Male Tract Research Articles

The epidemiology of male lower urinary tract symptoms associated with benign prostatic hyperplasia: Results of 20 years of Korean community care and surveys.

To investigate the prevalence of lower urinary tract symptoms/benign prostatic hyperplasia in a Korean population. The Korean Prostate & Voiding Health Association provided free prostate-related community health care and conducted surveys in all regions of Korea from 2001 to 2022 with the cooperation of local government public health centers. A total of 72,068 males older than 50 were surveyed and analyzed. History taking, International Prostate Symptom Score (IPSS), transrectal ultrasonography, prostate-specific antigen (PSA) testing, uroflowmetry, and urine volume testing were performed. The mean prostate volumes in males in their 50s, 60s, 70s, and 80s or above were 24.7 g, 27.7 g, 31 g, and 33.7 g, respectively. The proportion of males with high PSA greater than 3 ng/mL was 3.8% among males in their 50s, 7.7% among males in their 60s, 13.1% among males in their 70s, and 17.9% among males 80 years of age or older. The mean IPSS total scores in males in their 50s, 60s, 70s, and 80s or above were 10.7, 12.7, 14.5, and 16, respectively. Severe symptoms were reported by 27.3% of males, whereas 51.7% reported moderate symptoms. The mean Qmax in males in their 50s, 60s, 70s, and 80s or above were 20 mL/s, 17.4 mL/s, 15.4 mL/s, and 13.8 mL/s, respectively. In this population-based study, mean prostate volume, IPSS, PSA, and Qmax were 30.6±15.1 g, 14.8±8.2, 1.9±4.7 ng/mL, and 15.6±6.5 mL/s, respectively. Aging was significantly associated with increased prostate volume, PSA levels, and IPSS scores, and with decreased Qmax and urine volume.

Sperm morphology, and macro and microscopic description of male and female reproductive tract in the North African houbara bustard (Chlamydotis undulata)

Ex-situ conservation programs are useful tools for preserving endangered species, and knowledge of their reproductive physiology is essential for achieving conservation objectives in captive breeding programs. The North African houbara bustard (Chlamydotis undulata) is a vulnerable bird species bred in captivity to restore its natural populations. To better understand the reproductive biology of this species, we first described the anatomy and histology of the reproductive tracts of male and female North African houbara bustards. We described and classified the normal and abnormal sperm morphologies for the species. The reproductive tracts of males and females were collected during the breeding season (BS) (21 males and 14 females) and the non-breeding season (NBS) (four males and two females). Pictures and measurements of the testes and oviducts were taken, and testis colour was graded from 1 (black) to 6 (white). Organs were fixed and processed for histological analysis, scanning electron microscopy (SEM), and transmission electron microscopy (TEM). The testis, epididymis, oviduct size, testicular capsule thickness, seminiferous tubule (ST) diameter, and histological layers of the oviduct were compared between the BS and NBS groups. Sperm morphometry was evaluated using fixed ejaculates (n=22, from 22 males). Ejaculates (n=417, 166 males) were collected and fixed during the BS, and their morphology and morphometry were evaluated using phase-contrast microscopy. Ejaculate mixes (n=12) were fixed and analysed using SEM and TEM. Overall, the anatomical structure and histology of the male and female reproductive tracts were similar to those of other avian species. The testes were symmetric, and a regression of testis and oviduct size, the thickness of the mucosa and serosa of the oviduct, and ST diameter (p<0.001) were observed during NBS compared with those during BS. Sperm storage structures are located inside the oviduct at the uterovaginal junction and infundibulum. Melanin granules were observed in the interstitial space of the seminiferous epithelium, which explains the testis pigmentation. Melanin was also found in the ovaries and the uterus. Houbara sperm have an elongated nuclear form and a round-shaped acrosome lacking perforatorium and rostrum. Most analysed samples were limitrophe normospermic (normal= 68.5 ± 14.7%), houbara sperm morphology could be classified into eight categories: normal sperm, acrosome, head, midpiece, tail, and teratogenic defects, swollen head, and cytoplasmic droplet. This study provides the first anatomical and histological descriptions of the male and female reproductive tracts of the North African houbara bustard. Further investigation into the functional role of melanin in the testes is warranted.

Novel online comprehensive pelvic floor therapy program following prostatectomy.

