Search Results (516)

Background: Menopausal symptoms may adversely affect women’s overall health and well-being. Aim: This study investigated the effects of menopausal symptoms on subjective well-being in women in the 40–65 age group. Methods: The study sample consisted of 510 women, with 318 postmenopausal and 192 perimenopausal participants. Data were gathered using a Sociodemographic Information Form, the Menopause Rating Scale (MRS), and the Subjective Well-being Scale (SWBS), all administered as self-report instruments. Menopausal status was determined using the Stages of Reproductive Aging Workshop +10 criteria. Descriptive statistics, Chi-square test, Pearson correlation, and regression analyses were used. Results: Three regression models were specified to investigate the relationship between menopausal symptoms and subjective well-being. Model 1 demonstrated that overall menopausal symptoms were significant negative predictors of subjective well-being (B = −0.749, SE = 0.156, β = −0.260, t = −4.788, p < 0.001, 95% CI [−1.06, −0.44], R² = 0.068). Model 2 showed that both urogenital symptoms (B = −1.208, SE = 0.517, β = −0.139, t = −2.336, p = 0.020, 95% CI [−2.22, −0.20]) and somatic symptoms (B = −2.068, SE = 0.731, β = −0.168, t = −2.830, p = 0.005, 95% CI [−3.50, −0.64]) were significant negative predictors. Model 3 indicated that psychological symptoms significantly and negatively predicted subjective well-being (B = −1.114, SE = 0.262, β = −0.233, t = −4.253, p < 0.001, 95% CI [−1.63, −0.60], R² = 0.054). Conclusions: The findings highlight the importance of comprehensive health strategies and demonstrate that psychological symptoms significantly impact overall well-being. Full article

Characterizing the microbiota is essential to improve the understanding and management of urogenital disorders. Using 16S rDNA sequencing, this study investigated the urogenital microbiota, including urine, vaginal, and prostatic communities, in a litter of 10 healthy beagle puppies from 4 months of age until the completion of the first estrous cycle in females and 18 months in males. A further objective was to compare these microbial profiles with those of their dam. Significant differences were observed between urinary and genital microbiota in both sexes, evolving over time. Notably, in females, puberty and the first estrous cycle were associated with marked changes in the vaginal microbiota, outweighing individual variability. In contrast, urinary microbiota remained stable during female growth. In males, microbiota showed time-dependent and individual-specific progression, with distinct microbial communities identified in the urinary bladder and prostate. Shared genera between the dam and her offspring were observed, but inter-individual variability suggested a limited maternal influence. Further investigation is needed to clarify vertical transmission patterns. In conclusion, the urogenital microbiota of healthy dogs undergoes dynamic and distinct site-specific changes during early life. Full article

Background/Objectives: Children with congenital urogenital anomalies (CUA) face increased risk of urinary tract infections (UTIs) and may harbor resistant organisms due to recurrent infections and antibiotic exposure. This study characterized the distribution of uropathogens and antimicrobial resistance patterns at a tertiary center in Saudi Arabia. Methods: This retrospective cohort study included pediatric patients (<18 years) with documented congenital urogenital anomalies and positive urine cultures at King Khalid University Hospital, Riyadh (2015–2025). Susceptibility interpretations (S/I/R) were extracted from the hospital laboratory information system; multidrug resistance (MDR) was defined using organism-specific Magiorakos criteria. Results: A total of 168 patients (72.0% male; mean age 4.1 ± 4.5 years) contributed 411 UTI episodes. Among 403 mono-organism episodes (after excluding eight polymicrobial cultures), Escherichia coli predominated (150/403, 37.2%), followed by Klebsiella pneumoniae (96/403, 23.8%) and Pseudomonas aeruginosa (33/403, 8.2%). High resistance was observed for ampicillin (83.6%), trimethoprim-sulfamethoxazole (54.2%), and cephalosporins (cefazolin 62.8%, cefotaxime 35.6%). Carbapenems (2.9%) and aminoglycosides (9.2%) retained >90% susceptibility. Overall MDR was 35.5%, highest among Klebsiella oxytoca (57.1%) and Escherichia coli (47.6%). Recurrent infections showed numerically higher unadjusted resistance than single episodes. Conclusions: Pediatric patients with congenital urogenital anomalies showed high first-line antibiotic resistance. Carbapenems and aminoglycosides retained predominantly susceptible in vitro profiles in this cohort and may inform empiric considerations alongside ongoing local susceptibility surveillance for this high-risk population. Full article

