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Lemos N, Fernandes GL, Ribeiro AM, Maia-Lemos PS, Contiero W, Croos-Bezerra V, Tomlison G, Faber J, Oliveira ASB, Girão MJBC. Rehabilitation of People With Chronic Spinal Cord Injury Using a Laparoscopically Implanted Neurostimulator: Impact on Mobility and Urinary, Anorectal, and Sexual Functions. Neuromodulation 2023; 26:233-245. [PMID: 35248460 DOI: 10.1016/j.neurom.2022.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 12/01/2021] [Accepted: 01/04/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVES This study aimed to assess the impact of the laparoscopic implantation of neuromodulation electrodes (Possover-LION procedure) on mobility and on sexual, urinary, and anorectal functions of people with chronic spinal cord injury (SCI). MATERIAL AND METHODS Longitudinal analysis of 30 patients with chronic SCI (21 ASIA impairment scale (AIS) A, eight AIS B, and one AIS C) submitted to the Possover-LION procedure for bilateral neuromodulation of femoral, sciatic, and pudendal nerves. Assessments were performed before the surgical procedure and at 3, 6, and 12 months postoperatively. The primary outcome was evolution in walking, measured by the Walking Index for Spinal Cord Injury score, preoperatively and at 12 months. Secondary outcomes were changes in overall mobility (Mobility Assessment Tool for Evaluation of Rehabilitation score), urinary function and quality of life (Qualiveen questionnaire), and bowel (time for bowel emptying proceedings and Wexner's Fecal Incontinence Severity Index [FISI]) and sexual functions (International Index of Erectile Function for men and Female Sexual Function Index for women). Surgical time, intraoperative bleeding, and perioperative complications were also recorded. RESULTS Qualitatively, 18 of 25 (72%) patients with thoracic injury and 3 of 5 (60%) patients with cervical injury managed to establish a walker-assisted gait at one-year follow-up (p < 0.0001). A total of 11 (47.8%) have improved in their urinary incontinence (p < 0.0001), and seven (30.4%) improved their enuresis (p = 0.0156). The FISI improved from a median of 9 points preoperatively to 5.5 at 12 months (p = 0.0056). Of note, 20 of 28 (71.4%) patients reported an improvement on genital sensitivity at 12 months postoperatively (p < 0.0001), but this was not reflected in sexual quality-of-life questionnaires. CONCLUSIONS Patients experienced improved mobility and genital sensitivity and a reduction in the number of urinary and fecal incontinence episodes. By demonstrating reproducible outcomes and safety, this study helps establish the Possover-LION procedure as an addition to the therapeutic armamentarium for the rehabilitation of patients with chronic SCI. CLINICAL TRIAL REGISTRATION This study was registered at the WHO Clinical Trials Database through the Brazilian Registry of Clinical Trials-REBEC (Universal Tracking Number: U1111-1261-4428).
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Affiliation(s)
- Nucelio Lemos
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Toronto, Toronto, Canada; Department of Gynecology, Federal University of São Paulo, São Paulo, Brazil; Department of Gynecology and Neuropelveology, Increasing-Institute of Care and Rehabilitation in Neuropelveology and Gynecology, São Paulo, Brazil.
