ㅤTake-home message from Matthews 1995, published in The Journal of Urology):
Microsurgical vasovastomy has a higher patency rate (99% vs 65%) that vasoepididymostomy and a lower failure rate (12% vs 21%). The return of motile sperm is quicker with vasovasostomy (+/- 2months vs +/- 6months), with higher pregnancy rates (52% vs 21%).
Further intervention for persistent azoospermia is appropriate after 6 months for vasovasostomy and 12 months for vasepididymostomy.
ㅤTake-home message from Belker 1991, published in The Journal of Urology):
This study of reported outcomes of 1,469 microsurgical vasectomy reversals by the Vasovasostomy Study Group.
Age, duration of obstruction, and the presence of sperm in the fluid obtained during the procedure all affected the success of microsurgical vasectomy reversal.
ㅤTake-home message from Evers 2003, published in The Lancet:
This systematic review of seven randomised controlled trials found no significant evidence to support the use of varicocoele repair as an effective treatment for male or unexplained subfertility. However, the review might have had insufficient power to detect small effects due to the small number of patients in some subgroups.
ㅤTake-home message from Agarwal 2007, published in Urology:
Surgical varicocelectomy confers a significant improvement in semen parameters for infertile men with a combination of palpable varicocele and abnormal semen parameters.
ㅤTake-home message from Kaplan 2015, published in European Urology:
Use of testosterone does not increase risk of developing prostate cancer nor worsen its severity if previously diagnosed. It can be used safety to treat testosterone deficiency with careful clinical monitoring in men with history of prostatic malignancy.
ㅤTake-home message from Hume A Feldman 1994, published in The Journal of Urology ):
In a community-based, random sample survey of men 40-70 years old living in cities near Boston, overall prevalence of complete impotence was 52%.
Impotence is defined as the inability to attain and maintain an erection
The prevalence of impotence tripled from 5% to 15% between ages 40 and 70 years old.
Therefore, a man's age was strongly correlated with impotence
After adjusting for age, a higher probability of impotence was correlated with heart disease, hypertension, diabetes, anger and depression.
After adjusting for age, impotence was inversely correlated with high cholesterol, and low levels of male hormones.
The study concludes that impotence is a major health concern, because it is strongly associated with age and has negative consequences in terms of cardio-vascular disease.
ㅤTake-home message from Bhasin 2023, published in JAMA - Journal of American Medical Association (JAMA Network):
TRT was associated with a greater increase in PSA levels than placebo. However, the risk of prostate cancer, including high-grade disease, was not increased.