Asymptomatic pharyngeal Neisseria meningitidis (Nm) carriage is seen in >30% of sexually transmitted infection (STI) clinic attendees. With increasing reports of Nm urethritis and STI-related invasive disease outbreaks, longitudinal assessment and genomic characterization of Nm among patients at an urban STI clinic population in Columbus, Ohio, was undertaken. This study determined the genomic basis of oropharyngeal, urogenital and rectal Nm isolates carried by patients presenting for care. Cultures using media selective for Neisseria spp., Nm-specific PCR screening of colonies with oxidase-positive Gram-negative diplococci, PCR-based genogrouping and whole-genome sequencing of confirmed Nm were performed. Overall, genomic data of 453 oropharyngeal, 10 urethral, 5 rectal and 1 cervical Nm isolate were obtained between January 2018 and December 2019. Among oropharyngeal Nm isolates, genogrouping identified 37.7% as cnl (capsule null locus), 28% B, 13.5% E, 10.8% Z, 2.6% C and 2.6% Y. However, the cps locus was inactivated in ≥80% of isolates with specified genogroups. The major clonal complexes (ccs) were cc53, cc32, cc41/44, cc1157, cc198 and cc4821. Two oropharyngeal, one rectal and three urethral isolates belonged to the ST-11 Nm urethritis clade (NmUC). Group Y ST-1466 Nm, recently linked to global urogenital and systemic infections, was also identified in the oropharynx. Full article

Hypospadias is a congenital malformation of the male external genitalia resulting from incomplete fusion of the urethral folds during embryonic development. The perineal form represents the most severe phenotype and is frequently associated with abnormalities such as cryptorchidism and penile hypoplasia. Although surgical correction is generally recommended in young dogs, the long-term clinical course of severe hypospadias under conservative management remains poorly documented. In this study, we describe an unusual canine case of severe perineal hypospadias that survived to geriatric age under conservative management and subsequently developed bilateral testicular tumors arising from cryptorchid testes. Despite recurrent urinary tract infections during early life, the patient maintained an acceptable quality of life with long-term supportive care, providing a rare clinical example of extended survival without surgical correction. Because no molecular material was available from the patient, publicly available mouse transcriptomic datasets related to genital tubercle development and Leydig cell differentiation were consulted only as contextual reference. These datasets illustrate established developmental regulators and steroidogenic pathways relevant to genital formation and testicular function but do not represent direct molecular findings from the reported case. This report primarily highlights the clinical course and management of severe hypospadias in a dog, while using existing transcriptomic knowledge solely to provide biological context. The findings should therefore be interpreted as descriptive and hypothesis-generating rather than as evidence of a direct mechanistic link between developmental abnormalities and endocrine tumorigenesis. Full article

Male reproductive aging is increasingly recognized as a systemic process in which inflammaging drives progressive dysfunction of urogenital tissues. Key mechanisms include immune–metabolic alterations, activation of the NOD-like receptor protein 3 (NLRP3) inflammasome, as well as epigenetic remodeling. Evidence from experimental and clinical studies suggests that these processes are often investigated independently, and integrative models in humans remain limited. Here, we propose a conceptual framework linking the prostate, testis, and skeletal muscle, in which oxidative stress may act as a mediator amplifying systemic dysregulation at different levels during the aging process. Lifestyle and metabolic interventions, including caloric restriction, resistance exercise, and selected nutraceuticals, may act as key modulators of inflammaging pathways, thus highlighting new potential targets for precision medicine approaches. Full article

Surgical precision is critical in oncology, where complete tumor resection while preserving healthy tissue directly influences patient outcomes. Traditional intraoperative diagnostic tools, such as frozen-section analysis, are limited by time constraints, tissue sampling, and interpretative variability. Intraoperative mass spectrometry (MS) has recently emerged as a transformative approach, enabling rapid, label-free molecular profiling of surgical specimens in real time. Several technologies—including Rapid Evaporative Ionization Mass Spectrometry (REIMS, “iKnife”), Desorption Electrospray Ionization (DESI-MS), Matrix-Assisted Laser Desorption/Ionization (MALDI-MS) Imaging, Picosecond InfraRed Laser mass spectrometry (PIRL-MS), and novel devices such as the MasSpec Pen—offer unique strategies for intraoperative tumor characterization. Applications have been demonstrated across multiple cancer types, including brain, breast, gastrointestinal, and urogenital malignancies, where MS can improve margin assessment, tumor classification, and surgical guidance. Beyond its clinical promise, intraoperative MS faces technical and translational challenges, including high infrastructure costs, a lack of standardization, and the need for robust multicenter validation. Integration with artificial intelligence, imaging modalities, and multi-omics approaches may further enhance its clinical utility. This review summarizes current technologies, clinical applications, limitations, and future perspectives of intraoperative MS in oncology, highlighting its potential to reshape surgical oncology practice. Full article

