Male Sexual Dysfunction and Infertility in Spinal Cord Injury Patients: State-of-the-Art and Future Perspectives

Bello, Francesco Di; Creta, Massimiliano; Napolitano, Luigi; Califano, Gianluigi; Passaro, Francesco; Morra, Simone; Giovanni, A; Fusco, Giovanni Maria; Cirillo, Luigi; Morgera, Vincenzo; Cacace, Gianluigi; Luca, Luigi De; Spena, Gianluca; Ruvolo, Claudia Collà; Calace, Francesco Paolo; Manfredi, Celeste; Rocca, Roberto La; Celentano, Giuseppe; Turco, Carmine; Capece, Marco; D’Alterio, Carlo; Giordano, Antonio; Mauro, Ernesto Di; Trama, Francesco; Amicuzi, Ugo; Arcaniolo, Davide; Fusco, Ferdinando; Longo, Nicola

doi:10.3390/jpm12060873

Cited by 18 publications

(9 citation statements)

References 60 publications

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“…Lumbosacral pathologies can lead to infertility [4, 24]. After the spinal cord injury, impaired spermatogenesis and sexual dysfunction may occur in most men [4, 25]. The ON-originated sacral parasympathetic motoneurons innervating the genital organs were first described in 1899 by Onufrowicz [2, 3].…”

Section: Discussionmentioning

confidence: 99%

From Nose to Lumbar Spinal Cord – Reduced Sperm Numbers Occur by Olfactory Bulbectomy-Related Onuf’s Nucleus Degeneration: New Experimental Evidence for Kallmann Syndrome

Yolaş¹,

Kanat²,

Zeynal³

et al. 2023

Neuroendocrinology

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Introduction: Olfaction and its relation to human health is an area of growing interest. Although olfaction disorders have been considered a part of Kallmann Syndrome, the role of olfactory dysfunction on spermatogenesis has not been studied yet. We studied if olfactory bulbectomy causes dysfunction in spermatogenesis as a result of Onuf’s nucleus damage. Methods: Twenty-eight male rats were divided into three groups: six as the control (G-1; n=6), six as the only frontal burr-hole applied animals SHAM (G-1I; n=6), and 16 as the study group (G-III; n=16) in which OBX was performed. The animals were followed for two months. After the decapitation of the animals, olfactory bulb (OB) volumes (mm3), the neuron density of the Onuf nucleus (n/mm3), and sperm density (n/mm3) were estimated stereologically, and analyzed. Results: Olfactory bulb volumes (mm3), degenerated neuron density of Onuf's nucleus (n/mm3), and sperm numbers of control, SHAM, and study groups were estimated as: 4±0.5; 6±2 and 103.245±10.841 in G-I; 3.5±0.7; 14±4 and 96.891±9.569 in G-II and 1.3±0.3; 91±17 and 73.561±6.324 in GIII. The statistical results of degenerated neuron density of Onuf's nucleus and sperm numbers between groups are as p<0.005 for GI/GII; p<0.0005 for GII/GIII and p<0.00001 for G-I/G-III. Discussion/Conclusion: This study first time indicates that Onuf's nucleus degeneration secondary to OBX seems to be responsible for reduced sperm numbers.

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Section: Discussionmentioning

confidence: 99%

From Nose to Lumbar Spinal Cord – Reduced Sperm Numbers Occur by Olfactory Bulbectomy-Related Onuf’s Nucleus Degeneration: New Experimental Evidence for Kallmann Syndrome

Yolaş¹,

Kanat²,

Zeynal³

et al. 2023

Neuroendocrinology

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“…ED [14][15][16][17][18][19][20], PE [21], PD [22][23][24][25][26][27][28][29][30], male infertility [31,32], genital aesthetic concerns [33][34][35][36][37], as well as several other conditions [38][39][40][41][42][43][44][45] can significantly impact the sexual health of male patients. When this happens, worries and doubts often lead patients to independently search for information on the Internet with every available tool [1,2].…”

Section: Our Findings and Available Literaturementioning

confidence: 99%

Voice Assistants as Consultants for Male Patients with Sexual Dysfunction: A Reliable Option?