Although pelvic floor muscle training (PFMT) is widely shown to improve post-prostatectomy incontinence (PPI), numerous barriers impede access to formal PFMT and include the limited availability of specialized therapists and financial or scheduling barriers. To address these barriers, we developed a novel online program delivering comprehensive long-term PFMT, pelvic floor education (PFE), and dietary/behavioral modification education. This study is a prospective interim analysis of online PFMT/PFE (oPFMT/PFE), with focus on feasibility, satisfaction, and continence outcomes. Patients anticipating robotic-assisted laparoscopic prostatectomy (RALP) were recruited (6/2021-9/2022) for oPFMT/PFE. oPFMT/PFE comprises a 12-month program of 3 phases, including multiple exercises with varied contraction types and duration, and comprehensive dietary and behavioral technique education. Incontinence and quality of life (QOL) outcomes are assessed at 3 weeks, 3, 6, and 12 months following RALP using validated International Consultation on Incontinence Questionnaire Male Lower Urinary Tract Symptoms (ICIQ-MLUTS) and Incontinence Impact Questionnaire (IIQ-7) questionnaires and additional items assessing satisfaction, improvement, and daily pad use. Primary study outcomes included ICIQ-MLUTS stress urinary incontinence (SUI) domain score (SDS) and SUI cure [ICIQ SUI domain score (SDS) =0]. Interim 6-month analysis was performed using mixed effects linear regression and mixed effects Poisson regression. Analysis included 21 men (64±6 years). At 6-month follow-up, men undergoing oPFMT/PFE showed significant improvement in SDS compared to the 3-week time point [mean ± standard error (SE) =1.05±0.24 vs. 0.45±0.17, P=0.011], but still experienced higher scores than at baseline (P=0.017). Six-month patient-reported improvement averaged 7.42±0.74 (10-point Likert scale). All (100%) of 19 respondents (2 missing data) found the program easy to use, educational, and would recommend it to others, with 89% expressing satisfaction with the program. During patient interview at 6-month follow-up, no men reported inability to access the program online or any adverse events. Finally, IIQ-7 score improved significantly from the 3-week timepoint (4.47±1.10) at both time points (3-month 1.14±0.44, P<0.001 and 6-month 1.10±0.37, P<0.001), and neither 3- nor 6-month scores differed from baseline (P=0.808 and P=0.444, respectively). Our novel oPFMT/PFE yields significant improvements to validated urinary incontinence (UI) and QOL measures, providing a valuable and accessible treatment option for PPI.

Evaluating the performance of ChatGPT in answering questions related to benign prostate hyperplasia and prostate cancer.

The aim of this study was to evaluate the accuracy and reproducibility of ChatGPT's answers to frequently asked questions about benign prostate hyperplasia (BPH) and prostate cancer. Frequently asked questions on the websites of urology associations, hospitals, and social media about prostate cancer and BPH were evaluated. Also, strong recommendation-level data were noted in the recommendations tables of the European Urology Association (EAU) 2022 Guidelines on Prostate Cancer and Management of Non-neurogenic Male Lower Urinary Tract Symptoms sections. All questions were asked in order in ChatGPT Mar 23 Version. All answers were evaluated separately by two specialist urologists and scored between 1-4. Forty questions about BPH and 86 questions about prostate cancer were included in the study. The answers to all BPH-related questions resulted in 90.0% completely correct. This rate for questions about prostate cancer was 94.2%. The completely correct rate in the questions prepared according to the strong recommendations of the EAU guideline was 77.8% for BPH and 76.2% for prostate cancer. The similarity rates of the answers to the repeated questions were 90.0% and 93% for questions related to BPH and prostate cancer, respectively. ChatGPT has given satisfactory answers to questions about BPH and prostate cancer. Although it has limitations, it can be predicted that it will take an important place in the health sector in the future, as it is a constantly evolving platform. ChatGPT was able to provide helpful information about BPH and prostate cancer, although it is not perfect. It is constantly getting better, and may become an important resource in the healthcare field in the future.