| | - Gustavo L Fernandes
- Department of Gynecology, Federal University of São Paulo, São Paulo, Brazil; Department of Gynecology and Neuropelveology, Increasing-Institute of Care and Rehabilitation in Neuropelveology and Gynecology, São Paulo, Brazil; Department of Obstetrics and Gynecology, Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil
| | - Augusta M Ribeiro
- Department of Gynecology, Federal University of São Paulo, São Paulo, Brazil; Department of Gynecology and Neuropelveology, Increasing-Institute of Care and Rehabilitation in Neuropelveology and Gynecology, São Paulo, Brazil
| | - Priscila S Maia-Lemos
- Department of Gynecology and Neuropelveology, Increasing-Institute of Care and Rehabilitation in Neuropelveology and Gynecology, São Paulo, Brazil
| | - Wellington Contiero
- Department of Gynecology, Federal University of São Paulo, São Paulo, Brazil; Department of Gynecology and Neuropelveology, Increasing-Institute of Care and Rehabilitation in Neuropelveology and Gynecology, São Paulo, Brazil
| | - Victor Croos-Bezerra
- Department of Gynecology, Federal University of São Paulo, São Paulo, Brazil; Department of Gynecology and Neuropelveology, Increasing-Institute of Care and Rehabilitation in Neuropelveology and Gynecology, São Paulo, Brazil
| | - George Tomlison
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada
| | - Jean Faber
- Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, Brazil
| | - Acary S B Oliveira
- Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, Brazil
| | - Manoel J B C Girão
- Department of Gynecology, Federal University of São Paulo, São Paulo, Brazil
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de Assis Brasil ML, Zakhour S, Figueira GL, Pires PP, Nardi AE, Sardinha A. Sexuality Assessment of the Brazilian Population: An Integrative Review of the Available Instruments. JOURNAL OF SEX & MARITAL THERAPY 2022; 48:757-774. [PMID: 35195053 DOI: 10.1080/0092623x.2022.2035869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This paper provides an integrative review of psychometric instruments targeting sexual function and clinical measures of sexuality available to the Brazilian population. Our aim was to summarize the existing measures, indicating current development needs related to the quality of psychometric evidence, research design and untapped theoretical ground that could be relevant for clinical practice and research in sexuality. Electronic databases were searched. Additional records were found through a manual search. The general search terms and operators were (scale OR inventory OR questionnaire) AND (validation) AND (sexual beliefs OR sexuality OR sexual behavior OR sexual function OR sexual satisfaction) AND (Brazil or Brazilian). The results indicate a total of 18 developed or transculturally adapted and/or validated scales and questionnaires available in Brazilian Portuguese, covering sexual dysfunctions and clinical measures. Despite development, adaptation and validation efforts, there is a critical need for better psychometric and sampling strategies as well as norms for the clinical interpretation of test results. Ecological validity is also a challenge. At present, sexual assessments in Brazil offer some useful information, but reaching the applied clinical field remains a challenge.Supplemental data for this article is available online at https://doi.org/10.1080/0092623X.2022.2035869 .
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Affiliation(s)
| | - Stephanie Zakhour
- Treatment Resistant Depression Laboratory (DeReTrat), Institute of Psychiatry (IPUB), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Gabriel L Figueira
- Graduate School Psychology Program (PPGP), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Psychology, Celso Lisboa University, Rio de Janeiro, Brazil
| | - Pedro P Pires
- Department in the Institute of Psychology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - A E Nardi
- Institute of Psychiatry (IPUB), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Aline Sardinha
- Institute of Psychiatry (IPUB), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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Juho YC, Tang SH, Lin YH, Lin CX, Liang T, Cherng JH, Meng E. Germanium-Titanium-π Polymer Composites as Functional Textiles for Clinical Strategy to Evaluate Blood Circulation Improvement and Sexual Satisfaction. Polymers (Basel) 2021; 13:polym13234154. [PMID: 34883657 PMCID: PMC8659801 DOI: 10.3390/polym13234154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/13/2021] [Accepted: 11/23/2021] [Indexed: 01/22/2023] Open
Abstract
By continuously enhancing the blood flow, far-infrared (FIR) textile is anticipated to be a potential non-pharmacological therapy in patients with peripheral vascular disorders, for instance, patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD) and experiencing vasculogenic erectile dysfunction (VED). Hence, we manufactured a novel polymer composite, namely, germanium-titanium-π (Ge-Ti-π) textile and aimed to evaluate its characteristics and quality. We also investigated the immediate and long-term effects of the textile on patients with ESRD undergoing HD and experiencing VED. The Ge-Ti-π textile was found to have 0.93 FIR emissivity, 3.05 g/d strength, and 18.98% elongation. The results also showed a 51.6% bacteria reduction and negative fungal growth. On application in patients receiving HD, the Ge-Ti-π textile significantly reduced the limb numbness/pain (p < 0.001) and pain score on the visual analog scale (p < 0.001). Moreover, the Doppler ultrasound assessment data indicated a significant enhancement of blood flow in the right hand after 1 week of Ge-Ti-π textile treatment (p < 0.041). In VED patients, the Ge-Ti-π underpants treatment significantly improved the quality of sexual function and increased the average penile blood flow velocity after 3 months of the treatment. Our study suggests that the Ge-Ti-π textile could be beneficial for patients with blood circulation disorders.
