Original Article / Research Article

Increasing of post-freezing quality of Spermatogonial Stem Cells after pretreatment by vitamin E

Fereshte Aliakbari, Mohammadhossein Heidari, Mohammad Ali Hossini, Jalil Hosseini

Men's Health Journal, Vol. 3 No. 1 (2019), 13 April 2019 , Page e1

Introduction: Mouse spermatogonial stem cells (SSCs) can be cryopreserved for long periods while preserving their spermatogenic ability. Although cryopreservation has been found to increase reactive oxygen species (ROS) formation that damages cellular structures. In the present study, we added vitamin E to the basic freezing medium in order to evaluate its effect on the efficiency of spermatogonial stem cells.

Methods: SSCs isolated from testes of 6 days old male mice by enzymatic digestion. Vitamin E 100, 200, 400 µg/mL was added to the basic freezing medium. The cell viability was evaluated by MTT assay. After thawing, SSCs were cultured for 1 month and the expression pattern of specific genes of SSCs measured by real-time PCR technique.

Results: The survival rate of the freeze cells in the presence of vitamin E was significantly higher than the control group (p<0.05). The number of colonies and their diameter measured after one month were significantly higher in the vitamin E groups than in the control group (p≤0.05).

Conclusion: Adding vitamin E to the basic freezing medium thus can be helpful in increasing the quality and viability of SSCs after cryopreservation.


The Effect of Varicocelectomy on Semen Analysis and Serum Levels of InhibinB

Mohammadreza Mohammadi Fallah, Ali Tayyebi Azar

Men's Health Journal, Vol. 3 No. 1 (2019), 13 April 2019 , Page e2

Background: Varicocele means dilation and torsion of spermatic veins. About 15%-40% of infertile men suffer from Varicocele. It seems that 70% of secondary infertility in men occurs due to Varicocele. Varicocele is the most common surgical cause for male infertility. Varicocelectomy is considered as the best treatment method for patients with Varicocele that increases 30%-50% of the postoperative fertility rate. The purpose of this study was to investigate the effect of Varicocelectomy on inhibin B and use this marker to predict infertility in men.

Methods: In this study, all infertile patients in any age that were candidate for Varicocelectomy and hospitalized in Imam Hospital in Urmia were included. Exclusion criteria were defined as orchitis, trauma, diabetes, radiotherapy, chemotherapy and coitus complications. Sperm analysis (SA) was conducted three times for patients and then serum levels of FSH, LH, T, inhibin B, SA were measured before surgery and also six months after surgery. Furthermore, during the hospitalization and infertility period, testes were examined before surgery in terms of consistency and size.

Results: The mean ± SEM (standard error median) age of 40 patients was 28.4±5.14 (range: 18-40) years old. Mean size of the testes and mean sperm density and serum levels of LH.FSH remained the same. However, mean sperm motility, serum levels of T and inhibin B were statistically significant after the Varicocelectomy (p-value=0.005). A significant relationship was found between serum levels of inhibin B and infertility; however, there was no significant relationship between sperm count and serum levels of LH, FSH and T. Varicocelectomy can improve sperm motility and increase Inhibin B in patients and so improves spermatogenesis parameters and it may be one of the causes of fertility in patients.

Conclusion: The results of this study indicate that sperm motility and increase in inhibin B after Varicocelectomy can improve spermatogenesis parameters. Serum levels of FSH, T, LH and sperm morphology and also grade of Varicocele, patient age, and testis size have no effect on spermatogenesis and fertility after Varicocelectomy.


Evaluation of Fertility Rate in the Couples after Uterine Septum Resection

Mansoureh Vahdat, Samaneh Rokhgireh, Elahe Afshari, Samaneh Mohammadpour, Mohammad Ali Hosseini

Men's Health Journal, Vol. 3 No. 1 (2019), 13 April 2019 , Page e3

Introduction: Uterine septum is one of the most common congenital abnormalities in women that leads to numerous gynecological problems and adverse obstetrics outcomes. This study aimed to evaluate the effects of Hysteroscopic Resection on pregnancy outcomes in women undergone the surgery.

Methods: In this quasi-experimental study, 90 women were included from April 2016 to June 2018 from patients attending to Rasoul Akram hospital of Tehran. The inclusion criteria included: the age lower than 35 years old, primary infertility, idiopathic recurrent spontaneous abortion, BMI between 19 and 30, and having informed consen. Septum was resected by scissor upward and lateral. After 10 months of follow-up in average, we assessed rate of live births, abortions, birth weight and presentation.

Results: 82 individuals were assessed for occurrence of conception (response rate=91%).  The mean age of patients was 30.01 ± 6.76 years and the mean BMI was 26.25 ± 4.88. Out of 82 patients, 36 patients were pregnant, of whom 16 (44.4%) had abortions. 5 (14.9%) of the pregnancies ended with preterm birth, and 6 (17%) ended with stillbirth.