Frequency of Urinary Incontinence Among Post COVID Males

Background: Amid the global health challenges posed by the COVID-19 pandemic, an association with urinary system complications has been identified. Urinary incontinence (UI) has become a significant post-COVID sequela among males, with substantial implications for their quality of life. Objective: The study aimed to quantify the frequency and delineate the severity of urinary incontinence in post-COVID male patients, as well as to document the prevalence of associated lower urinary tract symptoms. Methods: A cross-sectional observational study was executed, engaging 400 male post-COVID patients aged between 45 to 64 years from three hospitals in Lahore. Participants were selected via non-probability convenience sampling and provided data through the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) and Male Lower Urinary Tract Symptoms (ICIQ-MLUTS). Statistical analyses were performed using SPSS version 21. Results: The prevalence of urinary incontinence among the participants was high, with 367 (91.75%) reporting some degree of UI. In terms of severity, moderate UI was the most common, affecting 248 (67.5%) of those with UI, followed by slight UI in 82 (22.5%), and severe UI in 37 (10%) participants. The study identified urgency (reported by 133 participants or 33.3% 'occasionally' and 132 or 33% 'most of the time') and postvoid dribbling (reported by 159 participants or 39.8% 'most of the time') as the most frequent symptoms. Notably, there were no reports of very severe urinary incontinence. Conclusion: The study concludes a high prevalence of urinary incontinence among male patients post-COVID-19, with the majority experiencing moderate severity. These findings underscore the importance of including urinary incontinence assessments in post-COVID patient care and may inform the development of targeted interventions to improve patient outcomes.

Reoperation after surgical treatment for benign prostatic hyperplasia: a systematic review.

Surgical treatment is important for male lower urinary tract symptom (LUTS) management, but there are few reviews of the risks of reoperation. To systematically evaluate the current evidence regarding the reoperation rates of surgical treatment for LUTS in accordance with current recommendations and guidelines. Eligible studies published up to July 2023, were searched for in the PubMed® (National Library of Medicine, Bethesda, MD, USA), Embase® (Elsevier, Amsterdam, the Netherlands), and Web of Science™ (Clarivate™, Philadelphia, PA, USA) databases. STATA® (StataCorp LP, College Station, TX, USA) software was used to conduct the meta-analysis. Random-effects models were used to calculate the pooled incidences (PIs) of reoperation and the 95% confidence intervals (CIs). A total of 119 studies with 130,106 patients were included. The reoperation rate of transurethral resection of the prostate (TURP) at 1, 2, 3, and 5 years was 4.0%, 5.0%, 6.0%, and 7.7%, respectively. The reoperation rate of plasma kinetic loop resection of the prostate (PKRP) at 1, 2, 3, and 5 years was 3.5%, 3.6%, 5.7%, and 6.6%, respectively. The reoperation rate of holmium laser enucleation of the prostate (HoLEP) at 1, 2, 3, and 5 years was 2.4%, 3.3%, 5.4%, and 6.6%, respectively. The reoperation rate of photoselective vaporization of the prostate (PVP) at 1, 2, 3, and 5 years was 3.3%, 4.1%, 6.7%, and 7.1%, respectively. The reoperation rate of surgery with AquaBeam® at 1, 2, 3, and 5 years was 2.6%, 3.1%, 3.0%, and 4.1%, respectively. The reoperation rate of prostatic artery embolization (PAE) at 1, 2, 3, and 5 years was 12.2%, 20.0%, 26.4%, and 23.8%, respectively. The reoperation rate of transurethral microwave thermotherapy (TUMT) at 1, 2, 3, and 5 years was 9.9%, 19.9%, 23.3%, and 31.2%, respectively. The reoperation rate of transurethral incision of the prostate (TUIP) at 5 years was 13.4%. The reoperation rate of open prostatectomy (OP) at 1 and 5 years was 1.3% and 4.4%, respectively. The reoperation rate of thulium laser enucleation of the prostate (ThuLEP) at 1, 2, and 5 years was 3.7%, 7.7%, and 8.4%, respectively. Our results summarized the reoperation rates of 10 surgical procedures over follow-up durations of 1, 2, 3, and 5 years, which could provide reference for urologists and LUTS patients. https://www.crd.york.ac.uk/PROSPERO, identifier CRD42023445780.

Translation and validation into Brazilian Portuguese of the English version of the International Consultation on Incontinence Modular Questionnaire for Male Lower Urinary Tract Symptoms (ICIQ-MLUTS).

