With increasing knowledge that the immune system has a major impact on reproductive ‎health, the potential for cells arising in organs such as the thymus to alleviate oxidative stress ‎has been revealed. This study addresses the impact of neonatal thymectomy on male ‎reproductive function in pubertal and adult animals. Neonatal Sprague Dawley rats were allotted to four treatments consisting of fully thymectomized, partially thymectomized, intact, and sham-operated rats. Half of the rats in each treatment were sacrificed at 40 and the other half at 80 days of age. Testicular volume, ventral prostate and spleen weight, several sperm attributes (concentration, motility, livability, membrane integrity, sperm penetration into mucus, total antioxidant capacity, mitochondrial dehydrogenase activity), plasma superoxide dismutase, glutathione, and testosterone level as well as fertility decreased in thymectomized rats. Adrenal gland weight, sperm malondialdehyde level, indices of oxidative stress, sperm abnormality, testicular and sperm lipid peroxidation, protein carbonylation, and sperm reactive oxygen species generation increased in thymectomized rats. In thymectomized rats, the testes contained high levels of malondialdehyde but low levels of glutathione and ferric-reducing antioxidant power. Epididymal sperm reactive oxygen species, blood lipid peroxidation, and oxidative stress indices ‎‎in blood and spermatozoa were highest in fully thymectomized, intermediate ‎in partially thymectomized, and lowest in both pubertal and mature control rats. Blood levels of superoxide dismutase, lipid peroxidation indices, and ‎testosterone, and mitochondrial adenosine triphosphate and ‎dehydrogenase activities in epididymal spermatozoa were lowest in fully thymectomized, ‎intermediate in partially thymectomized, and highest in both pubertal and mature control rats.‎ The data indicated that increased oxidative stress and mitochondrial dysfunction might play a role in the mechanism of immunosuppression-induced testicular and sperm abnormalities.

Purpose: To compare the effi cacy and safety of available selective serotonin reuptake inhibitors (SSRIs) in order to fi nd the most effective drug with the least number of side effects in treatment of premature ejaculation (PE). Materials and Methods: This study was a randomized clinical trial. Four hundred and eighty patients with PE in the 4 groups referred to Imam Reza hospital Tehran, Iran from July 2018 to February 2019 were enrolled in the study. The patients received sertraline 50mg, fl uoxetine 20mg, paroxetine 20mg and citalopram 20mg, every 12 hours daily. The intravaginal ejaculatory latency time (IELT) before treatment, fourth and eighth weeks after treatment was recorded by the patient's wife with a stopwatch. Results: Mean IELT before, 4 and 8 weeks after treatment in four groups were: sertraline 69.4±54.3, 353.5±190.4, 376.3±143.5; fl uoxetine 75.5±64.3, 255.4±168.2, 314.8±190.4; paroxetine 71.5±69.1, 320.7±198.3, 379.9±154.3; citalopram 90.39±79.3, 279.9±192.1, 282.5±171.1 seconds, respectively. The ejaculation time signifi cantly increased in all groups (p <0.05), but there was no signifi cant difference between the groups (P=0.75). Also, there was no signifi cant difference in drugs side effects between groups (p >0.05). The most common side effects were drowsiness and dyspepsia, which were not severe enough to cause discontinuation of the drug. Conclusions: All available SSRIs were effective and usually had no serious complications. In patients who did not respond to any of these drugs, other SSRI drugs could be used as a salvage therapy.