Background/Objectives: Mycoplasma genitalium is an emerging cause of sexually transmitted infections (STIs) and is increasingly recognized for its association with cervicitis and pelvic inflammatory disease. However, prevalence data in specific Japanese subpopulations, particularly comparing pregnant and non-pregnant women, remains limited. This study aimed to determine the prevalence of M. genitalium and its co-infection rates with Chlamydia trachomatis and Neisseria gonorrhoeae among Japanese women. Methods: A cross-sectional study was conducted using vaginal swab specimens collected between April 2021 and November 2022 from patients visiting two clinics in Gifu, Japan. The study population comprised 2138 non-pregnant women presenting with urogenital symptoms or sexual contact history, and 236 pregnant women undergoing routine antenatal screening. Detection was performed using real-time polymerase chain reaction assays on the cobas^® 8800 system (Roche Diagnostics). Results: Among non-pregnant women, the overall prevalence was 3.8% (82/2138) for M. genitalium, 3.4% (72/2138) for C. trachomatis, and 0.4% (9/2138) for N. gonorrhoeae. Co-infection rates were low; M. genitalium and C. trachomatis co-infection was observed in 0.2% of cases. Among pregnant women, the prevalence was 3.8% (9/236) for both M. genitalium and C. trachomatis, and 0.4% (1/236) for N. gonorrhoeae. No statistically significant differences in prevalence were observed between pregnant and non-pregnant women for any pathogen. Conclusions: The prevalence of M. genitalium in this Japanese cohort was comparable to that of C. trachomatis in both pregnant and non-pregnant women, highlighting its significance as a major STI pathogen. These findings underscore the importance of including M. genitalium in routine STI screening panels for symptomatic women and antenatal care to prevent reproductive health complications. Given the high rates of antimicrobial resistance documented in Japanese M. genitalium strains, specific diagnostic testing is essential to enable targeted, resistance-guided therapy. Full article

Background/Objectives: Platelet-rich plasma (PRP) is an autologous blood-derived biologic enriched in platelets and bioactive mediators. In urology and sexual medicine, PRP has been promoted for erectile dysfunction (ED) and a growing range of urogenital disorders on the premise that it may support angiogenesis, neuroregeneration, immune modulation, and tissue remodeling. However, clinical uptake has outpaced high-quality evidence, while heterogeneity in PRP preparation, characterization, and delivery limits interpretability and reproducibility. This structured narrative review aims to critically integrate mechanistic, preclinical, and clinical evidence regarding PRP use in ED, Peyronie’s disease (PD), stress urinary incontinence (SUI), interstitial cystitis/bladder pain syndrome (IC/BPS), and selected emerging indications. We further aim to identify sources of heterogeneity and propose an actionable minimum reporting framework (PRP-Uro Checklist) to guide future research. Methods: A structured search of PubMed/MEDLINE was conducted for studies published between 2021 and 2025. The relevant literature on PRP use in ED, PD, SUI, IC/BPS, and related indications was included for critical narrative synthesis. Emphasis was placed on PRP classification and preparation variables, outcome measure validity, and sources of heterogeneity across studies. Results: Mechanistic and preclinical evidence supports PRP’s potential to modulate nerve repair, angiogenesis, extracellular matrix remodeling, and immune polarization through a complex secretome of growth factors, cytokines, and extracellular vesicles (EVs). Clinical evidence suggests that intracavernosal PRP may improve erectile function in selected populations, but effect size, durability, and superiority over placebo remain uncertain due to small trials, substantial placebo effects, short follow-up, and incomplete biologic characterization. Evidence for PRP in PD, SUI, and IC/BPS remains preliminary and is derived largely from small cohorts, proof-of-concept studies, or uncontrolled designs, although early findings suggest potential symptom benefit and acceptable short-term tolerability. Across indications, inconsistent PRP reporting, particularly the absence of absolute platelet dose, leukocyte quantification, activation method, and standardized treatment protocols, represents a major barrier to reproducibility and evidence synthesis. Conclusions: PRP is biologically plausible and appears broadly safe, but its role in urology and sexual medicine remains investigational and is not yet supported by guideline-level evidence. To enhance reproducibility and interpretation, we propose a Minimum PRP Reporting Checklist for Urology and Sexual Medicine Trials (PRP-Uro Checklist). Future progress requires rigorous standardized reporting, indication-specific biologic characterization, rigorously designed sham-controlled trials, clinically meaningful endpoints, and longer-term follow-up. Full article

