Volume Of Seminal Vesicles Research Articles

Curcumin ameliorates pyroptosis in diabetic seminal vesicles by upregulating TRPV6.

Diabetes damages the seminal vesicle tissues leading to a decrease in seminal fluid secretion, so investigations are ongoing to identify specific therapeutic approaches to address diabetes-induced damage to seminal vesicles. This study investigated the secretory dysfunction of seminal vesicles and how curcumin can ameliorate this dysfunction. First, 40 diabetic males (DM group) and 40 nondiabetic males (control group) underwent seminal vesicle ultrasound evaluation and ejaculate volume measurements. Then, the effects of curcumin on seminal vesicle function were investigated in a diabetic rat model. Fifty 8-week-old SPF-grade SD rats were categorized into five groups: control, DM (diabetes mellitus), low-dose CUR (curcumin 50mg/kg/d), medium-dose CUR (curcumin 100mg/kg/d), and high-dose CUR (curcumin 150mg/kg/d). After a month-long diet with varying curcumin doses, key parameters such as body weight, blood glucose levels, seminal vesicle volume, and seminal fluid secretion were measured. Transcriptome sequencingwas performed to assess differences in gene expression and structural changes in rat seminal vesicle tissues were examined by HE staining. Finally, human seminal vesicle cell lines were cultured and divided into five groups (HG-CON, HG-CUR-5µM, HG-CUR-10µM, HG-CUR-20µM, and HG-CUR-50µM) to measure the fructose levels in the seminal vesicle cell culture fluids and evaluate the expression of CASP1, GSDMD, and TRPV6. Post TRPV6 interference, variations in the gene expression of CASP1, GSDMD, and TRPV6 were monitored. Diabetic patients exhibited a notable reduction in seminal vesicle volume and ejaculate volume compared with the control group, with a direct correlation between the decrease in ejaculate and seminal vesicle volume. Animal studies demonstrated that curcumin supplementation significantly augmented seminal vesicle volume in diabetic rats and notably improved their seminal vesicle secretory dysfunction, particularly in the high-dose curcumin group. Transcriptome sequencing and experimental verification pinpointed the differential expression of TPRV6 and pyroptosis-associated genes (CASP1, GSDMD), with reduced TRPV6 expression but increased markers of pyroptosis (CASP1 and GSDMD) in diabetic rats. Curcumin treatment reversed these effects with an increase in TRPV6 and a decrease in GSDMD and CASP1. Cell transfection experiments indicated that TRPV6 downregulation increased GSDMD and CASP1 gene expression. Curcumin effectively activates TRPV6, thereby diminishing pyroptosis in the seminal vesicle tissues of diabetic rats. This activation not only leads to an increase in the seminal vesicle volume but also significantly ameliorates the seminal vesicle secretory dysfunction in diabetic rats.

Complanatuside A Inhibits Seminal Vesicle Cell Apoptosis by Activating SerpinB1a in Type 2 Diabetic Mice

Type 2 diabetes mellitus (T2DM) can trigger cell apoptosis of seminal vesicles (SVs) and impair seminal secretory functions. Complanatuside A (CA) is known for its anti‐inflammatory and antioxidant effects, as well as its ability to repair cellular damage. This study aimed to explore the potential molecular mechanisms through which CA mitigates cell apoptosis in the SVs of type 2 diabetic mice. A streptozotocin‐induced type 2 diabetic mice model was utilized, and a 1‐month intervention using CA (70 mg/kg) was administered. We monitored body weight, blood glucose levels, SV volume, and concentration of SV fluid. Hematoxylin and eosin staining was used to assess tissue damage. RNA sequencing was applied to identify differential gene expression, and the expression of target genes (ARG2, PBK, SerpinB1a, E2F2) was verified by qRT‐PCR. Changes in the apoptosis level of SV tissues in mice were detected with TUNEL staining. Compared to the control group, mice with T2DM exhibited decreased SV volume and SV fluid content, which was improved with CA treatment. Elevated expression of SerpinB1a and reduced apoptosis were observed in the T2DM‐CA group compared to T2DM mice. In summary, CA can inhibit cell apoptosis in the SVs, there by improving tissue damage in type 2 diabetic mice. SerpinB1a may be involved in this process. This study provides a new theoretical foundation for the treatment of seminal vesicle secretory dysfunction in type 2 diabetes mellitus.

Seminal Vesicle Treatment for Localized Prostate Cancer Treated with External Beam Radiotherapy.

