Publications by authors named "Nazim Gherabi"
Purpose: The objective of this manuscript is to assess the effect of varicocele repair (VR) in patients with clinical varicoceles on serum total testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and inhibin B serum levels.
Materials And Methods: The study was performed in compliance with the Meta-Analysis and Systematic Reviews of Observational Studies (MOOSE) guidelines and the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). All eligible studies were selected following the PICOS (Population, Intervention, Comparison/Comparator, Outcomes, Study design) model.
Nonobstructive azoospermia (NOA) is the most challenging and complex clinical scenario for infertile men. Besides circumstances such as hypogonadotropic hypogonadism, surgical sperm retrieval is typically necessary, and microdissection testicular sperm extraction (micro-TESE) is the procedure of choice for men with NOA desiring to father children with their own gametes. Micro-TESE results in the highest numbers of sperm cells retrieved for use with in vitro fertilization/intracytoplasmic sperm injection (ICSI) in comparison to all other techniques for surgical sperm retrieval in men with NOA.
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- * A survey created by Global Andrology Forum experts was disseminated online, collecting responses from 479 ED specialists across 62 countries, leading to insights on the most commonly used RT methods.
- * Results indicate that RT is becoming more popular, especially among middle-aged patients with mild-to-moderate ED, but the lack of robust evidence and guidelines highlights a need for further research in this area.
Article Synopsis
- Non-obstructive azoospermia (NOA) is a prevalent and complex issue with varied treatment options and no definitive guidelines, leading to differing management practices internationally.
- A comprehensive survey with 336 responses from specialists in 49 countries explored current medical and surgical strategies for NOA, analyzing results against existing guidelines and offering expert recommendations.
- Key findings included diverse approaches to hormonal therapy, significant variation in sperm retrieval success rates, and differing protocols around varicocele repair and follicle-stimulating hormone cutoff levels for sperm retrieval.
Article Synopsis
- * Conducted from July to September 2022, a questionnaire gathered responses from 367 doctors in 49 countries, focusing on how they diagnose NOA through methods like hormone tests and genetic analyses.
- * The survey identified that while many practices align with guidelines, significant differences in approaches were found, underscoring the need for standardized, evidence-based international guidelines for NOA evaluation.
Effects of Varicocele Repair on Sperm DNA Fragmentation and Seminal Malondialdehyde Levels in Infertile Men with Clinical Varicocele: A Systematic Review and Meta-Analysis.
World J Mens Health
April 2024
Article Synopsis
- This systematic review and meta-analysis investigates whether varicocele repair (VR) can lower sperm DNA fragmentation (SDF) and seminal oxidative stress (measured by malondialdehyde or MDA) in infertile men.
- An analysis of 29 studies involving 1,491 men shows a significant reduction in SDF post-VR, regardless of the surgical technique used and the method of SDF testing.
- The findings also indicate a notable decrease in seminal MDA levels following VR, supporting the effectiveness of varicocele repair in improving reproductive parameters in affected men.
Background: Urinary incontinence and other urinary symptoms tend to be frequent at menopause because of hormonal modifications and aging. Urinary symptoms are associated with the genitourinary syndrome of menopause which is characterized by physical changes of the vulva, vagina and lower urinary tract. The treatment strategies for postmenopausal urinary incontinence are various and may include estrogens, anticholinergics, and pelvic floor muscle training.
View Article and Find Full Text PDFTechnical Aspects and Clinical Limitations of Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations.
World J Mens Health
January 2024
Article Synopsis
- The study investigates global practices and challenges in using sperm DNA fragmentation (SDF) assays, which can affect male reproductive potential, as outlined in the latest WHO manual.
- A survey of 436 reproductive clinicians revealed that the most popular SDF assay is TUNEL, with a significant influence from availability on their choices.
- Clinicians see the value of SDF testing in understanding infertility but face barriers like insufficient professional guidelines and a lack of accepted reference values for interpreting SDF results.
Article Synopsis
- AI has rapidly advanced in medicine, particularly benefiting fields like andrology and reproductive medicine through technologies like machine learning and neural networks.
- AI tools can enhance the diagnosis and treatment of male infertility, improve patient care accuracy, and increase efficiency in clinical management and research.
