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Ide H, Akehi Y, Fukuhara S, Ohira S, Ogawa S, Kataoka T, Kumagai H, Kobayashi K, Komiya A, Shigehara K, Syuto T, Soh J, Tanabe M, Taniguchi H, Chiba K, Matsushita K, Mitsui Y, Yoneyama T, Shirakawa T, Fujii Y, Kumano H, Ueshiba H, Amano T, Sasaki H, Maeda S, Mizokami A, Suzuki K, Horie S. Summary of the clinical practice manual for late-onset hypogonadism. Int J Urol 2023; 30:422-430. [PMID: 36757880 DOI: 10.1111/iju.15160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 01/15/2023] [Indexed: 02/10/2023]
Abstract
Testosterone plays an important role in maintaining both physical and mental function. Age-related testosterone depletion contributes to the development of angina, arteriosclerosis, obesity, metabolic syndrome, dementia, frailty, and a range of other conditions. A condition involving age-related testosterone depletion and the associated clinical symptoms is defined as late-onset hypogonadism (LOH). LOH is treated by testosterone replacement therapy. Indications for testosterone replacement therapy are determined by evaluating symptoms and signs.
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Affiliation(s)
- Hisamitsu Ide
- Department of Urology, Dokkyo Medical University, Saitama Medical Center, Saitama, Japan
| | - Yuko Akehi
- Diabetes Therapeutics and Research Center, Institute of Advanced Medical Sciences, Tokushima University, Tokushima, Japan
| | - Shinichiro Fukuhara
- Department of Urology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Shin Ohira
- Department of Urology, Kawasaki Medical School, Okayama, Japan
| | - Sumito Ogawa
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tomoya Kataoka
- Department of Clinical Pharmaceutics, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Aichi, Japan
| | - Hiroshi Kumagai
- The Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Ko Kobayashi
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Akira Komiya
- Department of Urology, Kameda Medical Center, Chiba, Japan
| | - Kazuyoshi Shigehara
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa, Japan
| | - Takahiro Syuto
- Department of Urology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Jintetu Soh
- Department of Urology, Japanese Red Cross Society Kyoto Daini, Kyoto, Japan
| | - Makito Tanabe
- Department of Endocrinology and Diabetes Mellitus, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Hisanori Taniguchi
- Department of Urology and Andrology, Kansai Medical University, Hirakata, Osaka, Japan
| | - Koji Chiba
- Department of Urology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Kazuhito Matsushita
- Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan
| | - Yozo Mitsui
- Department of Urology, Toho University School of Medicine, Tokyo, Japan
| | - Takahiro Yoneyama
- Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Tomoya Shirakawa
- Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan
| | - Yasuhisa Fujii
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroaki Kumano
- Faculty of Human Sciences, Waseda University, Saitama, Japan
| | - Hajime Ueshiba
- Division of Diabetes, Metabolism and Endocrinology, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Toshiyasu Amano
- Department of Urology, Nagano Red Cross Hospital, Nagano, Japan
| | - Haruaki Sasaki
- Department of Urology, Showa University Fujigaoka Hospital, Kanagawa, Japan
| | - Seiji Maeda
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Atsushi Mizokami
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa, Japan
| | - Kazuhiro Suzuki
- Department of Urology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Shigeo Horie
- Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan
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Nishitani N, Kosaki K, Matsui M, Sugaya T, Kuro-O M, Saito C, Yamagata K, Maeda S. Association between trunk flexibility and renal flow pulsatility in middle-aged and older adults. Exp Gerontol 2023; 172:112060. [PMID: 36526099 DOI: 10.1016/j.exger.2022.112060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/20/2022] [Accepted: 12/11/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Recent clinical studies have indicated that poor trunk flexibility is associated with arterial stiffness in the aged. Arterial stiffness leads to elevated renal flow pulsatility, which accelerates age-related renal dysfunction and damages. However, data indicating the potential link between flexibility fitness and renal flow pulsatility are lacking. This study examined the cross-sectional association between trunk flexibility and renal flow pulsatility in middle-aged and older adults. METHODS A total of 175 middle-aged and older adults (aged 63 ± 9 years) were included in this study. Sit-and-reach tests (SRT) were performed to assess their trunk flexibility. Using a Doppler ultrasound, renal pulsatility index (PI) and resistive index (RI) were measured as parameters of renal flow pulsatility. RESULTS The study found that, in middle-aged and older adults, the SRT score was an independent determinant of renal PI (β = -0.134, P = 0.027) and RI (β = -0.135, P = 0.027). In the one-way analysis of covariance (ANCOVA), the renal PI and RI in the older group with a lower SRT score were found to be significantly higher than those in the middle-aged group. CONCLUSIONS Trunk flexibility is an independent determinant of renal flow pulsatility in middle-aged and older adults.