Menopause represents a key transitional phase in women’s health, characterized by declining estrogen levels and increased risk for cardiometabolic, musculoskeletal, and urogenital disorders. Beyond its endocrine roots, emerging evidence highlights the gut microbiome as a critical modulator of systemic hormonal balance. This review synthesizes current understanding of the bidirectional relationship between estrogen and the gut microbiome and its implications for women’s health during menopause. Evidence from current studies reveals distinct findings across populations, reflecting the complexity of estrogen regulation in part by the gut microbiome (i.e., estrobolome). While no ideal gut microbial composition has been identified for women across stages of perimenopause, likely due to geographically unique gut microbiome profiles among healthy women, greater microbial diversity has been positively associated with improved estrogen regulation. Conversely, reduced diversity and altered Firmicutes/Bacteroidetes ratios have been linked to biomarkers of inflammation during perimenopause, which is a key driver across many perimenopausal symptoms. Although hormone replacement therapy remains the primary clinical intervention during perimenopause, we highlight emerging evidence on the adjuvant potential of diet, synbiotics, phytoestrogens, and strain-specific probiotics in modulating the estrogen–gut microbiome axis for improved health span trajectories and better symptom management. Future longitudinal studies integrating diet, gut microbiome profiles and symptom trajectories are essential to clarify these mechanisms across ethnicity and geography. Ultimately, understanding localized diet–microbiome interactions will enable the development of accessible, personalized, and non-hormonal strategies to complement and increase agency in proactive management during the perimenopausal transition. Full article

Background and Objectives: The close anatomical relationship between pelvic support structures and the lower urinary tract contributes to high rates of urinary dysfunction among patients with pelvic organ prolapse (POP). POP reduction alone has been shown to alter urinary tract functioning. The aim of this study was to assess urinary functioning outcomes following a novel reconstructive surgical technique for POP. Materials and Methods: This randomized controlled trial was conducted between September 2024 and December 2025. The trial was registered in the German Clinical Trials Register (identifier: DRKS00038206), on 27 October 2025. Participants were randomly assigned to undergo either conventional laparoscopic sacrocervicopexy or the modified technique. Urinary outcomes were assessed using the International Consultation on Incontinence Questionnaire—Urinary Incontinence Short Form (ICIQ-UI), the Urogenital Distress Inventory Short Form (UDI-6), the cough test, and urodynamic testing. Assessments were performed prior to surgery and at a 6-month follow-up. Results: Both the classical and modified techniques resulted in significant improvements in ICIQ-UI and UDI-6 scores. However, no statistically significant differences were observed between groups. De novo SUI occurred in 14.3% of patients in the classical technique group and in no patients in the modified technique group. Conclusions: Urinary symptoms improved in both groups, with no statistically significant between-group differences. De novo SUI occurred only in the classical technique group, but this finding should be interpreted cautiously given the limited sample size. These results are exploratory and hypothesis-generating, and larger studies with longer follow-up are needed to clarify whether true between-group differences in postoperative continence outcomes exist. Full article

Background: We tested whether a contrast-free protocol can reproduce contrast-enhanced VI-RADS scoring and whether reader expertise influences results. Methods: In this retrospective single-center study (January–December 2024), 65 patients (69 lesions) underwent bladder multiparametric MRI. Two blinded radiologists assigned VI-RADS scores using only T2-weighted and diffusion-weighted imaging (biparametric, non-contrast MRI): an expert (>15 years in urogenital radiology) in genitourinary MRI and a non-expert (5 years of experience in genitorurinary radiology). Two complementary reference standards were used. For reproducibility analysis, the reference standard was the VI-RADS score from the original clinical report based on the full multiparametric examination including contrast-enhanced imaging. For diagnostic accuracy analysis, histopathology was used as the reference standard for muscle-invasive versus non-muscle-invasive disease. Agreement was evaluated with confusion matrices, overall agreement, and weighted Cohen’s kappa. Discrimination for high likelihood of muscle invasion (VI-RADS ≥ 4) was assessed with receiver operating characteristic analysis. Results: Reference scores were VI-RADS 2 (34.8%), 3 (14.5%), 4 (20.3%), and 5 (30.4%). Agreement was higher for the expert than the non-expert (73.9% vs. 56.5%; weighted kappa 0.74 [95% confidence interval 0.56–0.89] vs. 0.58 [0.37–0.75]). The area under the curve for VI-RADS ≥ 4 was 0.87 (0.78–0.95) for the expert and 0.81 (0.69–0.91) for the non-expert. Sensitivity at a biparametric threshold of VI-RADS ≥ 4 was 88.6% for both readers; specificity was 85.3% vs. 73.5%. Post-resection cases showed more discrepancies, mainly overstaging. Conclusions: Contrast-free biparametric MRI may approximate multiparametric VI-RADS scoring only in treatment-naïve pre-TURBT cases with clearly low-risk, non-equivocal imaging features, but performance is reader-dependent and less reliable in equivocal, higher-risk, and post-resection examinations. Contrast-enhanced multiparametric MRI remains preferred for staging. Full article