This study retrospectively reviewed data from men with localized prostate cancer treated with external beam radiotherapy (EBRT). We identified 359 men with localized prostate cancer treated with curative EBRT at the Cross Cancer Institute between 2010-2011. The volume of seminal vesicles (SVs) treated as well as dose values were extracted. These volumes were compared to gold standard contours drawn by a trained expert based on consensus European Society for Radiotherapy and Oncology (ESTRO) contouring guidelines. Patient and tumor characteristics were extracted for these patients. Memorial Sloan Kettering prostate cancer nomogram was used to assign a predicted risk of SV involvement for each patient based on baseline tumor characteristics. In patients with a predicted risk of SV involvement greater than 15% (n = 184), 86.5% (SD = 18.6) of the base of the SVs were treated with EBRT, compared to 66.7% (SD = 32.6) for patients with a predicted risk of SV involvement less than 15% (n = 175, p < 0.0001). Similarly, the mean percentage of proximal and total SV volumes treated with EBRT was 75.6% (SD = 24.4) and 68.7% (SD = 26.0) for patients with a predicted risk of SV involvement of greater than 15%, compared to 50.3% (SD = 31.0, p < 0.0001) and 41.0% (SD = 27.8, p < 0.0001) for patients with a risk of less than 15%. The results indicate that all parts of the SVs are more likely to be contoured in men with >15% risk of SV involvement than those with <15% risk. However, radiation oncologists still contour a high percentage of SVs in men with <15% risk of SV involvement, suggesting that there may be over-treatment of SVs that increases the risk of rectal or bladder toxicity.

Application of seminal vesiculoscopy on the treatment of seminal vesiculitis

Objective: The development of seminal vesicle technology has greatly improved the efficiency of diagnosis and treatment of seminal vesiculitis, but its long-term efficacy and postoperative complications still need to be evaluated further.&#x0D; Patients and methods: Ninety-eight patients with seminal vesiculitis were randomly assigned to a traditional medical treatment control group (n = 49) and a seminal vesiculoscopy group (n = 49). The clinical efficacy of the two groups of patients, including blood sperm and pain, was evaluated 1 month after surgery. The maximum urine flow rate (MFR) and the average urine flow rate (AFR) were measured.&#x0D; Results: Compared with traditional medicine, seminal vesicle endoscopy has a higher clinical effect on seminal vesiculitis. Seminal vesicle therapy was more effective in reducing blood cells in patient’s semen and improving the patient’s urinary function. The seminal vesicle volume and seminal fructose were significantly improved.&#x0D; Conclusions: The efficacy of seminal vesiculoscopy for seminal vesiculitis is better than traditional medicine.

Neoadjuvent androgen deprivation for seminal vesicle reduction: The optimal portion of seminal vesicle included in the high-dose CTV in localized prostate cancer radiotherapy

ObjectiveTo clarify the length and volume reduction of seminal vesicles (SVs) after neo-adjuvant hormonal therapy (NHT), in order to help contour the optimal SV included into high-dose clinical target volume (CTV) for radiotherapy in intermediate- and high-risk patients. MethodsMR images both before and after NHT (5.3 ​± ​2.2 months) were collected from thirty-one patients with cT2-4N0M0 prostate cancer. SV volume was measured in axial T1WI, while SV length was obtained in a reconstructed oblique coronary plane through its long axial from a 3D sequence. ResultsSVs showed evident reduction both in length and volume (length: median 12.1%, range 4.0%–28.0%; volume: median 39.9%, range 9.4%–66.2%). For SVs with and without MR detected involvement, length shortening were (16.7 ​± ​4.8)% and (11.1 ​± ​4.4)% (P ​< ​0.001); for involved SVs and lesions, volume reduction were (41.0 ​± ​16.0)% and (66.3 ​± ​14.4)%, respectively (P ​< ​0.001), both indicating a more sensitive response to NHT of the involved portion than normal SV. ConclusionsBoth volume and length of the SV will be reduced after receiving NHT. Besides, the invaded segments shrink more than normal SV tissue, indicating that SV portion included within the CTV can be reduced.

The European Academy of Andrology (EAA) ultrasound study on healthy, fertile men: An overview on male genital tract ultrasound reference ranges.