- Future advancements in AI integration are expected to lead to significant breakthroughs and improvements in evidence-based practices within andrology and reproductive medicine.
Unlabelled: Although SGLT2 inhibitors have been initially employed in the treatment of type 2 diabetes, their clinical use was later extended to the treatment of other conditions such as heart failure, chronic kidney disease and obesity. In patients with type 2 diabetes, the administration of SGLT2 inhibitors has been associated with an increased incidence of urogenital infections, which may be linked to high glucose levels in the urine. The rate of urogenital side effects may be different in non-diabetic patients.
View Article and Find Full Text PDFControversy and Consensus on the Management of Elevated Sperm DNA Fragmentation in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations.
World J Mens Health
October 2023
Article Synopsis
- The study investigates global practices for managing sperm DNA fragmentation (SDF) in infertile men, highlighting its impact on fertility and assisted reproductive technology (ART).
- A survey collecting data from 436 reproductive experts across 55 countries revealed a common recommendation for lifestyle changes and antioxidants, with varying durations for treatment and differing management approaches for specific infertility cases.
- The findings indicate a lack of uniformity in practices, emphasizing the need for standardized guidelines and expert consensus for treating men with elevated SDF.
Article Synopsis
- Infertility is a global issue affecting about 186 million people, with male factors contributing to around half of all cases, indicating a growing prevalence of male infertility over the past 40 years.
- The field of Andrology, which focuses on male reproductive health, has faced challenges due to cultural neglect regarding male partners in infertility diagnosis and treatment, and reliance on assisted reproductive techniques (ART) may overlook the importance of male gamete quality.
- Recent advancements in Andrology, including research on genetics, oxidative stress, and innovative technologies like artificial intelligence and gene engineering, highlight a critical need for further studies to better understand male infertility and improve ART outcomes.
Background: Overactive bladder (OAB) symptoms of frequency, urgency and urge incontinence are frequently associated with known neurological diseases like multiple sclerosis (MS), spinal cord injury (SCI), Parkinson's disease (PD), stroke.
Objective: The aim of our study was to review the efficacy of pharmacological and non-pharmacological treatments for neurogenic overactive bladder.
Materials And Methods: We searched two electronic databases (PubMed and EMBASE) for randomized controlled trials focusing on pharmacological and non-pharmacological medical treatments for overactive bladder symptoms associated with neurological diseases published up to 30 April 2022.
Objective: Proton pump inhibitors are widely used as treatment of acid-related disorders. They are considered safe although their long-term use has been associated with some adverse effects including an increased propensity for urinary calculi formation. The aim of this study was to systematically review available data from studies evaluating the association of PPIs and nephrolithiasis.
View Article and Find Full Text PDFPurpose: Varicocele is a common problem among infertile men. Varicocele repair (VR) is frequently performed to improve semen parameters and the chances of pregnancy. However, there is a lack of consensus about the diagnosis, indications for VR and its outcomes.
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- Alpha-adrenoreceptor antagonists, or alpha-blockers, are commonly used to treat conditions like high blood pressure and benign prostatic hyperplasia, but can impact sexual function differently based on the specific drug used.
- A systematic review and meta-analysis of 75 randomized controlled trials found that alpha-blockers significantly increased the odds of ejaculatory disorders, especially with uroselective agents like silodosin.
- However, there were no significant differences in the odds of erectile dysfunction when comparing alpha-blockers to placebo, indicating that not all sexual side effects are equally likely with these medications.
Objective: Endourological treatment is associated with a risk of postoperative febrile urinary tract infections and sepsis. The aim of this study was to review the reported rate of infectious complications in relation to the type and modality of the endourologic procedure.
Methods: This systematic review was conducted in accordance with the PRISMA guidelines.
Objective: To review the role of elastography in the evaluation and decision-making of adult, infertile men with varicocele.
Methods: A systematic search using the terms (Elastography) AND (Varicocele), (Stiffness) AND (Varicocele), (Elastography) AND (Male infertility) was performed in Pubmed/Medline. Studies reporting a) elastographic characteristics in varicocele-bearing comparing to normal testicles, and b) the correlation of elastography with varicocele grading, parameters of spermatogenesis, and outcomes of varicocele treatment were selected.