To translate and cross-culturally adapt the English version of the International Consultation on Incontinence Modular Questionnaire for Male Lower Urinary Tract Symptoms (ICIQ-MLUTS)into Brazilian Portuguese and evaluate its psychometric properties. Male lower urinary tract symptoms (LUTS)are frequent and commonly assessed with questionnaires. The ICIQ-MLUTSis a robust instrument that investigates the main aspects of LUTS in men and their impact on quality of life. Although highly recommended, Grade A is not as popular as the International Prostate Symptom Score (IPSS)and remained untranslated and unvalidated for Brazilian Portuguese. After authorization by the Advisory Board of the International Consultation on Incontinence (ICIQ) the translation process was conducted according to the standard guidelines and the ICIQ validation protocol. Internal consistency was assessed using Cronbach's ⍺ coefficient and values > 0.7 were considered satisfactory. To assess test-retest reliability and reproducibility, Spearman's correlation coefficient and intraclass correlation coefficient were used. For group data, a Spearman correlation coefficient or an intraclass correlation coefficient of at least 0.70 demonstrates good test-retest reliability. A p < 0.05 was considered significant. One hundred and eighty-six, aged61.41 ± 11.01 years, suffering from LUTS participated in the study between January 2021 and October 2022. Cronbach's ⍺, 0.875, demonstrated the internal consistency of the Portuguese version of ICIQ-MLUTS.The intraclass correlation coefficient of 0.912 (0.882; 0.935 - 95% CI)for the test-retest evidenced the stability and validity of the instrument. Likewise, Spearman's correlation coefficient highlighted the agreement between IPSS and ICIQ-MLUTS,0.906, <0.001. The Portuguese version of the ICIQ-MLUTSdemonstrated internal consistency, stability, and validity, in addition to agreement with the IPSS. The ICIQ-MLUTS,translated and validated into Brazilian Portuguese, is a robust and reliable instrument to assess LUTS in Brazilian men and can be used in the evaluation of treatment and research.

Bacterial Profile, Antibiotic Susceptibility Pattern and Associated Risk Factors of Urinary Tract Infection Among Patient Suffering from Chronic and/or Acute Prostatitis at the Yaoundé Central Hospital, Centre Cameroon

Background: A febrile urinary tract infection in men should suggest acute prostatitis. Any infection of the male urinary tract has the potential to affect the prostate. Acute prostatitis happens when your prostate gland becomes suddenly inflamed. The objectives of our study were to determine the prevalence of urinary tract infections and the associated risk factors in men presenting chronic and/or acute prostatitis. Also, to identify the associated bacterial strains and finally to establish their antibiotic susceptibility profile.&#x0D; Materials and Method: We conducted a prospective and cross-sectional study. A total of 77 male participants were recruited, aged 24 years to 84 years at the Urology Department of the Yaounde Central Hospital that presented with clinical signs and symptoms of urinary tract infection from February to June 2021. Urine specimens were collected and analyzed at the Bacteriology laboratory of the Yaoundé University Teaching Hospital. Isolation and identification of bacteria were done using conventional methods. Antibiotic susceptibility testing and interpretation were performed according to CASFM 2021, V.1.0 April. The statistical analysis of our data was done using SPSS version 22.0 software.&#x0D; Results: The prevalence of urinary tract infection in our studied population was 15.58% (12/77). Among the 12 participants with urinary tract infection, we isolated and identified six (6) bacteria species; Escherichia coli 25% (3/12), Proteus vulgaris 25% (3/12), Citrobacter freundii 16.67% (2/12), Pseudomonas fluorescent 16.67% (2/12), Enterococcus spp. 8.33% (1/12) and Proteus penneri 8.33% (1/12) respectively. Antibiotic susceptibility testing revealed reduced susceptibility to 3rd generation cephalosporins (cefotaxime, ceftazidime, ceftriaxone). Beta-lactams showed very low activity on almost all the family of Enterobacteriaceae strains isolated. Flouroquinolones (ciprofloxacin, ofloxacin and nalidixic acid) showed a resistance of more than 50% on the majority of the species isolated. All the isolated Gram negative bacteria were multi-drug resistant. Patients with a history of urinary tract tumors, urinary catheters, and diabetes were the most exposed to urinary tract infection; 58.33% (7/12 patients), 50.00 % (6/12) and 41.66% (5/12 patients) respectively. Participants of age &gt;55 years were those presenting the most with urinary tract infection.&#x0D; Conclusions: Overall, Enterobacteriaceae were primarily isolated from patients with prostatitis. Urological history such as urinary tract tumors, and Diabetes were significantly associated with UTI.

