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Gül M, Luca B, Dimitropoulos K, Capogrosso P, Milenkovic U, Cocci A, Veeratterapillay R, Hatzichristodoulou G, Modgil V, Russo GI, Tharakan T, Kalkanli A, Omar MI, Bettocchi C, Carvalho J, Corona G, Jones TH, Kadioglu A, Martinez-Salamanca JI, Serefoglu EC, Verze P, Minhas S, Salonia A. What is the effectiveness of surgical and non-surgical therapies in the treatment of ischemic priapism in patients with sickle cell disease? A systematic review by the EAU Sexual and Reproductive Health Guidelines Panel. Int J Impot Res 2024; 36:20-35. [PMID: 35941221 DOI: 10.1038/s41443-022-00590-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 11/09/2022]
Abstract
Sickle cell disease (SCD) is an inherited hemoglobin disorder characterized by the occlusion of small blood vessels by sickle-shaped red blood cells. SCD is associated with a number of complications, including ischemic priapism. While SCD accounts for at least one-third of all priapism cases, no definitive treatment strategy has been established to specifically treat patients with SC priapism. The aim of this systematic review was to assess the efficacy and safety of contemporary treatment modalities for acute and stuttering ischemic priapism associated with SCD. The primary outcome measures were defined as resolution of acute priapism (detumescence) and complete response of stuttering priapism, while the primary harm outcome was as sexual dysfunction. The protocol for the review has been registered (PROSPERO Nr: CRD42020182001), and a systematic search of Medline, Embase, and Cochrane controlled trials databases was performed. Three trials with 41 observational studies met the criteria for inclusion in this review. None of the trials assessed detumescence, as a primary outcome. All of the trials reported a complete response of stuttering priapism; however, the certainty of the evidence was low. It is clear that assessing the effectiveness of specific interventions for priapism in SCD, well-designed, adequately-powered, multicenter trials are strongly required.
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Affiliation(s)
- M Gül
- Department of Urology, Selcuk University School of Medicine, Urology, Konya, Turkey
| | - B Luca
- Urological Research Institute, IRCCS Ospedale San Raffaele, Experimental Oncology/Unit of Urology, Milan, Italy
| | | | - P Capogrosso
- ASST-Sette Laghi, Circolo & Fondazione Macchi Hospital, University of Insurbria, Varese, Italy
| | - U Milenkovic
- University of Leuven, Laboratory for Experimental Urology, Leuven, Belgium
| | - A Cocci
- Careggi Hospital, University of Florence, Urology, Florence, Italy
| | - R Veeratterapillay
- Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Urology, Newcastle, UK
| | - G Hatzichristodoulou
- Julius-Maximilians-University of Würzburg, Urology and Pediatric Urology, Würzburg, Germany
| | - V Modgil
- Manchester Royal Infirmary, Manchester University Hospitals NHS Foundation Trust, Manchester Andrology Centre, Manchester, UK
| | - G I Russo
- Vittorio Emanuele II, University of Catania, Urology, Catania, Italy
| | - T Tharakan
- Charing Cross Hospital, Imperial College Healthcare NHS Trust, Urology, London, UK
| | - A Kalkanli
- Taksim Education and Research Hospital, Department of Urology, Istanbul, Turkey
| | - M I Omar
- University of Aberdeen, Academic Urology Unit, Aberdeen, UK
| | - C Bettocchi
- University of Foggia, Department of Urology, Foggia, Italy
| | - J Carvalho
- Lusófona University of Humanities and Technologies, School of Psychology and Life Sciences, Lisbon, Portugal
| | - G Corona
- Azienda Usl Bologna Maggiore-Bellaria Hospital, Endocrinology Unit, Bologna, Italy
| | - T H Jones
- University of Sheffield Medical School, Oncology and Metabolism, Sheffield, UK
| | - A Kadioglu
- Istanbul University, Urology, Istanbul, Turkey
| | | | | | - P Verze
- University of Naples Federico II, Urology, Naples, Italy
| | - S Minhas
- Imperial Healthcare NHS Trust, Charing Cross Hospital, Urology, London, UK
| | - A Salonia
- URI-Urological Research Institute, Experimental Oncology/Unit of Urology, Milan, Italy.
- University Vita-salute San Raffaele, Milan, Italy.
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Milenkovic U, Cocci A, Veeratterapillay R, Dimitropoulos K, Boeri L, Capogrosso P, Cilesiz NC, Gul M, Hatzichristodoulou G, Modgil V, Russo GI, Tharakan T, Omar MI, Bettocchi C, Carvalho J, Yuhong Y, Corona G, Jones H, Kadioglu A, Martinez-Salamanca JI, Verze P, Serefoglu EC, Minhas S, Salonia A. Surgical and minimally invasive treatment of ischaemic and non-ischaemic priapism: a systematic review by the EAU Sexual and Reproductive Health Guidelines panel. Int J Impot Res 2024; 36:36-49. [PMID: 36151318 DOI: 10.1038/s41443-022-00604-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 06/13/2022] [Accepted: 07/28/2022] [Indexed: 11/09/2022]
Abstract
Surgical treatments for ischemic priapism (IP) include shunts or penile implants. Non-ischemic priapism (NIP) is usually the result of penile/perineal trauma causing an arterial fistula and embolisation may be required. We conducted a systematic review on behalf of the EAU Sexual and Reproductive health Guidelines panel to analyse the available evidence on efficacy and safety of surgical modalities for IP and NIP. Outcomes were priapism resolution, sexual function and adverse events following surgery. Overall, 63 studies (n = 923) met inclusion criteria up to September 2021. For IP (n = 702), surgery comprised distal (n = 274), proximal shunts (n = 209) and penile prostheses (n = 194). Resolution occurred in 18.7-100% for distal, 5.7-100% for proximal shunts and 100% for penile prostheses. Potency rate was 20-100% for distal, 11.1-77.2% for proximal shunts, and 26.3-100% for penile prostheses, respectively. Patient satisfaction was 60-100% following penile prostheses implantation. Complications were 0-42.5% for shunts and 0-13.6% for IPP. For NIP (n = 221), embolisation success was 85.7-100% and potency 80-100%. The majority of studies were retrospective cohort studies. Risk of bias was high. Overall, surgical shunts have acceptable success rates in IP. Proximal/venous shunts should be abandoned due to morbidity/ED rates. In IP > 48 h, best outcomes are seen with penile prostheses implantation. Embolisation is the mainstay technique for NIP with high resolution rates and adequate erectile function.