So far, male genital tract color-Doppler ultrasound (MGT-CDUS) was not standardized. Recently, the European Academy of Andrology (EAA) published the results of a multicenter study assessing the CDUS characteristics of healthy-fertile men (HFM) to obtain normative parameters. To report the EAA US study (i) standard operating procedures (SOPs) for assessing MGT-CDUS, (ii) main MGT-CDUS normative parameters, and (iii) compare the EAA and previously published "normal" CDUS values. A cohort of 248 HFM (35.3±5.9 years) was studied, evaluating MGT-CDUS before and after ejaculation following SOPs. SOPs for MGT-CDUS assessment are summarized here. All subjects underwent scrotal CDUS and 188 men underwent transrectal ultrasound before and after ejaculation. The main CDUS reference ranges and characteristics of the HFM-MGT are reported here. The mean testicular volume was ∼17mL. The lower limit for right and left testis was 12 and 11mL, defining testicular hypotrophy. The upper limit for epididymal head, body, tail, and vas deferens was 11.5, 5, 6, and 4.5mm, respectively. Testicular and epididymal arterial reference ranges are reported. The EAA varicocoele classification is reported. CDUS-varicocoele was detected in ∼37% of men. Prostate mean volume was ∼25mL, while lower and upper limits were 15 and 35mL, defining hypotrophy and enlargement, respectively. Prostate arterial reference ranges are reported. Prostate calcifications and inhomogeneity were frequent; midline prostatic cysts were rare and small. Ejaculatory duct abnormalities were absent. The upper limit for periprostatic venous plexus was 4.5mm. Lower and upper limits of seminal vesicles (SV) anterior-posterior diameter were 6 and 16mm, defining hypotrophy or dilation, respectively. Seminal vesicle volume and ejection fraction reference ranges are reported. SV-US abnormalities were rare. Deferential ampullas upper limit was 6mm. A discussion on the EAA and previously published "normal" CDUS values is reported here. The EAA findings will help in reproductive and general male health management.

The European Academy of Andrology (EAA) ultrasound study on healthy, fertile men: Prostate-vesicular transrectal ultrasound reference ranges and associations with clinical, seminal and biochemical characteristics.

BackgroundTransrectal ultrasound (TRUS) parameters are not standardized, especially in men of reproductive age. Hence, the European Academy of Andrology (EAA) promoted a multicenter study to assess the TRUS characteristics of healthy‐fertile men (HFM) to establish normative parameters.ObjectivesTo report and discuss the prostate and seminal vesicles (SV) reference ranges and characteristics in HFM and their associations with clinical, seminal, biochemical parameters.Methods188 men (35.6 ± 6.0 years) from a cohort of 248 HFM were studied, evaluating, on the same day, clinical, biochemical, seminal, TRUS parameters following Standard Operating Procedures.ResultsTRUS reference ranges and characteristics of the prostate and SV of HFM are reported herein. The mean PV was ∼25 ml. PV lower and upper limits were 15 and 35 ml, defining prostate hypotrophy and enlargement, respectively. PV was positively associated with age, waistline, current smoking (but not with T levels), seminal volume (and negatively with seminal pH), prostate inhomogeneity, macrocalcifications, calcification size and prostate arterial parameters, SV volume before and after ejaculation, deferential and epididymal size. Prostate calcifications and inhomogeneity were frequent, while midline prostatic cysts were rare and small. Ejaculatory duct abnormalities were absent. Periprostatic venous plexus size was positively associated with prostate calcifications, SV volume and arterial peak systolic velocity. Lower and upper limits of SV anterior‐posterior diameter after ejaculation were 6 and 16 mm, defining SV hypotrophy or dilation, respectively. SV total volume before ejaculation and delta SV total volume (DSTV) positively correlated with ejaculate volume, and DSTV correlated positively with sperm progressive motility. SV total volume after ejaculation was associated negatively with SV ejection fraction and positively with distal ampullas size. SV US abnormalities were rare. No association between TRUS and time to pregnancy, number of children or history of miscarriage was observed.ConclusionsThe present findings will help in better understanding male infertility pathophysiology and the meaning of specific TRUS findings.

Distended Seminal Vesicles Are Involved in Specific Cerebral Sexual Arousal: A Pilot Study Using Functional Brain Imaging in Young Healthy Men

BackgroundWhether seminal vesicles play a role in sexual activity in men is unknown. No study so far has compared the neural processing of visual sexual stimuli in men depending on the filling state of the seminal vesicles. ObjectiveTo evaluate potential specific cortical activation by visual sexual stimuli with distended and empty seminal vesicles. Design, setting, and participantsA prospective case-control trial was conducted. Six male individuals underwent two visits on 2 consecutive days for hormone analyses; Derogatis Interview for Sexual Functioning (DISF) questionnaire; functional magnetic resonance imaging (fMRI) with passively viewing sexual, neutral, positive, and negative emotional pictures; and structural pelvic MRI. After the first visit, the participants had to empty seminal vesicles by masturbation. During fMRI, every participant viewed alternating blocks of sexual, neutral, positive, and negative emotional pictures. Outcome measurements and statistical analysisComparisons between days 1 and 2 were evaluated using paired t tests. Results and limitationsNo significant differences were observed regarding hormone analyses, DISF questionnaire score, and arousal scoring between days 1 and 2. Seminal vesicle volume was significantly lower on day 2 (p = 0.003). Significantly higher activation was observed in the right precentral gyrus, middle frontal gyrus, and right superior temporal sulcus when contrasted for sexual over neutral (p < 0.05). ConclusionsIn response to pictures with sexual emotional content, significantly higher activation was detected in brain areas involved in motor preparation (arousal) and coding of desirability of visual sexual stimuli in men with distended seminal vesicles than in the same men with emptied seminal vesicles. This suggests that the filling state of the seminal vesicles may influence sexual desire in men. Patient summaryWe compared brain activity of men with filled and emptied seminal vesicles by functional magnetic resonance imaging. We found that men with filled seminal vesicles had higher activation of brain areas involved in arousal and sexual desire.