SARS-CoV-2 infection correlates with male benign prostatic hyperplasia deterioration.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) affects extra-respiratory systems, with small-scale studies showing worsened male lower urinary tract symptoms (LUTS) after coronavirus disease 2019 (COVID-19). This study explores the correlation between SARS-CoV-2 infection and male benign prostatic hyperplasia (BPH) complications using large-scale real world data. All male patients attending the public healthcare system in Hong Kong receiving alpha-blocker monotherapy for LUTS from 2021 to 2022 were included in this study. Patients with and without positive polymerase chain reaction (PCR) test for SARS-CoV-2 are selected as the exposure group and control group, respectively. Baseline characteristics are retrieved, with propensity score matching performed to ensure balance of covariates between the two groups. BPH complications were then compared and subgroup analyses were performed. After propensity score matching, 17,986 patients were included for analysis, among which half had PCR-confirmed SARS-CoV-2 infection (n=8993). When compared to controls, the SARS-CoV-2 group demonstrated statistically significant higher incidence of retention of urine (4.55% vs. 0.86%, p<0.001), haematuria (1.36% vs. 0.41%, p<0.001), clinical urinary tract infection (UTI) (4.31% vs. 1.49%, p<0.001), culture-proven bacteriuria (9.02% vs. 1.97%, p<0.001) and addition of 5ARI (0.50% vs. 0.02%, p<0.001). Subgroup analysis demonstrated similar differences across different age groups. There are no statistically significance differences in incidence of retention, haematuria, or addition of 5ARI across different COVID-19 severities. SARS-CoV-2 infection is associated with increased incidence of urinary retention, haematuria, UTI and the addition of combination therapy in the short term, regardless of COVID-19 severity. This is the largest study demonstrating the detrimental urological effects of SARS-CoV-2 infection.

The Reduction of Male Lower Urinary Tract Symptoms Is Associated With a Decreased Risk of Death.

Male lower urinary tract symptoms have been correlated with an increased risk of death; however, it is unclear if treatment will reduce this risk. Our objective was to determine whether a reduction in lower urinary tract symptoms is associated with a reduced risk of mortality. We conducted a secondary analysis of the MTOPS (Medical Treatment of Prostate Symptoms) randomized trial of placebo, doxazosin, finasteride, or doxazosin and finasteride. Men in the United States between 1993 and 1998 who were >50 years of age with moderate to severe lower urinary tract symptoms were included. We used various Cox regression models to assess the relationship between AUA Symptom Score (modeled as a time-varying exposure) and death. A total of 3,046 men (median age 62, quartiles 57-68) were randomized and had a baseline AUA Symptom Score. For each 1-point improvement in the AUA Symptom Score, the hazard ratio for death was 0.96 (0.94-0.99, P = .01). Our sensitivity analyses found a similar significant reduction in the hazard ratio for death within men who had active treatment, but not among men who were randomized to the placebo arm; our results did not change when men were censored at the time of transurethral prostate resection, with adjustment for potential confounders, or with a shorter observation period after the last study visit. A comparable significant reduction in death was seen with 1-point improvements in the storage (HR 0.94, 95% CI 0.88-0.99, P = .04) and voiding (HR 0.95, 95% CI 0.91-0.99, P = .03) subscales individually. Improvement in male lower urinary tract symptoms was associated with a reduced risk of death. Further study is warranted to determine if the male treatment paradigm should shift toward symptom treatment independent of bother.

Male urinary tract infection with Trichosporon asahii fungemia

Male urinary tract infection with Trichosporon asahii fungemia

Bacterial Communities of the Internal Reproductive and Digestive Tracts of Virgin and Mated Tuta absoluta.

Microorganisms can affect host reproduction, defense, and immunity through sexual or opportunistic transmission; however, there are few studies on insect reproductive organs and intestinal bacterial communities and their effects on mating. Tuta absoluta is a worldwide quarantine pest that seriously threatens the production of Solanaceae crops, and the microbial community within tomato leafminers remains unclear. In this study, 16s rRNA sequencing was used to analyze bacterial communities related to the reproductive organs and intestinal tracts of tomato leafminers (the sample accession numbers are from CNS0856533 to CNS0856577). Different bacterial communities were found in the reproductive organs and intestinal tracts of females and males. Community ecological analysis revealed three potential signs of bacterial sexual transmission: (1) Mating increased the similarity between male and female sex organs and intestinal communities. (2) The bacteria carried by mated individuals were found in unmated individuals of the opposite sex but not in unmated individuals of the same sex. (3) The bacteria carried by unmated individuals were lost after mating. In addition, the abundances of bacterial communities carried by eggs were significantly higher than those of adult worms. Our results confirm that mating leads to the transfer of bacterial communities in the reproductive organs and gut of tomato leafminers, and suggest that this community strongly influences the reproductive process.

Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia (BPH): AUA Guideline Amendment 2023.

