleable penile prosthesis implantation(PPI) were included in this study. The mean age of patients was (52.5 ± 12) years. Patients were married and in a stablerelationship. We excluded patients with anejaculation or patients’ candidates for re-implantation following a complicated PPI.All patients were asked to sign an informed consent, Stating the intravaginal ejaculation latency time (IELT) before PPI andafter six months of regular coitus following the operation. Patients were asked to Fill-in the Index of Premature Ejaculation (IPE). and Premature Ejaculation Diagnostic Tool Questionnaire (PEDT) before PPI and after six months of regular coitus following PPI.  Results: Our study found PPI to increase ejaculation latency in patients who had IELT less than 12 minutes before PPI. This is especially important in patients with acquired premature ejaculation (who experienced a reduction in latency time usually less than 3 min.). In the current study, the percentage of premature ejaculation (PE) decreased from 8 patients (20%) before the operation to 3 patients (7.5%) after the operation with a highly statistically significant difference.  Conclusion: PPI does not interfere with ejaculation or orgasmic function in ED patients. Ejaculation latency time may be increased in men with rapid ejaculation (less than three minutes) or moderate ejaculation time (3-12 min), however, few men after PPI may still suffer PE. PPI for ED patients with concomitant PE may offer an added value in delaying ejaculation after the operation.
Comparative study between transverse and longitudinal incisions in
microTESE in nonobstructive azoospermic patients
- Abstract: Background: Microdissection testicular sperm extraction (microTESE) has become the standard procedure in nonobstructive men with azoospermia. Typically, wide exposure incision is always adopted in the procedure to facilitate the identification of dilated seminiferous tubules under the microscope.Aim: The aim was to compare transverse and longitudinal tunical incision techniques in complex nonobstructive azoospermic patients subjected to microTESE regarding the sperm-retrieval rate.Patients and Methods: A total of 100 patients having nonobstructive azoospermia were subjected to the following: history taking, general and genital examination, semen analysis, microTESE, and testicular biopsy for histopathology. Bilateral microTESE was done through on one side by longitudinal incision technique and on the other side by transverse incision technique.  Results: Testicular sperm was successfully retrieved in 26% of patients. The sperm-retrieval rate in mixed pathology, hypospermatogenesis, spermatogenic arrest at spermatocyte level, and sertoli cell-only syndrome was 44, 60, 31, and 12.5%, respectively. This study showed no statistically significant difference in sperm retrieval between both techniques (P=0.510).  Conclusion: The microTESE technique does not affect sperm retrieval in challenging instances. This could be explained by the identical exposure of seminiferous tubules between the two techniques. However, follow-up research is required to determine whether the two procedures have fewer adverse effects on testicular parenchyma.  
Characteristics and management of testicular torsion patients presented to
a tertiary care hospital: A prospective cohort study
- Abstract: Background: Testicular torsion is a surgical emergency that occurs when twisting of the testicle around the spermatic cordtakes place. To our knowledge there are no regional manuscripts discussing testicular torsion.Aim: The current work aimed at filling this gap by studying the characteristics and management of patients presented withtesticular torsion.Patients and Methods: Study subjects were recruited from patients presented to Kasr Al-Ainy emergency departmentcomplaining of acute testicular pain for variable duration in a period of 6 months. A total of 33 patients were included.Results: The mean presenting age was 19.56 years (±6.94). Orchidectomy was done in 18 cases (54.5%) with the meanduration of torsion 6.43 hours ± 4.05. Orchidopexy was performed in 15 cases (45.4%) with the mean duration of torsion 28.56hours ± 11.08. There was a significant correlation between duration of torsion and fate of the testis. No statistically significantcorrelation between degree of torsion and fate of testis. In all cases, the type of torsion was intravaginal. Reactive hydrocelewas visualized in 15 patients, 11 of them (73.3%) underwent orchiopexy and 4 cases (26.7%) underwent orchiectomy. Nohydrocele could be visualized in 18 cases, 14 of them (77.8%) underwent orchiectomy and 4 cases (22.2%) underwentorchiopexy. A significant correlation was found between presence of reactive hydrocele and salvage of the testis.Conclusion: The time between the onset of pain and surgical intervention is the most important factor in prediction of the fateof the testis, in preoperative ultrasound, heterogeneity and absence of a reactive hydrocele were predictive factors of organloss but this is not a reason to delay surgery as some patients did not have.

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