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PURPOSE: This study aimed to evaluate the safety and efficacy of a rapidly absorbable protein stent during microsurgical vasovasostomy.MATERIALS AND METHODS: Fifty-four rats were randomly divided into control, conventional, and stent groups. The left vas deferens was ligated in the control group and cut with double-layer suturing in the conventional group. The stent group received full-layer suturing with protein stent implantation. Patency rate, sperm quality, and reproductive hormones were evaluated up to 8 weeks. Pathological changes were determined by assessment.RESULTS: Patency rates were similar for the stent and conventional groups (8th week) (p > 0.05). Operation time was lower for the stent group than for the conventional group (p < 0.05). The stent group did not differ significantly from the control or conventional groups in terms of effects on sperm quantity, motility, deformity rate, FSH level, LH level, and testosterone level (p > 0.05).CONCLUSIONS: This study provides a foundation for future studies that may further explore the potential of protein stents in vasovasostomy and other surgical procedures.

Background Semen analysis plays an important role in the diagnosis of male infertility. However, many studies have demonstrated that the current methods of semen analysis are inefficient for assessing male fertility. Objective To test whether prior discontinuous density gradient centrifugation (DDCG) improves the performance of semen analysis in diagnosing male infertility. Materials and methods Infertile men and fertile men were recruited from the clinic. Pre‐ and post‐DDGC values for the semen parameters of sperm concentration, total sperm number, percent total motility, percent progressive motility, percent normal sperm morphology, and sperm DNA fragmentation rate were compared. Results A total of 528 men (252 infertile men and 276 fertile men) were enrolled in the present study. After DDGC, sensitivity was significantly increased for sperm concentration, total sperm number, and sperm morphology (P < .01); specificity was significantly increased for progressive motility and sperm morphology (P < .01); and diagnostic accuracy was significantly improved for all of these parameters (area under the curve (AUC): P < .01). Total motility and sperm DNA fragmentation rate exhibited no obvious change in sensitivity, specificity or accuracy after DDGC (all P > .01). For the combination of all these semen parameters, diagnostic accuracy improved significantly after DDGC (AUC: P < .01). In a multiple regression analysis, only sperm morphology and sperm DNA fragmentation rate had P values less than 0.05 before DDGC, whereas all parameters except total sperm number contributed to the equation after DDGC. Discussion DDGC is a mature, standardized procedure for clinical commonly used to optimize spermatozoa. The diagnostic accuracy of semen analysis was significantly improved after DDGC, which indicated that assessing “functional spermatozoa” might be a more suitable method for semen analysis than the WHO 2010 criteria. Conclusion Assessing semen parameters after DDGC might improve their diagnostic accuracy for male infertility.

Background The reliability of the International Index of Erectile Function (IIEF-5) in diagnosing erectile dysfunction (ED) is significantly decreased for the population with premature ejaculation (PE). Aim We aimed to illustrate a better way of diagnosing ED among the general population through a web survey study. Methods We collected online surveys from 2,746 men between the ages of 18 and 65. Two methods were used to determine the prevalence of ED, and these 2 methods were compared. Additionally, we divided our sample into 2 equally sized groups by median age and repeated the analyses for each group. In Method Ⅰ (M Ⅰ), men with an IIEF-5 score ≤ 21 were diagnosed with ED. In Method Ⅱ (M Ⅱ), PE was defined as a PEDT score ≥ 9, and no-PE was defined as a PEDT score ≤ 8. We used an IIEF-6 score cutoff of ≤ 24 among the PE population and a cutoff of ≤ 25 among the no-PE population to diagnose ED. Main outcome measures We examined the results from the IIEF-5, PEDT, and IIEF-6. Results Of the 2,746 men, 1,540 were in a stable heterosexual relationship, and the prevalence of ED among these men was determined. The prevalence of ED, as measured by Method Ⅰ, was significantly higher than that measured by Method Ⅱ. The kappa coefficients between the 2 methods were 0.595, 0.704, and 0.430 for the overall, no-PE, and PE populations, respectively. The internal consistency of the IIEF-5 for the PE population increased if Question 5 (intercourse satisfaction) was removed. Similar trends were observed for the groups, and there were no substantial differences. Clinical implications Our research suggests that before using the erectile function assessment scale to evaluate erectile function, ejaculatory function should be assessed with the PEDT. Strengths and limitations This was the first study to highlight the importance of evaluating ejaculatory function using the PEDT before diagnosing ED via an internet survey. There may have been recruitment bias because our study was an internet survey. Conclusion Establishing the prevalence of ED by using a combination of the IIEF-6 and PEDT was more reliable than using the IIEF-5 alone. Further validation of the modified procedure, especially regarding the effects of age on the results, in future studies is required.

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