The purpose of this American Urological Association (AUA) Guideline amendment is to provide a useful reference on the effective evidence-based management of male lower urinary tract symptoms secondary/attributed to BPH (LUTS/BPH). The Minnesota Evidence Review Team searched Ovid MEDLINE, the Cochrane Library, and the Agency for Healthcare Research and Quality (AHRQ) database to identify studies relevant to the management of BPH. The guideline was updated in 2023 to capture eligible literature published between September 2020 and October 2022. When sufficient evidence existed, the body of evidence was assigned a strength rating of A (high), B (moderate), or C (low) for support of Strong, Moderate, or Conditional Recommendations. In the absence of sufficient evidence, additional information is provided as Clinical Principles and Expert Opinions. The BPH amendment resulted in changes to statements/supporting text on combination therapy, photoselective vaporization of the prostate (PVP), water vapor thermal therapy (WVTT), laser enucleation, and prostate artery embolization (PAE). A new statement on temporary implanted prostatic devices (TIPD) was added. In addition, statements on transurethral needle ablation (TUNA) and transurethral microwave thermotherapy (TUMT) were removed and information regarding these legacy technologies was added to the background section. References and the accompanying treatment algorithms were updated to align with the updated text. This guideline seeks to improve clinicians' ability to evaluate and treat patients with BPH/LUTS based on currently available evidence. Future studies will be essential to further support these statements to improve patient care.

Prevalence of Ureaplasma urealyticum, Mycoplasma hominis and Chlamydia trachomatis in symptomatic and asymptomatic patients.

The purpose of the present study was to assess the prevalence of Ureaplasma urealyticum (U. urealyticum), Mycoplasma hominis (M. hominis) and Chlamydia trachomatis (C. trachomatis) in a Romanian population considering the presence or absence of genital symptoms. Urethral and vaginal samples were collected from patients presenting at 'Ponderas' Academic Hospital (Bucharest, Romania) from January 2021 to December 2021. A total of 266 samples were obtained from two groups of patients: Symptomatic subjects with urethritis, prostatitis, vaginitis or both urethritis and prostatitis (n=59; 22%), and asymptomatic subjects (n=207; 78%). Mycoplasma and Chlamydia kits were used to assess the presence of U. urealyticum and M. hominis, and C. trachomatis, respectively. The symptomatic subjects comprised 27 patients with urethritis symptoms, of whom 4 (15%) were infected with U. urealyticum and 1 (4%) was infected with C. trachomatis. In addition, 23 (9%) of the patients had prostatitis-like symptoms, which in 3 (13%) of the patients was associated with U. urealyticum and in 1 patient (4%) was associated with C. trachomatis. None of the symptomatic patients were infected with M. hominis. By contrast, 29 (14%) of the asymptomatic patients were discovered to be infected with U. urealyticum, 13 (6%) were coinfected with both Mollicutes and 4 (2%) were infected with C. trachomatis; only 1 patient was positive for M. hominis alone. Two patients (14%) who presented with U. urealyticum and M. hominis coinfection were also infected with C. trachomatis. No patient with U. urealyticum or M. hominis alone was also positive for C. trachomatis. Therefore, the most frequently identified pathogen populating the genital tract in both males and females was U. urealyticum, followed by coinfection with U. urealyticum and M. hominis, and C. trachomatis. As these infections are asymptomatic in numerous cases, this suggests that a thorough screening should be mandatory.

PE005 - ‘Do as I say, not as I do’; A survey on clinician prescribing and self administration preferences for management of male Lower Urinary Tract Symptoms (LUTS)

PE005 - ‘Do as I say, not as I do’; A survey on clinician prescribing and self administration preferences for management of male Lower Urinary Tract Symptoms (LUTS)

The reproductive tract of the black soldier fly (Hermetia illucens) is highly differentiated and suggests adaptations to sexual selection