Soybean Extracts (Glycine Max) with Curcuma, Boswellia, Pinus and Urtica Are Able to Improve Quality of Life in Patients Affected by CP/CPPS: Is the Pro-Inflammatory Cytokine IL-8 Level Decreasing the Physiopathological Link?

The present study evaluates the efficacy of a combination of soyabean extracts associated with Curcuma Longa, Boswellia, Pinus pinaster and Urtica dioica (PROSTAFLOG®) in patients affected by CP/CPPS, through the evaluation of interleukin-8 (IL-8) plasma seminal levels. All patients diagnosed with CP/CPPS, attending the same urologic center, were enrolled in this randomized, controlled phase III study. Participants were randomized to receive oral capsules of PROSTAFLOG® (two capsules at bedtime every 24 h) or Ibuprofen 600 mg (1 tablet daily), lasting for a period of four weeks. NIH-CPSI and SF-36 questionnaires, as urological evaluations with a transrectal ultrasound (TRUS), the Meares–Stamey test, and IL-8 dosage in seminal plasma were performed at baseline and at 3 months follow-up. A total of 77 patients (mean age of 34.5 ± 6.1) were enrolled (PROSTAFLOG® (n = 39); ibuprofen (n = 38)) in the study. At 3 months, in the PROSTAFLOG® series, 69.2% of patients showed a significant reduction in the NIH-CPSI score, compared with 34.2% in the ibuprofen group (p &lt; 0001). The mean IL-8 levels were significantly lower in the PROSTAFLOG® cohort compared with the ibuprofen series (p &lt; 0.0001), while a significant reduction in the IL-8 level between the enrolment and last follow-up evaluation was also observed in this group (p &lt; 0.0001). Additionally, a significant reduction in the volume of the seminal vesicles assessed by TRUS was also found in the PROSTAFLOG® series during the observational timeframe (18.3 ± 7.1 mL vs. 11.2 ± 2.4 mL (p &lt; 0.0001). In conclusion, PROSTAFLOG® significantly improves the QoL in patients affected by CP/CPPS and it provides a significant reduction in IL-8 seminal levels as the overall seminal vesicles volume.

The Role of Oxytocin, Prolactin, and Estrogen in Male Sexual Functions

Background: The dysfunction in sexual ability has effects on the quality of life in men. Oxytocin plays a role in sexual and social behaviors. Hyperprolactemic males had erectile dysfunction. Endogenous estrogens in men, are not only important for health integrity but can additionally cause the promotion of many diseases. Objectives: The current review aimed to high light on the role of oxytocin, prolactin, and estrogen in male sexual functions. Oxytocin neurons have been heavily implicated in mediating sexual behavior in both humans and animals. Oxytocin hormone regulates social behaviors such as mating, maternal/paternal care, and bonding. Oxytocin levels rise during mating in females and males in humans and animals and may mediate anxiolytic/calming effects of sexual activity and antidepressant effects.Oxytocin’s role in regulating erection and ejaculation has been studied in mice and rats. Oxytocinergic projections from the paraventricular nucleus to the hippocampus, medulla oblongata, and spinal cord facilitate penile erection. Prolactin (PRL) serves a dual function both as a circulatory hormone and as a cytokine. PRL is known to be involved in the control of male copulatory behavior in humans, mice, rats, and other rodent models. It release during copulation in males and has a positive modulation for various aspects of testicular functions which hinting at the crucial role of prolactin in male reproduction. The lower concentration of prolactin was associated with reduced seminal vesicle volume and ejaculate in the infertile human male. Hypoprolactinemia has been associated with premature ejaculation and erectile dysfunction. Hyperprolactinemia can be caused by tumors, drugs, or idiopathic, leading to alterations in sexual behavior as loss of libido and erectile dysfunction. It is also reported that it can cause endocrine disturbances leading to abnormal levels of testosterone, FSH, and LH. Chronic hyperprolactinaemia suppresses copulatory behaviour in animal models and yields sexual dysfunction and other side effects in men. In men, testosterone acting via its action on androgen receptors may be dependent on the action of aromatase enzyme on of testosterone and converting it to estradiol (E2). Estrogens act through ERα and ERβ at the plasma membrane and in the nucleus to regulate functions of many organs in men. The role of estradiol action on libido is seen at various levels of regulation, starting with direct effects in the brain. Not only does estradiol modulate sexual behavior in the adult male, it also appears to organize the early brain to program sexual behavior. The exact role of estradiol in each area of male sexual function including libido, spermatogenesis, and erectile function is difficult to determine. A complex balance of testosterone, estradiol, aromatase, and estrogen receptors in brain, testes, and penis, confirmed the indispensable and highly regulated hormonal interaction of estrogen in the male. Conclusion: It can be concluded that oxytocin hormone regulates social behaviors such as mating, maternal/paternal care, and bonding. PRL is involved in the control of male copulatory behavior in humans, rats, mice, and other rodent models. Hypoprolactinemia has been associated with reduced seminal vesicle volume, premature ejaculation, and erectile dysfunction. Hyperprolactinemia can be caused by tumors, drugs, or idiopathic, leading to alterations in sexual behavior as loss of libido and erectile dysfunction. Also, hyperprolactemic males had erectile dysfunction. Estradiol modulates sexual behavior in the adult male, and appears to organize the early brain to program sexual behavior.