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Affiliation(s)
- U Milenkovic
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - A Cocci
- Department of Urology, University of Florence, Florence, Italy
| | | | - K Dimitropoulos
- Department of Urology, Aberdeen Royal Infirmary, Aberdeen, UK
| | - L Boeri
- Department of Urology, IRCCCS Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - P Capogrosso
- ASST-Sette Laghi, Circolo & Fondazione Macchi Hospital, University of Insurbria, Varese, Italy
| | - N C Cilesiz
- Department. of Urology, Istanbul Taksim GOP Training and Research Hospital, Istanbul, Turkey
| | - M Gul
- Department of Reproductive Biology, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - V Modgil
- Department of Urology, Manchester Royal Infirmary, Manchester, UK
| | - G I Russo
- Department of Urology, University of Catania, Catania, Italy
| | - T Tharakan
- Department of Urology, Charing Cross Hospital, London, UK
| | - M I Omar
- Department of Urology, University of Aberdeen, Abderdeen, UK
| | - C Bettocchi
- Department of Urology, University of Foggia, Foggia, Italy
| | - J Carvalho
- Department of Psychology and Health Sciences, Universidade Lusofona de Humanidades e Tecnologias, Lisbon, Portugal
| | - Y Yuhong
- Department of Medicine, McMaster University, Hamilton, Canada
| | - G Corona
- Department of Endocrinology, Maggiore-Bellaria Hospital, Bologna, Italy
| | - H Jones
- Department of Endocrinology, Barnsley Hospital, Barnsley, UK
| | - A Kadioglu
- Department of Radiology, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - J I Martinez-Salamanca
- Department of Urology, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - P Verze
- Department of Urology, University Federico II of Naples, Naples, Italy
| | - E C Serefoglu
- Department of Urology, Bahceci Health Group, Istanbul, Turkey
| | - S Minhas
- Department of Urology, Imperial College, London, UK
| | - A Salonia
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy.
- University Vita-Salute San Raffaele, Milan, Italy.
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Minhas S, Kakar S, Wall LB, Goldfarb CA. Foveal Triangular Fibrocartilage Complex Tears: Recognition of a Combined Tear Pattern. J Hand Surg Am 2023; 48:1063.e1-1063.e6. [PMID: 35550309 DOI: 10.1016/j.jhsa.2022.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 01/28/2022] [Accepted: 03/09/2022] [Indexed: 02/02/2023]
Abstract
PURPOSE Triangular fibrocartilage complex (TFCC) injuries are categorized most commonly by the Palmer and the Atzei and Luchetti classifications. Combined tears are reported less frequently, and the classification of these tears is unclear. In this study, we present a series of patients with combined central disc and foveal TFCC tears that do not fit into either of these classifications. METHODS Seventeen patients from 2 institutions presented with a combined central and foveal TFCC tear, confirmed by wrist arthroscopy between September 2017 and December 2020. Patient demographics, injury mechanism, associated injuries, clinical findings, magnetic resonance imaging results, surgeon description of tears, and treatment rendered were evaluated. RESULTS Patients were predominantly female (76%). Mean age was 40 years with a bimodal age distribution (7/17 patients <35 and 10/17 >45 years). Eleven patients (65%) sustained the injury from a fall. All had some degree of distal radioulnar joint (DRUJ) instability on clinical examination and almost half (8/17) had a history of a distal radius or ulnar styloid fracture during the initial injury. The foveal tear was confirmed by direct visual assessment and a positive hook test result; a suction test result commonly was positive as well. All patients underwent debridement of the central tear, and 16 of 17 underwent foveal TFCC repair with 1 having an irreparable tear. CONCLUSIONS We present a series of patients with combined central disc and foveal TFCC tears, a pattern that does not fit current classification schemes. All patients exhibited some degree of instability of the DRUJ and almost half had a history of distal radius or ulnar styloid fracture. Identification of a central tear of the TFCC, together with even subtle DRUJ instability, should lead to consideration of a coexistent foveal tear. TYPE OF STUDY/LEVEL OF EVIDENCE Diagnostic IV.
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Affiliation(s)
- Shobhit Minhas
- Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, MO
| | - Sanjeev Kakar
- Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN
| | - Lindley Bevelle Wall
- Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, MO
| | - Charles Alan Goldfarb
- Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, MO.
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Corona G, Vena W, Pizzocaro A, Pallotti F, Paoli D, Rastrelli G, Baldi E, Cilloni N, Gacci M, Semeraro F, Salonia A, Minhas S, Pivonello R, Sforza A, Vignozzi L, Isidori AM, Lenzi A, Maggi M, Lombardo F. Andrological effects of SARS-Cov-2 infection: a systematic review and meta-analysis. J Endocrinol Invest 2022; 45:2207-2219. [PMID: 35527294 PMCID: PMC9080963 DOI: 10.1007/s40618-022-01801-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/04/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE The short- and long-term andrological effects of coronavirus disease 2019 (COVID-19) have not been clarified. Our aim is to evaluate the available evidence regarding possible andrological consequences of COVID-19 either on seminal or hormonal parameters. The safety of the COVID-19 vaccines in terms of sperm quality was also investigated. METHODS All prospective and retrospective observational studies reporting information on severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) mRNA semen and male genitalia tract detection (n = 19), as well as those reporting data on semen analysis (n = 5) and hormonal parameters (n = 11) in infected/recovered patients without any arbitrary restriction were included. RESULTS Out of 204 retrieved articles, 35 were considered, including 2092 patients and 1138 controls with a mean age of 44.1 ± 12.6 years, and mean follow-up 24.3 ± 18.9 days. SARS-CoV-2 mRNA can be localized in male genitalia tracts during the acute phase of the disease. COVID-19 can result in short-term impaired sperm and T production. Available data cannot clarify long-term andrological effects. Low T observed in the acute phase of the disease is associated with an increased risk of being admitted to the Intensive Care Unit or death. The two available studies showed that the use of mRNA COVID-19 vaccines does not affect sperm quality. CONCLUSIONS The results of our analysis clearly suggest that each patient recovering from COVID-19 should be monitored to rule out sperm and T abnormalities. The specific contribution of reduced T levels during the acute phase of the infection needs to be better clarified.
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Affiliation(s)
- G Corona
- Endocrinology Unit, Medical Department, Azienda Usl, Maggiore-Bellaria Hospital, Bologna, Italy
| | - W Vena
- Unit of Endocrinology, Diabetology and Medical Andrology, IRCSS, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - A Pizzocaro
- Unit of Endocrinology, Diabetology and Medical Andrology, IRCSS, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - F Pallotti
- Department of Experimental Medicine, "Sapienza" University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - D Paoli
- Department of Experimental Medicine, "Sapienza" University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - G Rastrelli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - E Baldi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - N Cilloni
- Department of Anaesthesia, Intensive Care and EMS, Maggiore Hospital Bologna, Bologna, Italy
| | - M Gacci
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, Florence, Italy
| | - F Semeraro
- Department of Anaesthesia, Intensive Care and EMS, Maggiore Hospital Bologna, Bologna, Italy
| | - A Salonia
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - S Minhas
- Department of Urology, Imperial Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - R Pivonello
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Unità di Andrologia e Medicina della Riproduzione e della Sessualità Maschile e Femminile, Università Federico II di Napoli, Naples, Italy
- Staff of UNESCO Chair for Health Education and Sustainable Development Baldi E, Federico II University, Naples, Italy
| | - A Sforza
- Endocrinology Unit, Medical Department, Azienda Usl, Maggiore-Bellaria Hospital, Bologna, Italy
| | - L Vignozzi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - A M Isidori
- Department of Experimental Medicine, "Sapienza" University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - A Lenzi
- Department of Experimental Medicine, "Sapienza" University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - M Maggi
- Endocrinology Unit, "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy.
| | - F Lombardo
- Department of Experimental Medicine, "Sapienza" University of Rome, Policlinico Umberto I Hospital, Rome, Italy
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Nyantakyi A, Al-Hussini M, Ramsay J, Minhas S, Lewis S, Haddock L, Yap T. P-083 The incidence of sperm DNA damage in men with chronic reproductive health issues. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
What is the incidence of sperm DNA damage in men attending tertiary (urological) healthcare with long histories of infertility?