AbstractThe reproductive biology of the black soldier fly (BSF), Hermetia illucens (L.) (Diptera: Stratiomyidae), was investigated in males and females with a focus on how sperm is handled by males before – and by females after – copulation. As this insect has great economic importance for protein production from agri‐food wastes, its reproduction needs to be precisely known. A detailed description of male and female reproductive organs was made, and sperm were counted in male and female storage organs. Measures of testis and sperm counts were performed in males of various ages and their dynamics was compared to the ovaries of females. Both male and female tracts were long, and consisted of various successive parts. In males, testes fill the vas deferens with mature sperm, that are tangled as ‘windrows’, and sperm pass successively through a ‘studded pipe’ and three phallic ‘wands’ before being transferred to females. In virgin males, mean (± SEM) sperm number increased from approximately 9700 (± 1400, n = 5) to 39600 (± 3470, n = 13) in 20 days, and testes gradually decreased in size, indicating continuous spermatogenesis. Sperm cells are long, more than 3 mm. During copulation, sperm are deposited by phallic ‘wands’ at the base of each spermatheca in a smooth tube followed by a ‘fishnet canal’ at the top of which they accumulate before complete storage. They then pass through a ringed canal, an elbow, and a rigid rod strewn with glands, before reaching the spermathecal reservoir. Females store approximately 680 spermatozoa after one mating in each spermathecal reservoir. Such complex sperm storage organs of females may indicate strong female post‐mating selection, and reflect competition for long and numerous sperm in this species, in which female multiple matings are suspected. Besides its economical interest, BSF is an appealing model for further investigations on sexual selection.

Use of Urinary Biomarkers in Discriminating Interstitial Cystitis/Bladder Pain Syndrome from Male Lower Urinary Tract Dysfunctions.

To analyze the urinary biomarkers in men with lower urinary-tract symptoms (LUTS) and identify interstitial cystitis/bladder pain syndrome (IC/BPS) from the other lower urinary-tract dysfunctions (LUTDs) by the levels of characteristic urinary biomarkers. In total, 198 men with LUTS were prospectively enrolled and urine samples were collected before intervention or medical treatment. Videourodynamic studies were routinely performed and the LUTDs were diagnosed as having bladder-outlet obstruction (BOO) such as bladder-neck dysfunction, benign prostatic obstruction, or poor relaxation of external sphincter (PRES); and bladder dysfunction such as detrusor overactivity (DO), hypersensitive bladder (HSB), and IC/BPS. Patients suspicious of IC/BPS were further confirmed by cystoscopic hydrodistention under anesthesia. The urine samples were investigated for 11 urinary inflammatory biomarkers including eotaxin, IL-6, IL-8, CXCL10, MCP-1, MIP-1β, RANTES, TNF-α, NGF, BDNF, and PGE2; and 3 oxidative stress biomarkers 8-OHdG, 8-isoprostane, and TAC. The urinary biomarker levels were analyzed between LUTD subgroups and IC/BPS patients. The results of this study revealed that among the patients, IC/BPS was diagnosed in 48, BOO in 66, DO in 25, HSB in 27, PRES in 15, and normal in 17. Patients with BOO had a higher detrusor pressure and BOO index than IC/BPS, whereas patients with IC/BPS, BOO, and DO had a smaller cystometric bladder capacity than the PRES and normal subgroups. Among the urinary biomarkers, patients with IC/BPS had significantly higher levels of eotaxin, MCP-1, TNF-α, 8-OHdG, and TAC than all other LUTD subgroups. By a combination of different characteristic urinary biomarkers, TNF-α, and eotaxin, either alone or in combination, had the highest sensitivity, specificity, positive predictive value, and negative predictive value to discriminate IC/BPS from patients of all other LUTD subgroups, BOO, DO, or HSB subgroups. Inflammatory biomarker MCP-1 and oxidative stress biomarkers 8-OHdG and TAC, although significantly higher in IC/BPS than normal and PRES subgroups, did not have a diagnostic value between male patients with IC/BPS and the BOO, DO, or HSB subgroups. The study concluded that using urinary TNF-α and eotaxin levels, either alone or in combination, can be used as biomarkers to discriminate patients with IC/BPS from the other LUTD subgroups in men with LUTS.

Experimental infection of Artibeus lituratus bats and no detection of Zika virus in neotropical bats from French Guiana, Peru, and Costa Rica suggests a limited role of bats in Zika transmission.