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Affiliation(s)
- Natsumi Nishitani
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
| | - Keisei Kosaki
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan.
| | - Masahiro Matsui
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan; Japan Society for the Promotion of Science, Tokyo, Japan
| | - Takeshi Sugaya
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Makoto Kuro-O
- Division of Anti-aging Medicine, Center for Molecular Medicine, Jichi Medical University, Tochigi, Japan
| | - Chie Saito
- Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Kunihiro Yamagata
- Faculty of Medicine, University of Tsukuba, Ibaraki, Japan; R&D Center for Smart Wellness City Policies, University of Tsukuba, Ibaraki, Japan
| | - Seiji Maeda
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan; Faculty of Sport Sciences, Waseda University, Saitama, Japan
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Impact of Environmental and Dietary Issues on Male Sexual Health. CURRENT SEXUAL HEALTH REPORTS 2022. [DOI: 10.1007/s11930-021-00317-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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De Rocco Ponce M, Vecchiato M, Neunhaeuserer D, Battista F, Caretta N, Savalla F, Favero C, Garolla A, Foresta C, Ermolao A. Association Between Penile Color Doppler Ultrasonography and Cardiorespiratory Fitness in Patients With Vascular Erectile Dysfunction. Sex Med 2021; 9:100347. [PMID: 33975195 PMCID: PMC8240347 DOI: 10.1016/j.esxm.2021.100347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 02/28/2021] [Accepted: 03/02/2021] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION Vascular erectile dysfunction (ED) is a burdensome condition, associated with increased cardiovascular risk. Peak systolic velocity (PSV) represents the maximum pulse velocity in the cavernous artery measured by a penile color doppler ultrasonography (PCDU) during a pharmacologically induced erection and is considered a reliable parameter for the diagnosis of vascular ED. However, the cut-off value of standard PSV (30 cm/s) provides high sensitivity only in the diagnosis of advanced arteriogenic disease. Thus, an age-adjusted PSV (6.73 + 0.7 x age cm/s) has been proposed to offer a more accurate diagnosis of vascular ED. AIM In this study it was aimed to answer the following question: "Is there any positive association between indexes of vascular erectile dysfunction and cardiorespiratory fitness?" MAIN OUTCOME MEASURE AND METHODS 25 patients with a medical history of ED (median age 55.3 years) underwent PCDU after pharmacological stimulation. Subsequently, a functional evaluation with ECG-monitored, incremental, maximal cardiopulmonary exercise testing was performed. RESULTS Peak oxygen uptake (VO2 peak), peak oxygen uptake per body weight (VO2 peak/kg) and Watt/kg correlated with standard PSV, even when corrected for age and BMI (p < 0.05). No differences emerged in cardiopulmonary fitness between pathological and healthy patients (4 vs 21) identified using the standard PSV cut-off. Conversely, the age-adjusted PSV cut-off identified a greater number of patients as pathological (18 vs 7), presenting a significantly lower cardiopulmonary fitness, exercise capacity and efficiency when compared to patients with normal age-adjusted PSV (all p < 0.05). CONCLUSION Data showed an age and BMI independent association between vascular disfunction of cavernous artery and cardiopulmonary fitness, a known solid predictor of all-cause and disease-specific mortality. Moreover, the age-adjusted PSV better identified a subgroup of patients with vascular ED presenting impaired cardiorespiratory fitness and thus increased cardiovascular risk. De Rocco Ponce M, Vecchiato M, Neunhaeuserer D, et al. Association Between Penile Color Doppler Ultrasonography and Cardiorespiratory Fitness in Patients With Vascular Erectile Dysfunction. Sex Med 2021;9:100347.
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Affiliation(s)
- Maurizio De Rocco Ponce
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
| | - Marco Vecchiato
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy
| | - Daniel Neunhaeuserer
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy.