Summary answer
The majority of these men (95%), all with normal semen analyses had high levels of sperm DNA damage.
What is known already
Conventional semen analysis assesses sperm concentration, motility, and morphology but with a high degree of biological variability. Around 25% of men are given a diagnosis of unexplained infertility by normal semen analysis. The World Health Organisation (WHO) stated in 2021 that ‘clinically there is a growing awareness that chromosomal anomalies and gene mutations underlie a diverse spectrum of male infertility,’ so now recommends that sperm DNA is determined as an extended analysis. Sperm DNA damage occurs more often in infertile men and DNA damage is associated with recurrent pregnancy loss and decreased live birth rates following fertility treatment.
Study design, size, duration
A retrospective study of men attending a tertiary centre with productive failure had been offered a standard semen analysis and sperm DNA fragmentation using SpermComet technology.
Participants/materials, setting, methods
Results from 148 men tested between April 2017 and September 2021 were recruited from a tertiary urological database in the UK. Alongside a semen analysis, they also had a sperm DNA fragmentation test.
Sperm DNA quality for the participants was assessed and reported as average, low and high DNA damage as a percentage compared with clinical thresholds used by Examen from their sperm data bank of 74 fertile sperm donors with recently achieved clinical pregnancies.
Main results and the role of chance
The average comet score was 37.8% +/-0.5, low comet score was 35.3% +/- 1.5 and high comet score was 20.2% +/-1.2. These values were all significantly outside ( p < 0.001, Mann Whitney test)) fertile parameters.
95% of these men presenting for infertility investigations had a significantly raised DNA damage across their semen sample with low proportions of healthy sperm and high levels of sperm with genomic damage.
Limitations, reasons for caution
Retrospective design, small sample size, lack of randomisation and low power analysis.
Wider implications of the findings
Sperm DNA damage was found in most of these men who, over years of investigation hadn't been offered tests other than semen analysis or therapy to improve their sperm quality. Thus, this tool could be a useful adjunct to semen analysis to guide the men to reproductive health.
Trial registration number
not applicable
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Affiliation(s)
- A Nyantakyi
- King's College London, GKT Medical School , London, United Kingdom
| | - M Al-Hussini
- Guy's and St Thomas' NHS Foundation Trust, Urology , London, United Kingdom
| | - J Ramsay
- The Lister Fertility Clinic , Urology, London, United Kingdom
| | - S Minhas
- Imperial College London , Urology, London, United Kingdom
| | - S Lewis
- Examen, Chief Executive Officer , Belfast, United Kingdom
| | - L Haddock
- Examen, R and D Manager , Belfast, United Kingdom
| | - T Yap
- Guy's and St Thomas' NHS Foundation Trust, Urology , London, United Kingdom
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Farahani L, Mowla S, Tharakan T, Lee Y, Kundu S, Khanjani S, Sindi E, Rai R, Regan L, Ramsay J, Bennett P, Dhillo W, Minhas S, Jayasena C, MacIntyre D. O-252 Next generation sequencing analysis of the seminal microbiome in male partners of women with idiopathic recurrent pregnancy loss: results of a prospective cohort study. Hum Reprod 2022. [DOI: 10.1093/humrep/deac106.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
Is there an association between the semen microbiome, seminal reactive oxygen species (ROS) and DNA fragmentation in men with recurrent pregnancy loss (RPL)?
Summary answer
This pilot study outlines the subtle role that microbiota play in influencing ROS and sperm DNA damage for male partners of women with RPL
What is known already
RPL is defined as the loss of two or more consecutive pregnancies. This devastating condition impacts approximately 1% of couples. Paternal causes are not routinely screened for and an underlying cause is not found in up to 50% of cases. Recent studies have reported an association between elevated seminal ROS and sperm DNA fragmentation in the male partner, and RPL. We hypothesised that seminal microbiota contribute to increased ROS and sperm DNA damage. To test this, we investigated the relationship between seminal bacterial composition and ROS levels in men with proven fertility versus men with a history of RPL.
Study design, size, duration
We conducted a prospective, case-control study and recruited participants between November 2018 and March 2020 at Imperial College Healthcare NHS Trust. A total of 109 men participated in the study; 46 men with RPL and 63 men with proven fertility and no history of RPL. Each participant attended for a single study visit which consisted of a full medical history, assessment of testicular volume, height, weight, blood samples and production of a semen sample.
Participants/materials, setting, methods
Routine semen analysis (WHO) and endocrine and lipid profiles were performed for all patients. Semen ROS and DNA fragmentation were performed (luminol and TUNEL methodologies, respectively). ROS were classified as high (>3.77 RLU/s) or low (<3.77 RLU/s). Metataxonomic profiling of samples was performed using Illumina Miseq-based sequencing of the V1-V2 hypervariable regions of bacterial 16S rRNA gene amplicons. Multivariate and univariate modelling was performed to explore associations between metataxonomic profiles, ROS levels and clinical metadata.
Main results and the role of chance
Men with RPL had higher mean semen volume (p = 0.02) and increased prevalence of high ROS (p = 0.02, Fisher's exact) compared with controls; but other clinical characteristics were similar between groups. A total of 3,700,136 high quality sequence reads were generated for the dataset with an average of 33,946 reads/sample. Hierarchical clustering of bacterial genera relative abundances identified 4 distinct microbial signatures characterised by high relative abundance of 1. Streptococcus, 2. Lactobacillus and Gardnerella, 3. polymicrobial (including Prevotella), and 4. Corynebacterium and Finegoldia. Prevalences of these groups were similar in control and RPL groups (p = 0.11). Additionally, no association between the bacterial genera groups and elevated ROS, DNA fragmentation, or clinical factors such as age, ethnicity, or semen volume were observed (chi-square tests). At species taxonomy level relative abundance of L. crispatus was higher in controls compared to RPL, but did not withstand false discovery rate correction for multiple testing (p = 0.006, q = 0.67). Higher relative abundance of Microbacterium was detected in semen samples with high DNA fragmentation (p = 8.7E-4, q = 0.08). This relationship was even stronger within the RPL cohort (p = 2.8E-5, q = 0.002). No significant enrichment of specific taxa was observed between high or low ROS samples however, low ROS was associated with Corynebacterium relative abundance >20%.
Limitations, reasons for caution
More patients are required to enhance statistical power. Duplicate sample collection may establish the robustness of seminal compositions observed. Time since last sexual intercourse samples may affect the analysis. Concomitant analysis of the vaginal microbiome of female partners may improve our understanding of how partners may affect each other’s fertility.