Evaluation of incidental testicular dose with thermoluminescence dosimetry during prostate radiotherapy.

The aim of this study was to investigate incidental testicular doses during intensity modulated radiation therapy (IMRT) in patients treated with prostate radiotherapy only (PORT) and whole pelvis radiotherapy (WPRT). A total of 34 prostate cancer patients with intermediate and high risk were included in this prospective study. Each patient in the intermediate risk group received a total of 78 Gy in 39 fractions for prostate and seminal vesicles. In patients in the high risk group, 2 Gy daily fraction dose for pelvic lymphatics was given to 50 Gy, and then 78 Gy was given to prostate and seminal vesicles volumes. Treatment plans were created for all patients using the IMRT technique with 6MV. Testicular doses were measured for WPRT and PORT by thermoluminescence dosimetry (TLD) detectors placed on testis surface. Testicular doses measured for WPRT and PORT were compared. The isocenter to testicular distance for WPRT and PORT was 16.83-cm (13.20 to 18.80-cm) and 11.15 cm (9.10 to 13.00-cm), respectively. The mean testicular dose measurements of TPS and TLD per fraction during PORT were 2.41 cGy (1.95 to 3.60 cGy) and 3.70 cGy (2.80 to 5.10 cGy), respectively (p = 0.00). In WPRT irradiation, mean testicular dose values of TPS and TLD per fraction were measured as 3.85 cGy (2.00 to 5.70 cGy) and 5.85 cGy (4.25 to 7.55 cGy), respectively (p = 0.00). The cumulative mean scattered dose for PORT irradiation of 78 Gy in 39 fractions was 144.30 cGy. The mean cumulative dose received by the testis for the high-risk prostate patient was 228.15 cGy. There was a significant difference in testicular dose between WPRT and PORT irradiation. Testicular doses decreased significantly with increasing isocenter-testis distance. Incidental testicular dose during prostate radiotherapy can be significantly detrimental to spermatogenesis. Therefore, the testicles should be contoured as an organ at risk for the estimation of absorbed doses. The use of in vivo dosimetry is recommended for accurate measurement of testicular dose in radiotherapy of prostate cancer for men desiring continued fertility.

Dosimetric impact of interfraction prostate and seminal vesicle volume changes and rotation: A post-hoc analysis of a phase III randomized trial of MRI-guided versus CT-guided stereotactic body radiotherapy

Background and purposeInterfraction volumetric changes/rotations in the prostate and proximal seminal vesicles (SVs) might compromise target coverage when tight margins are used for prostate stereotactic body radiotherapy (SBRT). We investigated on-board MRI images from MRI-guided SBRT to better understand this. Materials and methodsTwenty consecutive patients treated with MRI-guided prostate SBRT (40 Gy/5 fractions) enrolled on the MRI arm of a phase III randomized trial were included. A 2 mm isotropic margin was used for prostate and proximal SVPTV. Target volume, prostate dimensions, angles of the proximal SV on axial (angle α) and sagittal view (angle θ) were measured on a 0.35 T simulation MRI and five on-board pre-treatment MRIs. Dice coefficient of the targets and target dosimetry were calculated. ResultsAll patients experienced an isotropic increase in prostate volume during SBRT (p = 0.0016): 0.1%, 9.0%, 12.1%, 15.1%, and 14.2% (median) at fractions 1–5, respectively, regardless of baseline volume, which was significantly reduced with neoadjuvant ADT (p = 0.0042). There was minimal interfraction rotation of prostate, however, considerable variations in proximal SV angle α (median 21.5°) and angle θ (median 17.6°) were seen. Median V100% was 97.5% and 87.1% for prostate and proximal SV CTV, respectively. V95%≥95% was achieved in 94% of fractions for the prostate and in 59% for proximal SV. ConclusionProstate volume consistently increased during SBRT. Interfraction prostatic rotation was minimal while rotation of the proximal SV was considerable. Prostate dosimetry was favorable, but online adaptive therapy may be indicated occasionally to account for prostatic swelling and in particular proximal SV rotations.