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Affiliation(s)
- Yu-Cing Juho
- Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan; (Y.-C.J.); (S.-H.T.)
| | - Shou-Hung Tang
- Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan; (Y.-C.J.); (S.-H.T.)
| | - Yi-Hsin Lin
- Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan;
| | - Chen-Xi Lin
- School of Nursing, National Defense Medical Center, Taipei 114, Taiwan;
| | - Tenson Liang
- Quality of Pain and Sleep Association, Taipei 105, Taiwan;
| | - Juin-Hong Cherng
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 114, Taiwan
- Department and Graduate Institute of Biology and Anatomy, National Defense Medical Center, Taipei 114, Taiwan
- Correspondence: (J.-H.C.); (E.M.); Tel.: +886-2-8792-3100 (ext. 18681) (J.-H.C.); +886-2-8792-7169 (E.M.)
| | - En Meng
- Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan; (Y.-C.J.); (S.-H.T.)
- Correspondence: (J.-H.C.); (E.M.); Tel.: +886-2-8792-3100 (ext. 18681) (J.-H.C.); +886-2-8792-7169 (E.M.)
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Laranja WW, Pereira TA, Guimarães PVB, Tobias-Machado M, Leandro-Merhi VA, de Aquino JLB, Reis LO. Do rapid emotional thermometers correlate with multidimensional validated structured questionnaires in low-risk prostate cancer? Int Urol Nephrol 2020; 52:1073-1078. [PMID: 32056135 DOI: 10.1007/s11255-020-02399-w] [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: 12/11/2019] [Accepted: 01/30/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE To promptly identify mental suffering in low-risk prostate cancer (LRPC) patients, vulnerable to over- and undertreatment, we evaluated the correlation of rapid emotional thermometers (ET) with multidimensional validated structured questionnaires. METHODS At diagnosis, consecutive LRPC patients underwent five ET domains: emotional suffering, anxiety, depression (DT), revolt and need for help and multidimensional questionnaires: beck anxiety inventory (BAI), beck depression inventory (BDI), beck hopelessness scale, SF36 (physical functioning PF, role limitations due to physical health RP, bodily pain BP, general health perceptions GH, vitality VT, social functioning SF, role limitations due to emotional problems RE and general mental health MH), international index of erectile function and international prostate symptom score (IPSS). RESULTS Among 30 included patients, mean age 67.4 y (52-74), 20 days after the diagnosis (15-30), mean time to obtain ET 27 s (15-57) and all questionnaires 36.7 min (31-49), ETs showed moderate/strong Spearman correlation among themselves. DT domain displayed the best correlation to most of the multidimensional validated structured questionnaires: moderate to BDI, SF-36 (PF, GH, VT, SF, RE, MH) and IPSS and strong to BAI. CONCLUSION DT revealed the best correlation to validated structured questionnaires of diverse dimensions with clear potential for quick screening of patients with psychological suffering and in need of further evaluation and support.
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Affiliation(s)
- Walker Wendell Laranja
- UroScience, University of Campinas and Pontifical Catholic University of Campinas, Campinas, SP, Brazil
| | - Thairo Alves Pereira
- UroScience, University of Campinas and Pontifical Catholic University of Campinas, Campinas, SP, Brazil
| | | | - Marcos Tobias-Machado
- UroScience, University of Campinas and Pontifical Catholic University of Campinas, Campinas, SP, Brazil
| | | | - José Luis Braga de Aquino
- UroScience, University of Campinas and Pontifical Catholic University of Campinas, Campinas, SP, Brazil
| | - Leonardo Oliveira Reis
- UroScience, University of Campinas and Pontifical Catholic University of Campinas, Campinas, SP, Brazil.