Wider implications of the findings
Our data suggests interactions between microbiota composition, ROS and sperm DNA damage which may be implicated in the pathogenesis of recurrent miscarriage. Further studies are needed to determine if seminal microbiota play causal roles in RPL, and whether interventions modifying the seminal microbiome may modify pregnancy outcomes in affected couples
Trial registration number
not applicable
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Affiliation(s)
- L Farahani
- Imperial College Healthcare NHS Trust, Obstetrics & Gynaecology , London, United Kingdom
| | - S Mowla
- Imperial College, Institute of Reproductive Developmental Biology , London, United Kingdom
| | - T Tharakan
- Charing Cross Hospital , Urology, London, United Kingdom
| | - Y Lee
- Imperial College, Institute of Reproductive Developmental Biology , London, United Kingdom
| | - S Kundu
- Imperial College, Institute of Reproductive Developmental Biology , London, United Kingdom
| | - S Khanjani
- University College London Hospital , Gynaecology, London, United Kingdom
| | - E Sindi
- Imperial College, Section of Investigative Medicine , London, United Kingdom
| | - R Rai
- Imperial College Healthcare NHS Trust, Obstetrics & Gynaecology , London, United Kingdom
| | - L Regan
- Imperial College Healthcare NHS Trust, Obstetrics & Gynaecology , London, United Kingdom
| | - J Ramsay
- Hammersmith Hospital , Andrology, London, United Kingdom
| | - P Bennett
- Imperial College, Institute of Reproductive Developmental Biology , London, United Kingdom
| | - W Dhillo
- Imperial College, Section of Investigative Medicine , London, United Kingdom
| | - S Minhas
- Charing Cross Hospital , Urology, London, United Kingdom
| | - C Jayasena
- Imperial College, Section of Investigative Medicine , London, United Kingdom
| | - D MacIntyre
- Imperial College, Institute of Reproductive Developmental Biology , London, United Kingdom
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Cayetano Alcaraz A, Rashid R, Tharakan T, Jayasena C, Minhas S. Does testicular sperm extraction improve ICSI outcomes in non-azoospermic infertile men with raised sperm DNA fragmentation: A systematic review and meta-analysis. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00254-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Falcone M, Capogrosso P, Sokolakis I, Dimitropoulos K, Minhas S, Salonia A, Russo G. What are the benefits and harms of the surgical management options for adult buried penis? A systematic review. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01132-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Chen R, Tharakan T, Jayasena C, Lewis S, Parikh J, Thum MY, Nicopoullos J, Yap T, Minhas S. Does intracytoplasmic morphologically selected sperm injection improve live birth rates compared to ICSI in men with infertility and raised sperm DNA fragmentation? Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00890-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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Milenkovic U, Cocci A, Veeratterapillay R, Dimitropoulos K, Boeri L, Capogrosso P, Cilesiz N, Gul M, Hatzichristodoulou G, Modgil V, Russo G, Tharakan T, Omar M, Bettocchi C, Carvalho J, Yuhong Y, Corona G, Jones H, Kadioglu A, Martinez-Salamanca J, Verze P, Serefoglu E, Minhas S, Salonia A. Surgical treatment in ischaemic and non-ischaemic priapism: A systematic review. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00878-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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11
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Abdallah M, Tharukan T, Ramsay J, Yap T, Thum Y, Nicopoullos J, Lewis S, Jayasena C, Minhas S. Identifying the differential effects of sperm DNA fragmentation on the reproductive cycle in couples undergoing IVF and ICSI. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00889-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Capogrosso P, Russo G, Tharakan T, Dimitropoulos K, Veeratterapillay R, Milenkovic U, Cocci A, Boeri L, Cilesiz N, Gul M, Hatzichristodoulou G, Modgil V, Omar M, Bettocchi C, Carvalho J, Corona G, Jones T, Kadioglu A, Marinez-Salamanca J, Serefoglu E, Verze P, Minhas S, Salonia A. Effectiveness of non-surgical therapies in the treatment of non-sickle cell disease-related ischemic priapism - findings from a systematic review. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00704-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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13
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Ager M, Salonia A, Mayo De Castro J, Donaldson J, Omar M, Dimitrpoulos K, Tharakan T, Boeri L, Janisch F, Muilwijk T, Nijman R, Radmayr C, Laguna Pes M, Minhas S. Which ultrasound or MRI characteristics demonstrate the highest diagnostic accuracy in identifying malignancy in males with indeterminate lesions of the testis? A systematic review. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00688-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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14
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Ho C, Vaughan-Constable D, Ramsay J, Jayasena C, Tharakan T, Yap T, Minhas S, Homa S. Male infertility and the effect of seminal and urinary infections on sperm DNA fragmentation, reactive oxygen species and WHO semen parameters. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00886-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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15
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Basade M, Singhal M, Rathi AK, Nandi M, Minhas S, Goswami C, Shinde S, Parikh PM, Aggarwal S. Practical consensus recommendations regarding the management of HER2 neu positive metastatic breast cancer. South Asian J Cancer 2020; 7:146-150. [PMID: 29721483 PMCID: PMC5909294 DOI: 10.4103/sajc.sajc_123_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Metastatic breast cancer (MBC) is cancer that has spread from the breast to another part of the body or has come back in another distant location. Treatment options for MBC depend on several factors, including where the cancer has spread, the patient's overall health, and the levels of hormone receptors and HER2 in the tumour. Over-expression of HER2 is generally considered to be a negative prognostic feature because it accompanies an increase in breast cancer mortality. However, the development of agents that specifically target HER2 has improved the management of patients with these tumours.[7],[8],[9],[10] This expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at these practical consensus recommendations in regards with the use of these agents and the management of HER2 positive MBC for the benefit of community oncologists.
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Affiliation(s)
- M Basade
- Department of Medical Oncology, Saifee Hospital, Mumbai, Maharashtra, India
| | - M Singhal
- Department of Medical Oncology, Indraprastha Apollo Hospital, New Delhi, India
| | - A K Rathi
- Department of Radiation Oncology, MAMC, New Delhi, India
| | - M Nandi
- Department of Medical Oncology, Jaypee Hospital, Noida, Uttar Pradesh, India
| | - S Minhas
- Department of Medical Oncology, Sir Ganga Ram Hospital, New Delhi, India
| | - C Goswami
- Department of Medical Oncology, Jaypee Hospital, Noida, Uttar Pradesh, India
| | - S Shinde
- Department of Radiation Oncology, Medica Superspecialty Hospital, Kolkata, West Bengal, India
| | - P M Parikh
- Department of Oncology, Shalby Cancer and Research Institute, Mumbai, Maharashtra, India
| | - S Aggarwal
- Department of Radiation Oncology, Medica Superspecialty Hospital, Kolkata, West Bengal, India
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16
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Aggarwal S, Vaid A, Ramesh A, Parikh PM, Purohit S, Avasthi B, Gupta S, Ranjan S, Kaushal V, Salim S, Singh R, Minhas S, Doval D. Practical consensus recommendations on management of HR + ve early breast cancer with specific reference to genomic profiling. South Asian J Cancer 2020; 7:96-101. [PMID: 29721472 PMCID: PMC5909304 DOI: 10.4103/sajc.sajc_110_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Breast cancer is a heterogeneous disease and patients are managed clinically based on ER, PR, HER2 expression, and key risk factors. The use of gene expression assays for early stage disease is already common practice. These tests have found a place in risk stratifying the heterogeneous group of stage I–II breast cancers for recurrence, for predicting chemotherapy response, and for predicting breast cancer-related mortality. Most guidelines for hormone receptor (HR)–positive early breast cancer recommend addition of adjuvant chemotherapy for most women, leading to overtreatment, which causes considerable morbidity and cost. Expert oncologist discussed about strategies of gene expression assays and aid in chemotherapy recommendations for treatment of HR + ve EBC and the expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at this practical consensus recommendations for the benefit of community oncologists.