Napolitano

Barone

Spirito

et al. 2023

IJERPH

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The aim of this study was to evaluate the ability of Google Assistant, Alexa, and Siri to recognize and answer questions about male sexual health. Each VA was tested on a smart speaker: Alexa on Amazon Echo Dot 4th Gen., Google Assistant on Google Home Mini, and Siri on Apple HomePod. A pool of patients’ frequently asked questions regarding erectile dysfunction (ED), premature ejaculation (PE), Peyronie’s disease (PD), male infertility, and other aspects of male sexual health were identified by authors. The recognition of question was evaluated (“yes” or “not”). For each recognized question, the response characteristics (domains) were rated on a scale from 0 to 10 (according to the quality). We chose the recognition rate of the questions as the primary outcome and the quality of the answers as the secondary outcome. Overall, the best VA in recognizing questions was Siri, with a total of 83.3% questions compared with 64.0% for Alexa (p = 0.024) and 74.0% for Google Assistant (p = 0.061). Siri was associated with a significantly higher recognition rate than Alexa for PE (80% vs. 40%; p = 0.002) and PD (66.7% vs. 33.3%; p = 0.010). The quality of the responses was classified as low in 57 out of 105 cases (54.3%), intermediate in 46 cases (43.8%), and high in only 2 cases (1.9%), highlighting an overall intermediate-low quality of the answers. Male infertility was the condition associated with the highest mean scores in “Targeted response to the problem” (7.32 ± 2.57), “Scientific correctness of the answer”, (5.9 ± 2.76) “Completeness of the answer” (5.14 ± 2.56), and “Understandability of the response for a patient” (5.3 ± 2.51) domains. Siri was associated with significantly higher scores than Alexa (p < 0.05) in several domains of all conditions evaluated. The question recognition rate of VAs is quite high; however, the quality of the answers is still intermediate-low. Siri seems superior to Alexa in both question recognition and response quality. Male infertility appears to be the sexual dysfunction best addressed by VAs.

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“…While the majority of females with SCI can reproduce ( 3 ), in contrast, the overwhelming majority of males cannot reproduce without medical intervention ( 4 ). Male reproductive complications include: sexual dysfunction (erectile and/or ejaculatory dysfunction), fertility problems (impaired spermatogenesis and/or poor sperm quality), and systemic disorders (genitourinary infection and endocrine imbalance) ( 4 – 6 ). Testosterone deficiency, defined as total serum testosterone < 11.3 nmol/L, is among the potential causes of these complications, with its specific impact varying due to individual differences ( 7 , 8 ).…”

Section: Introductionmentioning

confidence: 99%

Nitric oxide-induced lipophagic defects contribute to testosterone deficiency in rats with spinal cord injury

Zhuang,

Liu,

Chen

et al. 2024

Front. Endocrinol.

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IntroductionMales with acute spinal cord injury (SCI) frequently exhibit testosterone deficiency and reproductive dysfunction. While such incidence rates are high in chronic patients, the underlying mechanisms remain elusive.Methods and resultsHerein, we generated a rat SCI model, which recapitulated complications in human males, including low testosterone levels and spermatogenic disorders. Proteomics analyses showed that the differentially expressed proteins were mostly enriched in lipid metabolism and steroid metabolism and biosynthesis. In SCI rats, we observed that testicular nitric oxide (NO) levels were elevated and lipid droplet-autophagosome co-localization in testicular interstitial cells was decreased. We hypothesized that NO impaired lipophagy in Leydig cells (LCs) to disrupt testosterone biosynthesis and spermatogenesis. As postulated, exogenous NO donor (S-nitroso-N-acetylpenicillamine (SNAP)) treatment markedly raised NO levels and disturbed lipophagy via the AMPK/mTOR/ULK1 pathway, and ultimately impaired testosterone production in mouse LCs. However, such alterations were not fully observed when cells were treated with an endogenous NO donor (L-arginine), suggesting that mouse LCs were devoid of an endogenous NO-production system. Alternatively, activated (M1) macrophages were predominant NO sources, as inducible NO synthase inhibition attenuated lipophagic defects and testosterone insufficiency in LCs in a macrophage-LC co-culture system. In scavenging NO (2-4-carboxyphenyl-4,4,5,5-tetramethylimidazoline-1-oxyl-3-oxide (CPTIO)) we effectively restored lipophagy and testosterone levels both in vitro and in vivo, and importantly, spermatogenesis in vivo. Autophagy activation by LYN-1604 also promoted lipid degradation and testosterone synthesis.DiscussionIn summary, we showed that NO-disrupted-lipophagy caused testosterone deficiency following SCI, and NO clearance or autophagy activation could be effective in preventing reproductive dysfunction in males with SCI.

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Male Sexual Dysfunction and Infertility in Spinal Cord Injury Patients: State-of-the-Art and Future Perspectives

Cited by 18 publications

References 60 publications

From Nose to Lumbar Spinal Cord – Reduced Sperm Numbers Occur by Olfactory Bulbectomy-Related Onuf’s Nucleus Degeneration: New Experimental Evidence for Kallmann Syndrome

From Nose to Lumbar Spinal Cord – Reduced Sperm Numbers Occur by Olfactory Bulbectomy-Related Onuf’s Nucleus Degeneration: New Experimental Evidence for Kallmann Syndrome

Voice Assistants as Consultants for Male Patients with Sexual Dysfunction: A Reliable Option?

Nitric oxide-induced lipophagic defects contribute to testosterone deficiency in rats with spinal cord injury

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