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Urkmez A, Yuksel OH, Ozsoy E, Topaktas R, Sahin A, Koca O, Ozturk MI. REPLY TO THE AUTHORS: RE: The effect of urethroplasty surgery on erectile and orgasmic functions: a prospective study. Int Braz J Urol 2019; 45:415-416. [PMID: 30735330 PMCID: PMC6541120 DOI: 10.1590/s1677-5538.ibju.2018.0793.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 12/30/2018] [Indexed: 11/22/2022] Open
Affiliation(s)
- Ahmet Urkmez
- Department of Urology, University of Health Sciences, Haydarpasa Numune Research & Training Hospital, Istanbul, Turkey
| | - Ozgur H Yuksel
- Department of Urology, University of Health Sciences, Fatih Sultan Mehmet Research & Training Hospital, Istanbul, Turkey
| | - Emrah Ozsoy
- Department of Urology, University of Health Sciences, Haydarpasa Numune Research & Training Hospital, Istanbul, Turkey
| | - Ramazan Topaktas
- Department of Urology, University of Health Sciences, Haydarpasa Numune Research & Training Hospital, Istanbul, Turkey
| | - Aytac Sahin
- Department of Urology, University of Health Sciences, Fatih Sultan Mehmet Research & Training Hospital, Istanbul, Turkey
| | - Orhan Koca
- Department of Urology, University of Health Sciences, Haydarpasa Numune Research & Training Hospital, Istanbul, Turkey
| | - Metin I Ozturk
- Department of Urology, University of Health Sciences, Haydarpasa Numune Research & Training Hospital, Istanbul, Turkey
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Sanches BC, Laranja WW, Alonso JC, Rejowski RF, Simões FA, Reis LO. Does underestimated penile size impact erectile function in healthy men? Int J Impot Res 2018; 30:158-162. [PMID: 29925936 DOI: 10.1038/s41443-018-0039-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 04/17/2018] [Accepted: 04/30/2018] [Indexed: 11/09/2022]
Abstract
The aim of this study is to assess the impact of objective (stretched) and subjective penile size in the erectile function in a urological check-up program on a cross-sectional study including 689 men aged 35-70 years. IIEF-5 questionnaire, physical examination (penile length, prostate volume, blood pressure, body mass index-BMI), metabolic syndrome (MS), comorbidities, habits (sexual intercourse frequency, physical activity, alcohol, and tobacco use), level of education, serum glucose, total testosterone, estradiol, PSA, lipid profile, and self-perceptions (ejaculation time and subjective penile size) were examined in multivariate models using logistic and linear regressions. Penile objective mean length was 13.08 cm ± 2.32 and 67 (9.72%) patients referred small penis self-perception. Seventy-six (11.03%) participants had severe erectile dysfunction (ED), 75 (10.88%) had mild to moderate and moderate ED, 112 (16.25%) had mild ED and 426 (61.83%) had no ED. Risk factors for ED that held statistical significance were self-perceived small penis (OR = 2.23, 95% CI 1.35-3.69, p = .0017), sexual intercourse frequency (per week) (OR = 0.45, 95% CI 0.38-0.52, p < .0001), satisfactory ejaculation time (no vs. yes, OR = 2.06, 95% CI 1.46-2.92, p < .0001), comorbidity (yes vs. no, OR = 2.01, 95% CI 1.46-2.76, p < .0001), age >65 years (OR = 2.93, 95% CI 1.53-5.61, p < .0001), tobacco use (yes vs. no, OR = 1.41, 95% CI 1.02-1.96, p < .0375), regular physical activity (no vs. yes, OR = 1.59, 95% CI 1.13-2.23, p < .0083), serum total testosterone < 200 ng/dl (OR = 3.48, 95% CI 1.69-7.16, p = 0.0009), serum glucose > 100 mg/dl (OR = 1.69, 95% CI 1.18-2.43, p = 0.0044) and systolic blood pressure > 130 mmHg (OR = 1.60, 95% CI 1.16-2.19, p = 0.0037). Results suggest that in addition to previously reported risk factors, patient's subjective impressions of penile size negatively impacts sexual life in about 10% of men considered healthy, while objective penile length does not play significant role in erectile function.
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Affiliation(s)
- Brunno Cf Sanches
- Pontifical Catholic University of Campinas, PUC-Campinas, São Paulo, Brazil.,University of Campinas, PUC-Campinas, São Paulo, Brazil
| | - Walker W Laranja
- University of Campinas, PUC-Campinas, São Paulo, Brazil.,Paulínia Municipal Hospital, PUC-Campinas, São Paulo, Brazil
| | - João Cc Alonso
- Paulínia Municipal Hospital, PUC-Campinas, São Paulo, Brazil
| | | | | | - Leonardo O Reis
- Pontifical Catholic University of Campinas, PUC-Campinas, São Paulo, Brazil. .,University of Campinas, PUC-Campinas, São Paulo, Brazil. .,Paulínia Municipal Hospital, PUC-Campinas, São Paulo, Brazil.
