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        Chlamydia trachomatis versus common uropathogens as a cause of chronic bacterial prostatitis: Is there any difference? Results of a prospective parallel-cohort study

        Tommaso Cai,Francesca Pisano,Gabriella Nesi,Vittorio Magri,Paolo Verze,Gianpaolo Perletti,Paolo Gontero,Vincenzo Mirone,Riccardo Bartoletti 대한비뇨의학회 2017 Investigative and Clinical Urology Vol.58 No.6

        Purpose: The role of Chlamydia trachomatis (CT) infection in chronic bacterial prostatitis (CBP) is well known. What is unclear is whether there are any differences in the course or clinical outcome of the disease when the cause is CT or other uropathogens. Materials and Methods: A series of 311 patients affected by CBP due to CT (cohort A) was compared with a group of 524 patients affected by CBP caused by common uropathogen bacteria (cohort B). All participants completed the following questionnaires: National Institutes of Health Chronic Prostatitis Symptom Index, International Prostate Symptom Score, International Index of Erectile Function-15 erectile function domain (IIEF-15-EFD), Premature Ejaculation Diagnostic Tool (PEDT), and the Short Form 36 (SF-36) Health Survey. All patients were followed with clinical and microbiological evaluations. Results: After a mean follow-up time of 42.3 months, the number of symptomatic episodes was significantly higher in patients in cohort A than in cohort B (4.1±1.1 vs. 2.8±0.8, p<0.001), and the mean time to first symptomatic recurrence was shorter in cohort A than in cohort B (3.3±2.3 months vs. 5.7±1.9 months, p<0.001). Moreover, scores on the SF-36 tool were significantly lower in cohort A (96.5±1.0 vs. 99.7±1.9, p<0.001) at the first symptomatic recurrence. Cohort A also showed significantly lower scores on the IIEF-15-EFD and PEDT questionnaires at the end of the follow-up period (26.8±2.9 vs. 27.3±3.3, p=0.02 and 11.5±2.3 vs. 4.5±2.8, p<0.001, respectively). Conclusions: Patients affected by CBP due to CT infection have a higher number of symptomatic recurrences with a more severe impact on quality of life.

      • SCOPUSKCI등재

        Novel method of histopathological analysis after testicular sperm extraction in patients with nonobstructive and obstructive azoospermia

        Cito, Gianmartin,Coccia, Maria Elisabetta,Picone, Rita,Nesi, Gabriella,Cocci, Andrea,Dabizzi, Sara,Garaffa, Giulio,Fucci, Rossella,Falcone, Patrizia,Bertocci, Francesco,Santi, Raffaella,Criscuoli, Luc The Korean Society for Reproductive Medicine 2018 Clinical and Experimental Reproductive Medicine Vol.45 No.4

        Objective: To assess whether the "testicular pool" could be used for histological analysis and whether it gave more accurate information than the standard testicular biopsy. Methods: Between January 2017 and March 2018, this single-center prospective study included 60 azoospermic men undergoing conventional bilateral testicular sperm extraction. Six samples were excised from each testicle and transferred to an embryologist. One additional biopsy was randomly taken from each testis for a histological analysis. After processing, the testicular pool was also sent for a histological analysis, which showed normal spermatogenesis (NS), hypospermatogenesis (HYPO), maturation arrest (MA), Sertoli cell-only syndrome (SCOS), and tubular atrophy (TA). Results: Twenty of the 60 patients (33.3%) had obstructive azoospermia (OA), while the remaining 40 (66.6%) had nonobstructive azoospermia. Their mean age was 40.5 years. All patients with OA had previously undergone unsuccessful testicular fine-needle aspiration. Successful sperm retrieval (SSR) occurred in 93.3% of patients. Histological analysis of the testicular biopsy revealed NS in 12 patients (20%), HYPO and TA in 28 patients (46.6%), MA in eight patients (13.3%), and SCOS in 12 patients (20%). The testicular pool analysis showed NS in 12 patients (20%), HYPO and TA in 44 patients (73.3%), MA in four patients (6.6%), and SCOS in no patients. In four patients with MA (6.6% of the total sample) and 12 patients with SCOS (20% of the total sample) according to the standard testicular biopsy, the embryologist found SSR with cryopreservation. Overall, in 44 patients (73.3%), the testicular pool analysis confirmed the histological findings of the standard testicular biopsy. In the 16 cases (26.6%) with a discrepancy between the single-biopsy histological findings and SSR, the testicular pool analysis confirmed the embryological data on SSR. Conclusion: The testicular pool proved to be easily analyzable, practical, manageable, and more accurate for predicting sperm retrieval than standard testicular biopsy.

      • KCI등재

        Sperm retrieval by conventional testicular sperm extraction for assisted reproduction in patients with Zinner syndrome

        Cito Gianmartin,Luca Gemma1,Claudia Giachini,Micelli Elisabetta,Cocci Andrea,Fucci Rossella,Picone Rita,Simone Sforza,Gabriella Nesi,Raffaella Santi,Minervini Andrea,Lorenzo Masier,Carini Marco,Coccia 대한생식의학회 2021 Clinical and Experimental Reproductive Medicine Vol.48 No.1

        We present data from three Caucasian men with Zinner syndrome who attended our center for the treatment of primary couple’s infertility. Each patient was scheduled for multiple conventional testicular sperm extraction (cTESE) and cryopreservation. The mean duration of infertility was 243 months. Sperm analysis confirmed absolute azoospermia. In patient 1, imaging revealed right and left testis volumes of 24 mL and 23 mL, respectively; dilatation of the right caput epididymis, corpus, and cauda; left seminal vesicle agenesis; severe right seminal vesicle hypotrophy; right renal agenesis; and left nephroptosis. The patient’s levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and total testosterone (TT) were 3.2 IU/L, 5.2 IU/L, and 22.3 nmol/L, respectively. Patient 2 exhibited right and left testis volumes of 18 mL and 16 mL, respectively; a left seminal vesicle cyst of 3228 mm; ipsilateral kidney absence; and right seminal vesicle agenesis. The patient’s levels of FSH, LH, and TT were 2.8 IU/L, 4.2 IU/L, and 14.3 nmol/L, respectively. In patient 3, ultrasound showed a testicular volume of 10 mL bilaterally, a 6546 mm left seminal vesicle cyst, right seminal vesicle enlargement, and left kidney agenesis. The patient’s levels of FSH, LH, and TT were 32.0 IU/L, 16.3 IU/L, and 9.0 nmol/L, respectively. Sperm retrieval via cTESE was successful in all patients. It may be advisable to perform cTESE to obtain fresh sperm on the day of oocyte retrieval. Sperm cryopreservation should be avoided, since thawing could further compromise the sperm quality.

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