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Affiliation(s)
- S Aggarwal
- Department of Medical Oncology, Sir Ganga Ram Hospital, New Delhi, India
| | - A Vaid
- Department of Medical Oncology, Medanata Hospital, Gurugram, Haryana, India
| | - A Ramesh
- Department of Medical Oncology, HCG Cancer Center, Chennai, Tamil Nadu, India.,Department of Medical Oncology, SMH Curie Cancer Center, New Delhi, India
| | - Purvish M Parikh
- Department of Oncology, Shalby Cancer and Research Institute, Mumbai, Maharashtra, India
| | - S Purohit
- Department of Medical Oncology, Artemis Hospital, Gurugram, Haryana, India
| | - B Avasthi
- Department or Radiation Oncology, Fortis Hospital, New Delhi, India
| | - S Gupta
- Department of Medical Oncology, Sarvodaya Hospital, Faridabad, Haryana, India
| | - S Ranjan
- Department of Medicine, INHS Sanjivani, Kochi, Kerala, India
| | - V Kaushal
- Department of Radiation Oncology, RCC, Rohtak, Haryana, India
| | - S Salim
- Department of Oncology, Hakim Sanaullah Cancer Center, Baramulla, Jammu and Kashmir, India
| | - R Singh
- Department of Medical Oncology, Army Hospital R and R, New Delhi, India
| | - S Minhas
- Department of Medical Oncology, Medanata Hospital, Gurugram, Haryana, India
| | - D Doval
- Department of Medical Oncology, Rajiv Gandhi Cancer Institute, New Delhi, India
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17
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Kravvas G, Ge L, Ng J, Shim TN, Doiron PR, Watchorn R, Kentley J, Panou E, Dinneen M, Freeman A, Jameson C, Haider A, Francis N, Minhas S, Alnajjar H, Muneer A, Bunker CB. The management of penile intraepithelial neoplasia (PeIN): clinical and histological features and treatment of 345 patients and a review of the literature. J DERMATOL TREAT 2020; 33:1047-1062. [DOI: 10.1080/09546634.2020.1800574] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- G. Kravvas
- Department of Dermatology, University College London Hospitals, London, UK
| | - L. Ge
- Department of Dermatology, University College London Hospitals, London, UK
| | - J. Ng
- Department of Dermatology, Chelsea & Westminster Hospital, London, UK
| | - T. N. Shim
- Department of Dermatology, University College London Hospitals, London, UK
| | - P. R. Doiron
- Department of Dermatology, University College London Hospitals, London, UK
| | - R. Watchorn
- Department of Dermatology, University College London Hospitals, London, UK
| | - J. Kentley
- Department of Dermatology, Chelsea & Westminster Hospital, London, UK
| | - E. Panou
- Department of Dermatology, University College London Hospitals, London, UK
| | - M. Dinneen
- Department of Urology, Chelsea & Westminster Hospital, London, UK
| | - A. Freeman
- Department of Histopathology, University College London Hospitals, London, UK
| | - C. Jameson
- Department of Histopathology, University College London Hospitals, London, UK
| | - A. Haider
- Department of Histopathology, University College London Hospitals, London, UK
| | - N. Francis
- Department of Histopathology, Imperial College Hospitals, London, UK
| | - S. Minhas
- Department of Urology, Imperial College Hospitals, London, UK
| | - H. Alnajjar
- Department of Urology, University College London Hospitals, London, UK
| | - A. Muneer
- Department of Urology, University College London Hospitals, London, UK
| | - C. B. Bunker
- Department of Dermatology, University College London Hospitals, London, UK
- Department of Dermatology, Chelsea & Westminster Hospital, London, UK
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Khoo C, Scott A, Peters M, Maynard W, Chamberlain G, Fooks P, Hrouda D, Minhas S. A contemporary analysis of radical orchidectomy for testis cancer. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34105-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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19
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Smith M, Tharakan T, Stroud T, Goh E, Figueiredo M, Joannou L, Dearing C, Vyas L, Jayasena C, Ramsay J, Minhas S. Assessing trends in sperm cryopreservation at a tertiary referral centre over 25-years. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33025-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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20
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Tharakan T, Dodia D, Attra T, Smith M, Vyas L, Maynard W, Bracewell-Milnes T, Thum M, Yap T, Jayasena C, Ramsay J, Minhas S. The impact of total motile sperm count on IVF/ICSI outcomes: Is total motile sperm count a better parameter than sperm morphology? EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33021-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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21
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Shim TN, Brown SJ, Francis ND, Dinneen M, Hawkins D, Muneer A, Minhas S, Irwin McLean WH, Bunker CB. Male genital lichen sclerosus and filaggrin. Clin Exp Dermatol 2019; 45:127-128. [DOI: 10.1111/ced.14023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 05/27/2019] [Accepted: 06/12/2019] [Indexed: 11/29/2022]
Affiliation(s)
- T. N. Shim
- Department of Dermatology University College London Hospitals NHS Foundation Trust London UK
| | - S. J. Brown
- Department of Dermatology and Genetic MedicineUniversity of DundeeDundee UK
| | - N. D. Francis
- Department of Histopathology Imperial College Healthcare NHS Trust, Charing Cross Hospital London UK
| | - M. Dinneen
- Chelsea and Westminster Hospital NHS Foundation Trust London UK
| | - D. Hawkins
- Imperial College School of Medicine London, United Kingdom, HIV/GUM Chelsea and Westminster Campus London UK
| | - A. Muneer
- Department of Dermatology University College London Hospitals NHS Foundation Trust London UK
| | - S. Minhas
- Department of Dermatology University College London Hospitals NHS Foundation Trust London UK
| | - W. H. Irwin McLean
- Division of Molecular Medicine, Medical Sciences University of Dundee Dundee UK
| | - C. B. Bunker
- Department of Dermatology University College London Hospitals NHS Foundation Trust London UK
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22
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Almekaty K, Zahran MH, Zoeir A, Minhas S, Salem K. The role of artery‐preserving varicocelectomy in subfertile men with severe oligozoospermia: a randomized controlled study. Andrology 2019; 7:193-198. [DOI: 10.1111/andr.12580] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 10/18/2018] [Accepted: 12/01/2018] [Indexed: 01/09/2023]
Affiliation(s)
- K. Almekaty
- Faculty of Medicine Tanta University Tanta Egypt
| | - M. H. Zahran
- Mansoura University Urology and Nephrology Center Mansoura Egypt
| | - A. Zoeir
- Faculty of Medicine Tanta University Tanta Egypt
| | - S. Minhas
- Imperial College Healthcare NHS Trust London UK
| | - K. Salem
- Faculty of Medicine Tanta University Tanta Egypt
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23
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St John BP, Snider AE, Kellermier H, Minhas S, Nottingham JM. Endometriosis of the appendix presenting as acute appendicitis with unusual appearance. Int J Surg Case Rep 2018; 53:211-213. [PMID: 30423543 PMCID: PMC6232694 DOI: 10.1016/j.ijscr.2018.10.048] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 10/14/2018] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Endometriosis of the appendix is an uncommon mimicker of acute appendicitis which makes for a diagnostic dilemma. PRESENTATION OF CASE We present a rare case of a menstruating woman presenting with classic symptoms of appendicitis, without the characteristic inflammatory changes seen on laparoscopy consistent with appendicitis. Instead, the appendix appeared unusually contracted on itself. Pathologic review of the appendix revealed microscopic findings of endometriosis. DISCUSSION We theorize the growth and shedding of the endometrial tissue during menstruation caused compression of the neural plexi in the wall of the appendix leading to the presentation mimicking acute appendicitis. CONCLUSION Given the potential for endometrial appendicitis, we propose appendectomy in reproductive age female patients with right lower quadrant pain, regardless of appendix appearance on laparoscopy.