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Yang B, Xu P, Shi Y, Xu J, Zheng L, Li H, Ma L, Yang S, Zhao Y, Zhang Y, Du Q, Chu Q, Chen B, Tan Y, Li X, Li C, Sun F, Zhu Y, Li H. Erectile Dysfunction and Associated Risk Factors in Chinese Males of Infertile Couples. J Sex Med 2018; 15:671-677. [PMID: 29576430 DOI: 10.1016/j.jsxm.2018.02.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 02/01/2018] [Accepted: 02/19/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Knowledge on the occurrence of erectile dysfunction (ED) and timely ovulatory intercourse failure (TOIF) in Chinese men of infertile couples is limited. AIM To obtain representative estimates of ED and TOIF in Chinese men of infertile couples and to analyze potential risk factors associated with ED. METHODS 4,299 Chinese men of infertile couples with an average age of 32.85 ± 5.98 years were surveyed using the 5-item International Index of Erectile Function (IIEF-5) questionnaire for their ED occurrence. Multiple logistic regression analysis was used to disclose risk factors associated with ED. OUTCOMES The occurrence of ED was 57.8% and that of TOIF was up to 26.2% in Chinese men of infertile couples. RESULTS Based on IIEF-5 criteria, 34.9% of men had mild ED and only 2.6% had severe ED. Secondary infertility, infertility with known causes, and chronic prostatitis were significant risk factors associated with ED. TOIF was significantly higher (23.3%) in men of infertile couples with ED than in those without ED (8.6%), indicating that TOIF is likely a contributing factor to male infertility. CLINICAL IMPLICATIONS Understanding the occurrence and types of ED and TOIF in men of infertile couples and their associated risk factors will help physicians treat clinical cases of male infertility more effectively. STRENGTHS AND LIMITATIONS Large numbers of infertile outpatients from multiple hospital clinics across the country were included in this study. The concept of TOIF was raised for the 1st time and studied preliminarily in Chinese men of infertile couples. The lack of participants' psychological status, a control group of men of fertile couples, and measurement of testosterone levels was a limitation in this clinic-based study. CONCLUSION The occurrence of ED was higher in Chinese men of infertile couples than in the general Chinese male population. Yang B, Xu P, Shi Y, et al. Erectile Dysfunction and Associated Risk Factors in Chinese Males of Infertile Couples. J Sex Med 2018;15:671-677.
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Affiliation(s)
- Bin Yang
- Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Peng Xu
- Reproductive Center of Jinghua Hospitals, Shenyang Oriental Medical Group, Shenyang, Liaoning, China
| | - Yichao Shi
- Center for Reproduction, Changzhou Number 2 People's Hospital, affiliated with Nanjing Medical University, Changzhou, Jiangsu, China
| | - Jixiu Xu
- Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Lianwen Zheng
- Reproductive Center of the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Haisong Li
- Department of Andrology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Lianghong Ma
- Department of Urology, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
| | - Shenmin Yang
- Center for Reproduction and Genetics, Suzhou Municipal Hospital, Suzhou Hospital, affiliated with Nanjing Medical University, Suzhou, Jiangsu, China
| | - Yong Zhao
- Reproductive Medical Center, Navy General Hospital, Beijing, China
| | - Yan Zhang
- Department of Urology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Qiang Du
- Department of Reproduction, ShengJing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Qingjun Chu
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Bin Chen
- Department of Urology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yan Tan
- Department of Andrology, the People's Hospital of Shiyan, Shiyan, Hubei, China
| | - Xiangru Li
- Andrology Clinic, Shengli Hospital of Shengli Petroleum Administrative Bureau, Dongying, Shandong, China
| | - Chaobin Li
- Department of Andrology, Woman and Child Health Hospital, Baoji, Shanxi, China
| | - Fa Sun
- Department of Urology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Yongtong Zhu
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Hongjun Li
- Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
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