Relationship of smoking with COVID-19 and its adverse effects

There is a direct relationship between COVID-19 and smoking. This relationship has detrimental consequences for smoking and COVID-19 on body physiology. Smoking causes disc herniation, lungs diseases, heart illness, lipid profile changes, muscle protein synthesis declines, head, neck, and gastric cancers, cerebral inflammation, weight loss and obesity. The smoking habit of pregnant women leads to miscarriage, poor foetal growth, and low lipid and protein levels in breast milk. In males, it also reduces semen ejaculation and seminal vesicle volume. The treatment is based on quitting the smoking. Preventive measures such as a healthy diet and regular exercise can help to mitigate the negative consequences of smoking. In addition, smoking has been recognised as a major factor in COVID-19 transmission. Tobacco smokers are at increased risk of serious COVID-19 infection due to poor lung function, cross-infection, and vulnerable hygiene behaviors. People who have smoked in the past are thought to be more susceptible than non-smokers to have more severe COVID-19 illness symptoms. COVID-19 is more common among smokers than nonsmokers. Current smokers are five times more likely to have influenza infection than non-smokers. Smoking has been identified as one of the risk factors linked to infection and death.

Significant relationship between parameters measured by transrectal color Doppler ultrasound and sexual dysfunction in patients with BPH 12 months after TURP

BackgroundA link between sexual dysfunction and lower urinary tract symptoms due to benign prostatic hyperplasia (BPH) has been noticed. Transurethral resection of the prostate (TURP) remains the standard treatment for symptomatic BPH, whether TURP causes sexual dysfunction is still uncertain. In this retrospective study, we investigated the relationship between parameters measured by color Doppler ultrasound (CDU) and sexual dysfunction in patients with BPH 12 months after TURP.MethodsThe parameters include presumed circle area ratio (PCAR), maximal horizontal area of seminal vesicles (MHA), resistive index of the prostate (RIP), and peak systolic velocity in the flaccid penis (PSV). The international prostate symptom score was used to evaluate the lower urinary tract symptoms and the five-item version of the International Index of Erectile Function was used to evaluate sexual function before and after TURP.ResultsOf the 103 patients without sexual dysfunction before TURP, 11 (10.7%) had erectile dysfunction (ED) after TURP. These 11 patients had significantly lower PCAR, RIP, PSV and MHA than those without ED. The patients with retrograde ejaculation after TURP had significantly lower PCAR than those without retrograde ejaculation, and the patients with premature ejaculation after TURP had significantly lower MHA than those without premature ejaculation. Comparing the parameters between baseline and after TURP, PCAR, RIP, and MHA decreased significantly in the patients with sexual dysfunction, but no significant differences were noted in the patients without sexual dysfunction after TURP.ConclusionsMore extended TURP can lead to a higher incidence of ED and retrograde ejaculation in BPH patients without sexual dysfunction before TURP. Patients with a lower volume of seminal vesicles after TURP may have a higher incidence of premature ejaculation.

Can We Clinically Distinguish Anejaculation From Retrograde Ejaculation in Patients on α1A-Blockers Therapy for Lower Urinary Tract Symptoms?

ObjectiveTo investigate the physiopathology of ejaculatory disorders (EjD) and discriminate between retrograde ejaculation (REj) and anejaculation (AEj) induced by α1A-blockers, through the association between the mean postorgasm seminal vesicle volume and the presence of sperm in midstream urine, in patients with moderate-to-severe lower urinary tract symptoms (LUTS) secondary to benign prostatic enlargement. Materials and MethodsTherapy-naïve male patients with LUTS and without previous EjD were treated with α1A-blockers. Pre- and post-treatment EjD were investigated through question 4 of the 4-item Male Sexual Function questionnaire and the Male Sexual Health Questionnaire for Ejaculatory Dysfunction Short Form (MSHQ-EjD-SF). After 12 weeks, postorgasm urine was collected for sperm count and seminal vesicle volume was calculated through transrectal ultrasound. ResultsAll 42 patients reported with EjD after treatment with α1A-blockers: 4-item Male Sexual Function questionnaire and MSHQ-EjD-SF Q4 scores were significantly higher (P <.001) and MSHQ-EjD-SF Q1-3 score was significantly lower (P <.001) than before. Postorgasm seminal vesicle volume was significantly higher in patients with postorgasm sperm-negative urine (AEj), and lower in patients with postorgasm sperm-positive urine (REj; P <.001). ConclusionWe clearly demonstrated an association between the presence of sperm in the midstream urine and seminal vesicle volume after orgasm, strongly confirming and differentiating the hypothesis of a dual etiology for EjD (REj vs AEj) secondary to α1A-blockers therapy for LUTS.