| | - Francesca Battista
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy
| | - Nicola Caretta
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
| | - Francesco Savalla
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy
| | - Claudia Favero
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy
| | - Andrea Garolla
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
| | - Carlo Foresta
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
| | - Andrea Ermolao
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy
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Kumagai H, Myoenzono K, Yoshikawa T, Tsujimoto T, Shimomura K, Maeda S. Regular aerobic exercise improves sexual function assessed by the Aging Males' Symptoms questionnaire in adult men. Aging Male 2020; 23:1194-1201. [PMID: 32048543 DOI: 10.1080/13685538.2020.1724940] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
The leading cause of aging-induced male-specific disorders such as physical, mental and/or sexual symptoms is testosterone deficiency. Although aerobic exercise is suggested to improves circulating testosterone levels, physical fitness, depressive symptoms, and sexual function, the effect of regular aerobic exercise on aging-induced disorders has not yet been clarified. Here we performed cross-sectional and interventional studies to identify the effect of aerobic exercise on aging-induced disorders assessed by the Aging Males' Symptoms questionnaire (AMS). In study 1, the relationship between aerobic exercise capacity (i.e. peak oxygen consumption) and AMS scores were cross-sectionally examined in 169 adult men. In study 2, the effect of a 12-week regular aerobic exercise on AMS scores was longitudinally investigated in 18 adult men. In study 1, the AMS-total, AMS-somatic, AMS-psychological, and AMS-sexual scores were significantly correlated to aerobic exercise capacity even after considering age and testosterone levels. In study 2, 12-week aerobic exercise training significantly improved AMS-sexual and tended to improve AMS-total scores. Additionally, an increase in vigorous physical activity was correlated to improve in the AMS-sexual score. These results suggest that regular aerobic exercise is an effective strategy to improve aging-induced disorders in men.
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Affiliation(s)
- Hiroshi Kumagai
- Division of Sports Medicine, Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
- Graduate School of Health and Sports Science, Juntendo University, Chiba, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Kanae Myoenzono
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Toru Yoshikawa
- Faculty of Sports and Health Science, Ryutsu Keizai University, Ryugasaki, Japan
| | | | - Kosei Shimomura
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Seiji Maeda
- Division of Sports Medicine, Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
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Predictors of Sexual Desire and Sexual Function in Sedentary Middle-Aged Adults: The Role of Lean Mass Index and S-Klotho Plasma Levels. The FIT-AGEING Study. J Sex Med 2020; 17:665-677. [PMID: 32089483 DOI: 10.1016/j.jsxm.2020.01.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 12/27/2019] [Accepted: 01/21/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND Unhealthy lifestyle and aging negatively impact sexuality; consequently, the prevalence of sexual problems increases sharply in middle-aged adults, but the determinants of low sexual desire and sexual dysfunction are not fully elucidated. AIMS To investigate the association of cardiometabolic profile, free testosterone plasma levels, body composition, physical fitness, and S-Klotho plasma levels with sexual desire and sexual function in middle-aged sedentary adults. METHODS Seventy-four (39 women) sedentary middle-aged adults (45-65 years old) were recruited for the present cross-sectional study. OUTCOMES The blood samples were collected in the morning (12 h of fasting) to determine cardiometabolic biomarkers and free testosterone and S-Klotho plasma levels. The cardiometabolic risk score was calculated based on the International Diabetes Federation's clinical criteria, quantitative insulin sensitivity check index, and homeostatic model assessment of insulin resistance index. A dual-energy X-ray absorptiometry scanner was used to determine the lean mass index (LMI) and the fat mass index. Maximal oxygen uptake was determined by a maximum treadmill test using indirect calorimetry. Muscular strength was measured with knee extensor isokinetic dynamometry (60° s-1). Sexual desire was assessed with the Sexual Desire Inventory 2. Sexual function was assessed with the Massachusetts General Hospital-Sexual Functioning Questionnaire. RESULTS After age adjustment, free testosterone plasma levels were associated with solitary sexual desire in women (R2 = 0.193, β = 0.342, P = .044). The LMI was associated with solitary sexual desire in men (R2 = 0.258, β = 0.445, P = .024) and sexual function in women (R2 = 0.470, β = -0.607, P < .001). S-Klotho plasma levels were associated with solitary sexual desire and sexual function in men (R2 = 0.412, β = 0.817, P = .001; R2 = 0.193, β = -0.659, P = .021, respectively) and with dyadic sexual desire and sexual function in women (R2 = 0.270, β = 0.508, P = .020; R2 = 0.467, β = -0.676, P < .001, respectively). CLINICAL IMPLICATIONS S-Klotho plasma levels may represent a potential new biomarker for sexual desire and sexual function. Lean body mass development may benefit sexual desire and sexual function. STRENGTHS AND LIMITATIONS Strengths include the analysis of novel and diverse biomarkers of health for sexual desire and sexual function. Limitations include the cross-sectional design and a relatively small sample size; thus, results should be interpreted cautiously and in the study population context. CONCLUSION S-Klotho plasma levels were strongly associated with dyadic sexual desire, solitary sexual desire, and sexual function in sedentary middle-aged adults. The LMI was also positively associated with solitary sexual desire and sexual function in men and women, respectively. Dote-Montero M, De-la-O A, Castillo MJ, et al. Predictors of Sexual Desire and Sexual Function in Sedentary Middle-Aged Adults: The Role of Lean Mass Index and S-Klotho Plasma Levels. The FIT-AGEING Study. J Sex Med 2020;17:665-677.
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