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Affiliation(s)
- B P St John
- University of South Carolina, Department of Surgery, Columbia, SC, United States.
| | - A E Snider
- University of South Carolina, Department of Surgery, Columbia, SC, United States
| | - H Kellermier
- Palmetto Health Richland, Department of Pathology, Columbia, SC, United States
| | - S Minhas
- University of South Carolina, Department of Surgery, Columbia, SC, United States
| | - J M Nottingham
- University of South Carolina, Department of Surgery, Columbia, SC, United States
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24
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Shim TN, Doiron PR, Francis N, Minhas S, Muneer A, Hawkins D, Dinneen M, Bunker CB. Penile lymphoedema: approach to investigation and management. Clin Exp Dermatol 2018; 44:20-31. [PMID: 30009576 DOI: 10.1111/ced.13609] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2017] [Indexed: 01/24/2023]
Abstract
BACKGROUND Penile lymphoedema (with and without cellulitis) is a rare, often chronic, clinically heterogeneous entity with an uncertain pathogenesis and an important differential diagnosis. It creates significant physical and psychosexual morbidity, and presents considerable therapeutic challenges. The existing literature is limited. AIM To describe and share our updated cumulative experience of a cohort of patients with penile lymphoedema. METHODS This was a retrospective review of the case records of patients with chronic penile lymphoedema seen in two dedicated male genital dermatology clinics between January 2011 and July 2016. RESULTS In total, 41 cases were identified. Over a third had Crohn disease (CD) (which was occult in one-third of these), and over a third had serological evidence of streptococcal infection. All patients responded to systemic antibiotics and specialized urological surgery circumcision and excision). CONCLUSIONS Penile lymphoedema should be investigated to exclude underlying pathology especially CD and streptococcal infection. Treatment with antibiotics should be considered early and long term to try to preserve the foreskin: most patients are uncircumcised. Some patients may benefit from a course or courses of oral steroids. The development of gross dysfunction of the prepuce usually dictates circumcision and excision of lymphoedematous tissue once the situation is medically stabilized.
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Affiliation(s)
- T N Shim
- Department of Dermatology, University Hospital, Coventry, West Midlands, UK.,Department of Dermatology, Chelsea and Westminster Hospital, London, UK.,Department of Dermatology, University College Hospital, London, UK
| | - P R Doiron
- Department of Dermatology, Chelsea and Westminster Hospital, London, UK.,Department of Dermatology, University College Hospital, London, UK.,Department of Dermatology, University of Toronto, Faculty of Medicine, Toronto, Canada
| | - N Francis
- Department of Pathology, Charing Cross Hospital, London, UK
| | - S Minhas
- Department of Urology, Charing Cross Hospital, London, UK.,Department of Urology, University College Hospital, London, UK
| | - A Muneer
- Department of Urology, University College Hospital, London, UK
| | - D Hawkins
- Department of HIV/GUM , Chelsea and Westminster Hospital, London, UK
| | - M Dinneen
- Department of Urology, Chelsea and Westminster Hospital, London, UK
| | - C B Bunker
- Department of Dermatology, Chelsea and Westminster Hospital, London, UK.,Department of Dermatology, University College Hospital, London, UK
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Johnson M, Sangster P, Raheem A, Zainal Y, Poselay S, Hallerstrom M, Johnson T, Mohammadi B, Hafez K, Bhandari C, Vincens A, Yap T, Shabbir M, Minhas S, Ralph D. 040 A UK multicentre study analysing the surgical sperm retrieval rates in men with non-mosaic Klinefelter's syndrome undergoing mTESE. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2018.04.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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26
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Parikh PM, Wadhwa J, Minhas S, Gupta A, Mittal S, Ranjan S, Mehta P, Singh R, Kataria SP, Salim S, Ahmed M, Aggarwal S. Practical consensus recommendation on when to do BRCA testing. South Asian J Cancer 2018; 7:106-109. [PMID: 29721474 PMCID: PMC5909285 DOI: 10.4103/sajc.sajc_112_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BRCA-mutation associated breast cancer and to future cancer risks and sensitivity to systemic therapies. Now that rapid genetic testing for BRCA1 and BRCA2 mutations is available, BRCA mutation status can be considered when making treatment and prevention decisions for BRCA testing, BRCA mutation carriers with breast cancer. Expert group used data from published literature, practical experience, and opinion of a large group of academic oncologists, to arrive at practical consensus recommendations for use by the community oncologists.
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Affiliation(s)
- Purvish M. Parikh
- Department of Oncology, Shalby Cancer and Research Institute, Mumbai, Maharashtra, India
| | - J. Wadhwa
- Department of Medical Oncology, Medanta Hospital, Gurugram, Haryana, India
| | - S. Minhas
- Department of Medical Oncology, Sir Ganga Ram Hospital, New Delhi, India
| | - A. Gupta
- Department of Radiation Oncology, Safdarjung Hospital, New Delhi, India
| | - S. Mittal
- Department of Medical Oncology, Action Balajee Cancer Center, New Delhi, India
| | - S. Ranjan
- Department of Medicine, INHS Sanjivani, Kochi, Kerala, India
| | - P. Mehta
- Department of Medical Oncology, Asian Institute of Medical Sciences, Faridabad, Haryana, India
| | - R. Singh
- Department of Medical Oncology, Artemis Hospital, Gurugram, Haryana, India
| | - S. P. Kataria
- Department of Medical Oncology, Safdarjung Hospital, New Delhi, India
| | - S. Salim
- Department of Oncology, Hakim Sanaullah Cancer Center, Baramulla, Jammu and Kashmir, India
| | - M. Ahmed
- Department of Radiation Oncology, Jolly Grant Himalayan Institute, Dehradoon, Uttarakhand, India
| | - S. Aggarwal
- Department of Medical Oncology, Sir Ganga Ram Hospital, New Delhi, India
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27
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Minhas S, Odono R, Collins K, Vigdorchik J, Schwarzkopf R. The Role and Timing of Treatment Strategies During Two-Stage Revision for Periprosthetic Joint Infections. Bull Hosp Jt Dis (2013) 2017; 75:246-247. [PMID: 29151012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Prosthetic joint infection continues to be a source of significant morbidity to patients and an economic burden to society as a whole. Two-stage revision is the current gold standard for treatment of periprosthetic joint infection in North America. Despite this, much discussion persists about treatment strategies surrounding the interim of the two-stage revision and treatment beyond reimplantation. The aim of this review is to answer some of these questions, specifically: are C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) helpful prior to reimplantation, is aspiration helpful, what is the role and timing for systemic antibiotics, and is there a role for oral suppression following second-stage reimplantation? METHODS A literature review was completed in an attempt to address unanswered questions associated with two-stage reimplantation. Investigators' recommendations and current practices are described. RESULTS ESR and CRP are less reliable in the interim of a two-stage revision than for diagnosis of infection in a primary total joint arthroplasty. There is inconclusive evidence regarding the utility of joint aspiration in two-stage revisions. Additionally, no evidence has been developed for length of IV antibiotic treatment after second-stage reimplantation, and in a few studies, oral antibiotic suppression has shown some benefit in reducing reinfection rates. CONCLUSION The question of optimum treatment strategies has yet to be answered: attempts are underway to obtain suitable data with multi-center studies and large patient populations. Periprosthetic joint infection is a serious and life altering complication and with continued research we can further clarify treatment strategies.