The objective of this review is to synthesize current knowledge and evidence on male reproductive health by addressing preventive medicine strategies and biomarkers, as well as to provide clinicians, researchers, and policy makers with a coherent framework for prevention of male reproductive health. In this review male (in)fertility and determinants of male reproductive health as well as preventive strategies with special attention to primary, secondary and tertiary prevention in male reproductive health will be analyzed. From primary preventive measures: education, weight management, physical activity, sleep, healthy diet, alcohol and smoking consumption will be assessed, while from secondary preventive measures: sexually transmitted infection (STI) from the point of transmission prevention, testicular self-examination, hormonal testing and management, chronic diseases and semen analysis will be discussed; and from tertiary preventive measures: treatment of STI, treatment of congenital abnormalities, infertility treatment and urogenital cancer treatment will be elaborated. Additionally, biomarkers in male reproductive health will be synthesized and discussed. Bridging the gap between evidence and practice will ultimately lead to better understanding of the complex state of male reproductive health, thus minimizing the potential missed windows of opportunities in timely adequate preventive interventions implementations, as well as on time diagnostic and optimal treatment options. Full article

Transthyretin amyloidosis (ATTR) is a progressive multisystem disorder characterized by extracellular deposition of misfolded transthyretin fibrils, leading to neurological, cardiac, gastrointestinal, urogenital, sexual, and ophthalmological involvement. While disease-modifying therapies have significantly improved survival and slowed disease progression, a substantial proportion of patients continue to experience a high symptomatic burden that markedly impairs quality of life. Symptomatic manifestations often occur early, may precede the diagnosis, and frequently persist despite etiological treatment. This review provides a comprehensive overview of the symptomatic management of ATTR, with particular emphasis on autonomic dysfunction and its systemic consequences. We discuss current therapeutic strategies for orthostatic hypotension, gastrointestinal dysmotility, nutritional impairment, sexual dysfunction, lower urinary tract dysfunction, and ophthalmological involvement, highlighting both pharmacological and non-pharmacological approaches. Special attention is given to treatment limitations related to cardiac involvement, autonomic failure, and drug tolerability. Despite the clinical relevance of symptom control in ATTR, evidence-based recommendations remain scarce, and no dedicated guidelines currently exist. Most therapeutic approaches are derived from observational studies, expert opinion, and clinical experience. Improved awareness of symptomatic manifestations, early intervention, and a multidisciplinary, individualized approach are essential to optimize patient outcomes. Future research should focus on prospective studies and the development of structured symptomatic treatment algorithms to complement disease-modifying therapies and enhance patient-centered care in ATTR. Full article

Mycoplasma genitalium (MG) is a cell wall–deficient bacterial pathogen associated with several sexually transmitted infections (STIs), including nongonococcal urethritis, cervicitis, and pelvic inflammatory disease. In the context of increasing antibiotic resistance and the challenges in clinical management, molecular epidemiological data are crucial for supporting surveillance strategies. This study aimed to assess the prevalence and genetic diversity of M. genitalium infections in a tertiary care hospital located in Northeastern Italy. In 2023, 2524 subjects (1622 men and 902 women) were screened using real-time multiplex PCR for the detection of major urogenital pathogens. M. genitalium-positive samples were molecularly characterized using a locus-typing approach based on sequence polymorphisms in the mgpB gene and the MG309 locus, enabling enhanced strain discrimination. Results revealed an overall positivity rate of 7.4% (118 cases), with a significantly higher prevalence in men (10.2%) than in women (2.6%), and the highest detection rate found in rectal swab specimens. Coinfections were detected in 48% of M. genitalium-positive subjects, most commonly involving Ureaplasma urealyticum (24%) and Metamycoplasma hominis (14%). Molecular typing on 22 M. genitalium-positive samples revealed significant locus-specific genetic heterogeneity, alongside the presence of a dominant cluster of 14 isolates with closely related allele profiles, suggesting the circulation of predominant local M. genitalium alleles within the analysed population. Full article