Bats are important natural reservoir hosts of a diverse range of viruses that can be transmitted to humans and have been suggested to play an important role in the Zika virus (ZIKV) transmission cycle. However, the exact role of these animals as reservoirs for flaviviruses is still controversial. To further expand our understanding of the role of bats in the ZIKV transmission cycle in Latin America, we carried out an experimental infection in wild-caught Artibeus lituratus bats and sampled several free-living neotropical bats across three countries of the region. Experimental ZIKV infection was performed in wild-caught adult bats (4 females and 5 males). The most relevant findings were hemorrhages in the bladder, stomach and patagium. Significant histological findings included inflammatory infiltrate consisting of a predominance of neutrophils and lymphocytes, in addition to degeneration in the reproductive tract of males and females. This suggests that bat reproduction might be at some level affected by ZIKV. Leukopenia was also observed in some inoculated animals. Hemorrhages, genital alterations, and leukopenia are suggested to be caused by ZIKV; however, since these were wild-caught bats, we cannot exclude other agents. Detection of ZIKV by qPCR was observed at low concentrations in only two urine samples in two inoculated animals. All other animals and tissues tested were negative. Finally, no virus-neutralizing antibodies were found in any animal. To determine ZIKV infection in nature, the blood of a total of 2056 bats was sampled for ZIKV detection by qPCR. Most of the sampled individuals belonged to the genus Pteronotus sp. (23%), followed by the species Carollia sp. (17%), Anoura sp. (14%), and Molossus sp. (13.7%). No sample of any tested species was positive for ZIKV by qPCR. These results together suggest that bats are not efficient amplifiers or reservoirs of ZIKV and may not have an important role in ZIKV transmission dynamics.

Predicting Prostate Surgery Outcomes from Standard Clinical Assessments of Lower Urinary Tract Symptoms To Derive Prognostic Symptom and Flowmetry Criteria

BackgroundAssessment of male lower urinary tract symptoms (LUTS) needs to identify predictors of symptom outcomes when interventional treatment is planned. ObjectiveTo develop a novel prediction model for prostate surgery outcomes and validate it using a separate patient cohort and derive thresholds for key clinical parameters. Design, setting, and participantsFrom the UPSTREAM trial of 820 men seeking treatment for LUTS, analysis of bladder diary (BD), International Prostate Symptom Score (IPSS), IPSS-quality of life, and uroflowmetry data was performed for 176 participants who underwent prostate surgery and provided complete data. For external validation, data from a retrospective database of surgery outcomes in a Japanese urology department (n = 227) were used. Outcome measurements and statistical analysisSymptom improvement was defined as a reduction in total IPSS of ≥3 points. Multiple logistic regression, classification tree analysis, and random forest models were generated, including versions with and without BD data. Results and limitationsMultiple logistic regression without BD data identified age (p = 0.029), total IPSS (p = 0.0016), and maximum flow rate (Qmax; p = 0.066) as predictors of outcomes, with area under the receiver operating characteristic curve (AUC) of 77.1%. Classification tree analysis without BD data gave thresholds of IPSS <16 and Qmax ≥13 ml/s (AUC 75.0%). The random forest model, which included all clinical parameters except BD data, had an AUC of 94.7%. Internal validation using the bootstrap method showed reasonable AUCs (69.6–85.8%). Analyses using BD data marginally improved the model fits. External validation gave comparable AUCs for logistic regression, classification tree analysis, and random forest models (all without BD; 70.9%, 67.3%, and 68.5%, respectively). Limitations include the significant number of men with incomplete baseline data and limited assessments in the external validation cohort. ConclusionsOutcomes of prostate surgery can be predicted preoperatively using age, total IPSS, and uroflowmetry data, with prognostic thresholds of 16 for IPSS and 13 ml/s for Qmax. Patient summaryThis study identified key preoperative factors that can predict outcomes of prostate surgery for bothersome urinary symptoms, including which patients are at risk of a poor outcome.

Analysis of Open Access Journals in Urology: A Scientometric Sketch

An open access scientific journal is a peer-reviewed publication that is available for free online, allowing users to search, read, copy, share the link, download, and print full-text research papers. Urology is a medical practice that focuses on urinary tract problems in both men and women. An urologist is a physician who specializes in the urinary system. Back in the day, doctors would examine a patient’s urine for evidence of their illness. Urology, often known as genito-urinary surgery, is a surgical and medical specialty that focuses on the male and female urinary tract organs. This paper has analyzed the urology open access journals which are available in DOAJ (Directory of Open Access Journals). The results reveal that DOAJ indexes 12 open access journals published by Elsevier and followed by 8 journals are published by Wolters Kluwer Medknow. The other publishers such as Hindawi Limited 5 journals, Karger Publishers 4 journals. It is found that there are 37 blind peer review journals followed by 32 double blind peer review journals and 11 peer-reviews journals respectively indexed in DOAJ database. It is discovered in the study that maximum journals (74) in Urology are without DOAJ seal and only 8 journals have got the desired DOAJ seal, which represents as a symbol of certification and high publishing standards.