Evaluation of seminal vesicle volume variability in patients receiving radiotherapy to the prostate

AbstractIntroduction:Prostate positional variability has been widely explored with seminal vesicle (SV) variability, coming into the forefront only in recent years. While planning target volume (PTV) margins and preparation protocols ameliorate the effects of bladder and rectum volume changes on prostate, studies on SV variation have looked at only position, not volume variability.Aim:The aim of this study was to investigate whether the inter-fraction volume variability of the VSs can exist in patients receiving radiotherapy to the prostate.Method:SV variability was investigated by comparing four on-treatment cone beam computer tomography scans to a planning computer tomography (CT) image for two patients receiving prostate radiotherapy. For each case, variation in volumes (cm3) was compared with intra-observer variation.Results:SV volume variability was seen in both patients, with the largest change in volume being 78·38%. This variance was considerably (between 2 and 10 times) larger than the measured intra-observer variance.Conclusion:This study identified the potential for daily SV volume variability in patients receiving prostate radiotherapy. Future large-scale studies are warranted to identify the extent of this motion and potential clinical impact. Evidence-informed PTV margins and possible SV volume control protocols may need to be adopted.

Epididymal Sperm Characteristics, Testicular Morphometric Traits and Growth Parameters of Rabbit Bucks Fed Dietary Saccharomyces cerevisiae and/or Zinc Oxide

ABSTRACT The objectives of this twelve-week feeding trial were to determine the effects of dietary Saccharomyces cerevisiae and/or zinc oxide on epididymal sperm characteristics, testicular morphometric traits, and growth parameters of bucks. 16 (New Zealand White) bucks 16-wk-old, weighing 2.8kg were randomly allotted to one of 4 treatment groups. Each treatment was replicated four times, with 1 buck per replicate, in a completely randomized design (CRD). Each treatment group was randomly assigned to one of the four commercial experimental diets designated thus: TA = control diet with no additives, TB = 0.12g/kg Saccharomyces cerevisiae, TC = 150mg/kg zinc oxide and TD = 0.12g/kg Saccharomyces cerevisiae +150 mg/kg zinc oxide. Although treatment had no effect (p>0.05) on final body weight, average daily weight gain and feed conversion ratio, epididymal sperm characteristics and testicular morphometric traits differed significantly (p<0.05). Bucks on TB(Saccharomyces cerevisiae-based diet) had improved (p<0.05) sperm concentration, motility and live sperm, tubule diameter, epididymal volume, volume fraction of duct, and total duct volume, but decreased testicular volume. Bucks fed TA (control diet) had improved volume fraction of tubule but recorded the highest incidence of head and tail sperm abnormality. Though, TC(zinc oxide-based diet) enhanced (p<0.05) seminal vesicle volume, sperm pH was better among bucks fed TD (Saccharomyces cerevisiae + zinc oxide-based diet). It can be concluded that dietary inclusion of Saccharomyces cerevisiae at 0.12g/kg of feed improved epididymal sperm characteristics and testicular morphometric traits of rabbit bucks.

An image-guided radiotherapy decision support framework incorporating a Bayesian network and visualization tool.

To describe a Bayesian network (BN) and complementary visualization tool that aim to support decision-making during online cone-beam computed tomography (CBCT)-based image-guided radiotherapy (IGRT) for prostate cancer patients. The BN was created to represent relationships between observed prostate, proximal seminal vesicle (PSV), bladder and rectum volume variations, an image feature alignment score (FASTV_OAR ), delivered dose, and treatment plan compliance (TPC). Variables influencing tumor volume (TV) targeting accuracy such as intrafraction motion, and contouring and couch shift errors were also represented. A score of overall TPC (FASglobal ) and factors such as image quality were used to inform the BN output node providing advice about proceeding with treatment. The BN was quantified using conditional probabilities generated from published studies, FASTV_OAR/global modeling, and a survey of IGRT decision-making practices. A new IGRT visualization tool (IGRTREV ), in the form of Mollweide projection plots, was developed to provide a global summary of residual errors after online CBCT-planning CT registration. Sensitivity and scenario analyses were undertaken to evaluate the performance of the BN and the relative influence of the network variables on TPC and the decision to proceed with treatment. The IGRTREV plots were evaluated in conjunction with the BN scenario testing, using additional test data generated from retrospective CBCT-planning CT soft-tissue registrations for 13/36 patients whose data were used in the FASTV_OAR/global modeling. Modeling of the TV targeting errors resulted in a very low probability of corrected distances between the CBCT and planning CT prostate or PSV volumes being within their thresholds. Strength of influence evaluation with and without the BN TV targeting error nodes indicated that rectum- and bladder-related network variables had the highest relative importance. When the TV targeting error nodes were excluded from the BN, TPC was sensitive to observed PSV and rectum variations while the decision to treat was sensitive to observed prostate and PSV variations. When root nodes were set so the PSV and rectum variations exceeded thresholds, the probability of low TPC increased to 40%. Prostate and PSV variations exceeding thresholds increased the likelihood of repositioning or repeating patient preparation to 43%. Scenario testing using the test data from 13 patients, demonstrated two cases where the BN provided increased high TPC probabilities, despite some of the prostate and PSV volume variation metrics not being within tolerance. The IGRTREV tool was effective in highlighting and quantifying where TV and OAR variations occurred, supporting the BN recommendation to reposition the patient or repeat their bladder and bowel preparation. In another case, the IGRTREV tool was also effective in highlighting where PSV volume variation significantly exceeded tolerance when the BN had indicated to proceed with treatment. This study has demonstrated that both the BN and IGRTREV plots are effective tools for inclusion in a decision support system for online CBCT-based IGRT for prostate cancer patients. Alternate approaches to modeling TV targeting errors need to be explored as well as extension of the BN to support offline IGRT decisions related to adaptive radiotherapy.

