MP74-15 ORAL PROBENECID IMPROVES SPERM MOTILITY IN MEN WITH SPINAL CORD INJURY (SCI)

Abstract

You have accessJournal of UrologyInfertility: Therapy1 Apr 2015MP74-15 ORAL PROBENECID IMPROVES SPERM MOTILITY IN MEN WITH SPINAL CORD INJURY (SCI) Emad Ibrahim, Teodoro Aballa, Juan Pablo de Rivero Vaccari, Robert Keane, W. Dalton Dietrich, Charles Lynne, and Nancy Brackett Emad IbrahimEmad Ibrahim More articles by this author , Teodoro AballaTeodoro Aballa More articles by this author , Juan Pablo de Rivero VaccariJuan Pablo de Rivero Vaccari More articles by this author , Robert KeaneRobert Keane More articles by this author , W. Dalton DietrichW. Dalton Dietrich More articles by this author , Charles LynneCharles Lynne More articles by this author , and Nancy BrackettNancy Brackett More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2670AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Most men with SCI have abnormally low sperm motility which contributes to infertility. Our previous research has shown that the inflammasome signaling mechanism contributes to this condition [Fertil Steril 2013;99:118-24, Hum Reprod 2014;29:2368-73]. Probenecid is a uricosuric drug that inhibits the inflammasome signaling mechanism via interference with pannexin-1 channels. The objective of this study was to determine if oral administration of probenecid resulted in improved sperm motility in men with SCI. METHODS Subjects were 18 men with SCI who ejaculated regularly by penile vibratory stimulation or electroejaculation. Probenecid tablets (Watson Pharma Inc., Corona, CA) were administered in two phases. Phase 1: Subjects received 250 mg orally twice a day for 1 week. Phase 2: Subjects who completed Phase 1 with no complications were administered 500 mg orally twice a day for 3 weeks. Semen analysis was performed at three time points: Pre-treatment (Pre-Rx), 1-2 days before Phase 1; Post-treatment (Post-Rx), 1-2 days after completion of Phase 2; Follow-up (F/U), 4 weeks after completion of Phase 2. Outcomes were compared by repeated measures analysis of variance. RESULTS Oral probenecid treatment resulted in improved sperm motility in 17 of 18 men. After 4 weeks of treatment, mean sperm motility increased significantly from 18 ± 2.6% to 25 ± 3.7%, p < 0.005, Figure 1A). The improvement continued 4 weeks after cessation of oral probenecid but did not reach statistical significance (18 ± 2.6% vs. 22 ± 3.7%, p=0.19, Figure 1A). The most pronounced improvement was in the grade of sperm motility. Rapid linear motility increased significantly after 4 weeks of treatment (5.0 ± 1.3% vs. 16 ± 3.2%, p < 0.005, Figure 1B), and continued after the cessation of treatment (5.0 ± 1.3% vs. 15 ± 8.3%, p < 0.005, Figure 1B). Sperm concentrations remained normal throughout the course of the study. The medication was well-tolerated by all patients. CONCLUSIONS This is the first study to report improved sperm motility from an oral medication in men with spinal cord injury. Planned placebo-controlled trials will determine optimal dosage regimens. Probenecid holds promise as a simple, effective therapy for low sperm motility in this severely affected group of patients. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e944-e945 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Emad Ibrahim More articles by this author Teodoro Aballa More articles by this author Juan Pablo de Rivero Vaccari More articles by this author Robert Keane More articles by this author W. Dalton Dietrich More articles by this author Charles Lynne More articles by this author Nancy Brackett More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...