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Affiliation(s)
- J S Kalsi
- Institute of Urology and Nephrology, 48 Riding House Street, London W1P 7NN, UK.
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29
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Kravvas G, Shim T, Doiron P, Freeman A, Jameson C, Minhas S, Muneer A, Bunker C. The diagnosis and management of male genital lichen sclerosus: a retrospective review of 301 patients. J Eur Acad Dermatol Venereol 2017; 32:91-95. [DOI: 10.1111/jdv.14488] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 07/19/2017] [Indexed: 11/27/2022]
Affiliation(s)
- G. Kravvas
- Department of Dermatology; University College London Hospitals; London UK
| | - T.N. Shim
- Department of Dermatology; University College London Hospitals; London UK
| | - P.R. Doiron
- Department of Dermatology; University College London Hospitals; London UK
| | - A. Freeman
- Department of Histopathology; University College London Hospitals; London UK
| | - C. Jameson
- Department of Histopathology; University College London Hospitals; London UK
| | - S. Minhas
- Department of Urology; University College London Hospitals; London UK
| | - A. Muneer
- Department of Urology; University College London Hospitals; London UK
| | - C.B. Bunker
- Department of Dermatology; University College London Hospitals; London UK
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30
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Lamba N, Muskens IS, Meijer L, Briceno V, Edrees H, Aslam B, Minhas S, Smith TR, Mekary RA, Broekman ML. P14.22 Whole-Brain Radiotherapy versus Stereotactic Radiosurgery after Resection for Intracranial Metastasis: a systematic review and meta-analysis. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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31
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Kashif M, Minhas S, Altaf W, Nagi A. Dose response relationship of nuclear changes with fractionated concomitant chemoradiotherapy in assessing chemo-radiosensitivity of peritumoural area in oral squamous cell carcinoma patients. Eur J Cancer 2017. [DOI: 10.1016/s0959-8049(17)30428-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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32
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Kalejaiye O, Fontaine C, Langston J, Zacharachis E, Raheem A, Walkden M, Christopher N, Minhas S, Muneer A, Garaffa G. 373 High Flow Priapism is Associated With High Risk of Erectile Dysfunction and Corporal Fibrosis. J Sex Med 2017. [DOI: 10.1016/j.jsxm.2016.11.253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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33
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M A, Parnham A, Sandev V, Christodoulidou M, Akers C, Freeman A, Nigam R, Minhas S, Malone P, Muneer A. 172 Predicting Local Recurrence (LR) Following Glansectomy Combined With A Split-Thickness Skin Graft in Patients With Penile Squamous Cell Carcinoma. J Sex Med 2017. [DOI: 10.1016/j.jsxm.2016.11.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
Injection of the subcutaneous tissues of the penis for enlargement of penile girth has been practised for many years by laypeople and medical practitioners alike. However, with recognition of the complications, the practice has died out. We report a series of five patients who presented having injected foreign materials into the subcutaneous tissues of their penises, including paraffin and mineral oils. Our patients had a variable time course of presentation ranging from 1 day following injection to over 26 years. Self-injection of the subcutaneous tissues of the penis is an unusual presentation for a penile mass but should be considered as a differential diagnosis in patients with a long latent period to presentation or with characteristic magnetic resonance imaging and histological appearances.
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Affiliation(s)
- U Ahmed
- University College London Hospitals NHS Foundation Trust , UK
| | - A Freeman
- University College London Hospitals NHS Foundation Trust , UK
| | - A Kirkham
- University College London Hospitals NHS Foundation Trust , UK
| | - D J Ralph
- University College London Hospitals NHS Foundation Trust , UK
| | - S Minhas
- University College London Hospitals NHS Foundation Trust , UK
| | - A Muneer
- University College London Hospitals NHS Foundation Trust , UK
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Horenblas S, Minhas S. Minimal Invasive Management of Lymph Nodes. Urol Clin North Am 2016; 43:449-456. [PMID: 27717431 DOI: 10.1016/j.ucl.2016.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Penile cancer is a rare genitourinary malignancy. Lymph node involvement is the single most important factor determining survival in these patients, and those patients with occult disease are difficult to identify on conventional cross-sectional imaging. Until recently, lymph node sampling (eg, lymphadenectomy) has been the diagnostic modality of choice in the detection of micrometastasis. More recently, several novel molecular and minimally invasive diagnostic techniques have been developed, which have been demonstrated to decrease the false-negative and -positive results of conventional imaging and lymphadenectomy. This article focuses on the minimally invasive management of lymph nodes in men with penile cancer.
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Affiliation(s)
- S Horenblas
- Department of Urology, Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam 1066CX, The Netherlands.
| | - S Minhas
- University College Hospital, London, UK
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Shokeen Y, Taneja V, Sharma N, Minhas S, Jauhri M, Aggarwal S. 311P Differential expression of TGF-beta-smad pathway genes in chronic myeloid leukemia. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv526.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Shokeen Y, Taneja V, Sharma N, Minhas S, Jauhri M, Aggarwal S. 3210 Mutation analysis of TGF-beta-Smad pathway genes in chronic myeloid leukemia by next generation sequencing. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31787-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Minhas S. Editorial Comment. J Urol 2015; 194:701-2; discussion 702. [PMID: 26032488 DOI: 10.1016/j.juro.2015.03.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- S Minhas
- Department of Urology, University College London Hospital, London, United Kingdom
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Shim TN, Hawkins D, Muneer A, Minhas S, Freeman A, Jameson C, Francis N, Dinneen M, Bunker CB. P2.182 Male Genital Dermatoses in HIV. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Minhas S, Setia N, Pandita S, Saxena R, Verma I, Aggarwal S. Prevalence of CYP2C8 polymorphisms in a North Indian population. Genet Mol Res 2013; 12:2260-6. [DOI: 10.4238/2013.july.8.7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
Schwannomas are rare neoplasms that originate from Schwann cells. We present a case report of schwannoma of the ansa cervicalis in a patient where preoperative imaging suggested thyroid pathology. A 25-year-old man presented to the otolaryngology department with a one-year history of an asymptomatic, anterior triangle neck swelling. Imaging and FNA suggested a cystic lesion of the thyroid. However, intraoperatively, the lesion was found between the right sternohyoid and thyrohoid and histology showed findings consistent with a diagnosis of schwannoma, determined to originate from the ansa cervicalis based on its anatomical position. Schwannoma of the ansa cervicalis is extremely rare and there have only been four reported cases in the literature. Schwannomas are often misdiagnosed and confused for other lesions. In our case report we add to the sparse literature on this pathology and highlight common pitfalls in diagnosis and discuss the principles of management of this rare condition.
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Aggarwal S, Minhas S, Kohli S, Negi A, Ghosh A, Jauhari M. Indian experience with diethylstilbestrol in hormone-positive metastatic breast cancer after failure of standard hormone therapy. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e11502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Abstract
Introduction: Stuttering priapism is a rare condition characterised by recurrent prolonged erections. The condition is common in patients with sickle cell disease although a significant proportion suffer from idiopathic stuttering priapism. The management of this condition is mainly through anecdotal reports. Methods: We have retrospectively reviewed 60 patients with this condition in a single centre over a 25-year period. Risk factors were identified and the outcomes of both pharmacological therapies and surgical interventions were recorded. Results: Erections were characteristically nocturnal and painful in nature and lasted up to 72h in some patients. Analysis of the outcomes of both medical and surgical interventions has shown that the use of hormone analogues such as cyproterone acetate is the most efficacious treatment option as it allows a successful control of their erections without a significant loss of libido in 86% of patients. The most successful surgical option was the insertion of a penile prosthesis. Conclusion: Due to the rarity of this condition, the management is variable and based on anecdotal evidence. This study has reported our experience of the most efficacious treatment options for this condition. We also discuss the potential therapeutic role of PDE-5 inhibitors in this condition.