Significant changes of T2 value in the peripheral zone and seminal vesicles after ejaculation.

To analyse the quantitative changes of the prostate and seminal vesicles (SV) on magnetic resonance imaging (MRI) after ejaculation. Ten healthy young males were enrolled for T2-weighted and T2 mapping MRI before and after two consecutive ejaculations. T2 values of the peripheral zone (PZ) and the central gland (CG) at the midgland of the prostate were compared before and after ejaculation, respectively. T2 values of the PZ at the apex and base were also compared before and after, respectively. Pre- and post-ejaculation SV volumes were compared. The Wilcoxon's signed rank test with Bonferroni adjustment was used for comparison. After ejaculation, T2 values of the PZ significantly decreased (mean, 119±20 vs. 105±21, p=0.002) while those of the CG did not significantly change at the midgland. At the apex, T2 values of the PZ also decreased significantly (mean, 114±9 vs. 94±7, p=0.002). On the other hand, T2 values of the PZ did not change at the base. SV volumes were significantly reduced after ejaculation (mean, 11.1±7.7mL vs. 7.2±6.7mL, p=0.002). Ejaculation decreases T2 values of the PZ at the midgland and apex, and reduces SV volumes. Abstinence periods should be considered in evaluating the prostate and SV on MRI. • T2 values decrease after ejaculation in the apical-mid peripheral zone. • Ejaculation does not affect T2 values of the central gland. • Volume of the seminal vesicles decreases after ejaculation. • An abstinence period should be considered before pelvic MRI in men.

The longitudinal effect of ejaculation on seminal vesicle fluid volume and whole-prostate ADC as measured on prostate MRI

ObjectiveTo prospectively investigate the longitudinal effect of ejaculatory abstinence on MRI-measured seminal vesicle (SV) volume and whole-prostate ADC over consecutive days.Methods15 healthy male volunteers (mean 35.9 years, range 27–53) underwent 3-T MRI at baseline and 1, 2 and 3 days post-ejaculation. Prostate and SV volumes were derived by volume segmentation and whole-gland apparent diffusion coefficient (ADC) values calculated. A mixed-effects linear regression compared ADC values and prostate/seminal vesicle volumes in each volunteer between studies in a pairwise manner.ResultsAll subjects completed the four MRIs. Mean prostate volume was 22.45 cm3 (range 13.04–31.21 cm3), with no change between the four studies (p = 0.89–0.99). 13/15 subjects showed SV volume reduction from baseline to day 1, with group-mean decreasing from 6.45 to 4.80 cm3 (−25.6%, p < 0.001), and a significant reduction from baseline to day 2 (−18.1%, p = 0.002). There was a significant volume increase from both day 1 (+21.3%, p = 0.006) and day 2 (+10.2%, p = 0.022) to day 3 post-ejaculation. There was a significant reduction in ADC from 1.105 at baseline to 1.056 × 10−3 mm2/s at day 1 (mean −4.3%, p = 0.009).ConclusionThe longitudinal effect of ejaculation on SV volume was demonstrated. Significant reductions in SV volume and whole-gland ADC were observed post-ejaculation, supporting a 3-day period of abstinence before prostate MRI.Key Points• Seminal vesicle volume significantly reduced 24 h post-ejaculation remaining reduced at day 2• Seminal vesicle fluid volume significantly increased from day 1 to day 3 post-ejaculation• There was a significant reduction in whole-gland prostate ADC values day 1 post-ejaculation• 3-day abstinence from ejaculation is required to ensure maximal seminal vesicle distension