Premature ejaculation is the most common type of sexual dysfunction in men younger than 40 years. The optimal medical treatment for premature ejaculation has not been established in previous studies, but single dosing prior to sexual relations can work for some males, while in others, achieving a blood level through daily use of the medication may be necessary, as in the treatment of clinical depression. Obviously, if single dosing is successful, therapy is simpler and is associated with fewer adverse effects. Therefore, this may be the preferred initial therapy. Hence in this study, two therapeutic protocols of citalopram including as needed and twice a day were compared. This study was an un-blind randomized clinical trial. The patients aged older than 18 years with premature ejaculation were evaluated by urologist and after the disease was established and the questionnaire was fulfilled they were enrolled into the study. The patients were randomly assigned to receive either twice a day 20 mg citalopram or 20 mg four hours before coitus. The mean ejaculation time in two groups of PRN and BD was significantly differed in fourth week (P < 0.05) with 286.9±252.6 and 269.51±350.21 seconds, respectively, but apposite of BD group (485.±519.93 seconds), the patients in PRN group (288.53±267.27 seconds) showed no significant difference (P > 0.05), and however the baseline and fourth week measurement were alike between two groups; but in eighth week after treatment there was a significant difference between two groups (P < 0.05). Totally, it may be concluded that citalopram with every dose is effective in the treatment of premature ejaculation. However the BD regimen is more effective.

Background: Nowadays, parents are paying more attention to the penis size of their children, especially obese children. Objectives: The aim of this study was to investigate the correlation between obesity, testosterone, and estradiol in prepubertal non-obese and obese children with micropenis. Methods: This case-control study was done on 58 non-obese and 86 obese micropenis children aged 8 - 13 years at Golestan Hospital, Tehran, Iran, from June 2018 to May 2020. The body mass index (BMI), testosterone and estradiol levels, stretched penile length (SPL), and the correlation between these were studied. Results: The mean age of children in non-obese and obese groups was 10.2 ± 1.34 and 10.5 ± 1.6 years, respectively. SPL in non-obese and obese subjects was 3.1 ± 1.3 and 2.9 ± 1.22 cm, respectively. SPL in both groups was significantly correlated with height and testosterone (height: r = 0.239, P = 0.009; testosterone: r = 0.344, P = 0.001) but not with BMI, weight, and estradiol. After the adjustment for age, BMI, weight, and estradiol, adjusted odds ratio with confidence interval 95% for penile length across to height and testosterone levels in non-obese group was 1.52 (0.91 - 1.83; P = 0.001) and 0.56 (0.36 - 0.98; P = 0.001), respectively and in the obese group was 1.42 (0.81 - 1.66; P = 0.001) and 0.75 (0.51 - 0.87; P = 0.001), respectively. Conclusions: Penile length is positively correlated with height and testosterone but not with weight and estradiol in non-obese and obese children. It is probably not essential and obligatory to recommend weight loss for this issue and weight loss should not be concerned by children and their parents.

Background: Most issues of micropenis boys include poor body image and quality of life. Objectives: The purpose of this assay was to survey the relationship of anthropometric measures, testosterone, estradiol, gonadotropins and prolactin with stretched penile length (SPL) and flaccid glans-pubis length (GPL) in pre-pubertal boys with true small penis. Methods: This was prospective a cross-sectional observational study that was conducted in Imam Reza Hospital, Tehran, Iran from February 2015 to May 2020. The pre-pubertal children 7 - 14 years who referred with small penis size were evaluated by a pediatrician and urologist and, if they had true micropenis, they were enrolled in the study (n = 236). The anthropometric and hormonal measurements, SPL, GPL, and relationship of these variables were evaluated. Results: Mean ages of children were 11.65 ± 1.59 years. Mean SPL and GPL were 2.95 ± 1.23 and 2.29 ± 1.06 cm, respectively. There was a significant relationship between SPL and GPL (r = 0.976, P = 0.000). SPL and GPL were not correlated with BMI (r = -0.182, P = 0.054; r = -0.161, P = 0.089, respectively). A significant correlation was found between SPL and GPL with height, FSH, LH, Testosterone and T/E ratio (P < 0.01) but no correlation with weight, estradiol and prolactin (> 0.05). Conclusions: According to the finding of present study, the flaccid measurement can be as helpful as stretched measurement if it is done from pubic bone to tip of glans. Retraining of primary health workers about age-related penile length may be reducing the misdiagnosis of micropenis and concerns of parents, especially in obese boys. The penile length in prepubertal children was not related to BMI and weight but was significantly related to height. Furthermore, Estradiol level is not related to penile length in children with micropenis.