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Affiliation(s)
- A. Muneer
- Department of Andrology, Institute of Urology, University College London Hospitals, London, United Kingdom
| | - G. Garaffa
- Department of Andrology, Institute of Urology, University College London Hospitals, London, United Kingdom
| | - S. Minhas
- Department of Andrology, Institute of Urology, University College London Hospitals, London, United Kingdom
| | - D.J. Ralph
- Department of Andrology, Institute of Urology, University College London Hospitals, London, United Kingdom
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Abstract
INTRODUCTION Priapism is a urological emergency which is commonly classified into low-flow and high-flow priapism. Immediate intervention is required for low-flow cases as the development of ischaemia ultimately leads to long-term erectile dysfunction. Stuttering or recurrent priapism is less well understood. This subtype is characterised by short-lived painful erections and is commonly encountered in patients with sickle cell disease. METHODS A systematic review of the treatment options available for stuttering priapism is presented combined with our own experience in managing this condition over a period of 25 years. RESULTS Although numerous medical treatment options have been reported, the majority are through small trials or anecdotal reports. CONCLUSIONS Stuttering priapism is a condition which is still not well understood and there is no standardised algorithm for the management of this condition. A multicentre randomised trial is required to evaluate the treatment options.
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Affiliation(s)
- A Muneer
- University College London Hospitals, London, UK.
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Stief C, Minhas S. MP-04Surgery, Peyronie’s Disease, and Priapism. J Sex Med 2007. [DOI: 10.1111/j.1743-6109.2007.00390_11.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Abstract
To date, there is no FDA-approved therapy for premature ejaculation (PE). Recently, phosphodiesterase 5 inhibitors (PDE5-Is) have been demonstrated to have encouraging results in the treatment of PE by a few studies. The aim of this review was to assess the updated manuscripts and thereafter present the practical recommendations and possible mechanisms concerning PDE5-Is for treating PE. Using MEDLINE, we searched and assessed the peer manuscripts published from 1 January 1996 to 1 September 2005 about PDE5-Is for treating PE. The results show that the number of patients in all the reports is very few and most of the studies do not employ double-blinded and placebo-controlled tests, though they are prospective and randomized. Therefore, the results and conclusions might be biased. PDE5-Is are suggested to be used in PE with old age or associated with erectile dysfunction (ED), or to be employed alone or in combination with selective-serotonin reuptake inhibitors (SSRIs) when SSRIs fail to treat PE; behavioural therapy is proposed to be used for preventing the recurrence of PE following withdrawal of PDE5-Is. In addition, for the PE patient with a definite aetiological cause, the aetiology should be cured first, if PE still exists, followed by PDE-Is prescription. Possible mechanisms that are involved include relaxing the smooth muscles of vas deferens, seminal vesicle, prostate and urethra; decreasing the central sympathetic output; inducing peripheral analgesia; prolonging the duration of erection; and increasing confidence, the perception of ejaculatory control, overall sexual satisfaction, and decreasing the post-orgasmic refractory time to achieve a second erection after ejaculation. Well-designed multicentre studies are urgently warranted to further elucidate the efficacies and safety as well as mechanisms of PDE5-Is in the treatment of PE.
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Affiliation(s)
- W F Wang
- Department of Urology, Hainan Provincial People's Hospital, Haikou, Hainan Province, China.
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Benn SM, Jha G, Ratliff TW, Spiers K, Baskin R, Yunus F, Osarogiagbon R, Boston B, Minhas S, Jahanzeb M. Adjuvant trastuzumab (T) therapy in HER2+ breast cancer after ASCO 2005: Patients’ attitudes and immediate economic burden. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.10565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10565 Background: Data from 3 large randomized trials documenting the efficacy of T in the adjuvant setting were reported at ASCO 2005, and subsequently published in NEJM 2005; 353: (16) pp 1659–72 and 1673–1684 . We decided to offer T, and attempted to assess patients’ characteristics that influence its acceptance, in a subgroup of HER2 + patients that had already completed adjuvant chemotherapy at our institution within 12 months prior to these reported results. Methods: Using Electronic Medical Records (OpTx, Canada), we identified HER2+ breast cancer patients who had completed adjuvant therapy within the prior 12 months and administered an informational synopsis about the study results. They then completed a questionnaire, including their demographic information, that established their understanding of the data and documented their decision to receive or to not receive adjuvant T as an afterthought. Results: We identified 1442 breast cancer patients in Optx that were seen at UTCI for initial or follow up visits between May 2004 and May 2005. Those with 3 or fewer visits within the last year and those who received no chemotherapy (n = 770) were excluded. Of the remaining 672 patients, only 104 (15%) had documented HER2+ disease. Fourteen HER2+ patients had metastatic disease, while 84 patients, though HER2+, had either completed adjuvant chemotherapy greater than 12 months prior or were currently receiving adjuvant therapy or T, and/or had other reasons to not be suitable for T. Six patients qualified for this study; 5 decided to receive adjuvant T and 1 chose not to because she perceived the additional benefit to be minimal. Conclusions: While our sample size was too small in the end to draw conclusions about patients’ attitudes towards new data on adjuvant T, we were struck by the small number of patients who could be offered T as an afterthought despite our large patient volume. The magnitude of the perceived economic burden and its imminence after the release of these data may have been overestimated. [Table: see text]
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Affiliation(s)
- S. M. Benn
- University of Tennessee Cancer Institute, Memphis, TN
| | - G. Jha
- University of Tennessee Cancer Institute, Memphis, TN
| | - T. W. Ratliff
- University of Tennessee Cancer Institute, Memphis, TN
| | - K. Spiers
- University of Tennessee Cancer Institute, Memphis, TN
| | - R. Baskin
- University of Tennessee Cancer Institute, Memphis, TN
| | - F. Yunus
- University of Tennessee Cancer Institute, Memphis, TN
| | | | - B. Boston
- University of Tennessee Cancer Institute, Memphis, TN
| | - S. Minhas
- University of Tennessee Cancer Institute, Memphis, TN
| | - M. Jahanzeb
- University of Tennessee Cancer Institute, Memphis, TN
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Kalsi J, Minhas S, Christopher N, Ralph D. The Results of Plaque Incision and Venous Grafting (Lue Procedure) to Correct the Penile Deformity of Peyronie’s Disease. J Urol 2006. [DOI: 10.1016/s0022-5347(05)00286-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- J. Kalsi
- St. Peter’s Andrology Centre and Institute of Urology, London, United Kingdom
| | - S. Minhas
- St. Peter’s Andrology Centre and Institute of Urology, London, United Kingdom
| | - N. Christopher
- St. Peter’s Andrology Centre and Institute of Urology, London, United Kingdom
| | - D. Ralph
- St. Peter’s Andrology Centre and Institute of Urology, London, United Kingdom
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