Conclusion: The present study showed that the infertile patients with uterine septum and with no other causes of infertility were more likely to be pregnant compared to other patients with idiopathic infertility. Our study showed that post-operation fertility following Hysteroscopic Resection was lower than that in previous reports. According to the findings of this study, scissors may be safe, effective and cost-effective method for removing uterine septa.


Mortality rates due to Bladder cancer in Iran during 2001-2007: A national cancer registry-based study

Maryam Khayamzadeh, Fereshte Aliakbari, Zahra Zolghadr, Majid Emadeddin, Afshin Moradi, Mohammad Esmaeil Akbari, Amir Reza Abedi, Shahrzad Nematollahi, Jalil Hosseini

Men's Health Journal, Vol. 3 No. 1 (2019), 13 April 2019 , Page e5

Introduction: Bladder cancer is the ninth common cause of cancers in both sexes worldwide. Nevertheless, little is known about the descriptive and analytic epidemiology of bladder cancer in Iran. The present study aimed to describe the nationwide distribution of death due to bladder cancer in Iran.

Methods: This cross-sectional study used data of bladder cancer cases who were registered in the national cancer-registry system by the Ministry of Health and Medical Education during 2001-2007. Age-standardized mortality rates due to bladder cancer were presented according to nine geographic poles across the country.

Results: The overall mortality rate of bladder cancer (per 100,000 population) was 2.26 in men and 1.36 in women; while the rates were constantly higher for men across all age groups.  The highest and lowest age-standardized mortality rates in provinces (per 100,000 population) belonged to Mazandaran (6.126) and Tehran (1.112), respectively.

Conclusion: Death from bladder cancer seems to increase by age in Iran, mainly among men. This association might be partially due to increased life expectancy, altered high-risk lifestyle behaviors and/or improvement in cancer registration system. Information on the distribution of mortality due to bladder cancer could be useful for local prevention strategies, where specific profile of communities and patients is taken into account.


Re-admission Rate of Patients with Ureteral Stone: A Descriptive Study

Mohammad Mehdi Forouzanfar, Saleh Ghiasy, Alireza Majidi, Behrooz Hashemi, Morteza Sanei Taheri, Mahsa Ghodsi

Men's Health Journal, Vol. 3 No. 1 (2019), 13 April 2019 , Page e6

Introduction: Patients with acute renal colic need to choose between undergoing medical treatments and receiving interventions. The Aim of this study is to evaluate the outcomes of patients who are discharged from emergency departments with ureteral stones lesser than 6 millimeters. In doing so, the effect of diagnostic treatment approaches on clinical outcomes and referral rate is to be assessed.

Patients and Methods: This study was performed on patients with ureteral stones referred to emergency department of Shohadaye Tajrish Hospital between May2015 to June 2018. A checklist was filled out for each patient and it included their complete medical history, physical examination results and paraclinical data. Patients were then studied for 4 weeks to determine referral times to hospital and clinical outcomes.

Results: 105 patients include 81 men (77.14%) with average age of 37.1±12.4 years were studied. The mean stone diameter was 4.2±2.1 mm.  Most of ureteral stones were seen in the right-hand side (60 percent). 71 patients (67.6%) did not have any history of nephrolithiasis and 73 (69.5%) did not have positive family history for nephrolithiasis. Ureteral stones were still observed in 42 patients (40%) after two weeks of studies and only one patient (1.1%) had stone in Ultrasound Imaging after 4 weeks of observations.

Conclusion: Most Patients (95%) with stones smaller than 6 mm responded to Medical Expulsive Therapy (MET) after 4 weeks and passed spontaneously ureteral calculi.

Investigation of Epidemiological, Anatomical, and Risk Factors of the Thoracic Aortic Aneurysm and Dissection, in Mazandaran Heart Center

Mohammad Zahedi, Reza Alizade Navaie, Seyede Fateme Hoseini, Parham Mortazavi, Mohammad Malekan, Armin Allahverdi, Shaghayegh Hooshmand, Soheil Azizi

Men's Health Journal, Vol. 3 No. 1 (2019), 13 April 2019 , Page e8


Background: Aortic aneurysm is one of the most common cardiovascular diseases that can lead to numerous challenges for patients. The mortality rate of ruptured Thoracic Aortic Aneurysm (TAA) is observed to be high. In order to reduce this high rate, appropriate methods to diagnose TAA as well as its useful and aggravating factors are to be developed and/or identified. The objective of this study is the evaluation of the thoracic aortic aneurysm and dissection, in Mazandaran Heart Center.

Method: This cross-sectional study with a census design was performed on all patients with thoracic aortic aneurysm and dissection who have undergone aneurysm surgery, from December 2010 to January 2019. Patients’ information was extracted from their medical records archive. SPSS 16.0 was used for statistical analysis.

Result: From 53 patients with a thoracic aortic aneurysm, 77.4% were male. The mean age of patients was 59.70±12.07 years. 21 (39.6%) patients were more than or equal to 60 years old, while the remaining 32 (60.4%) were less than 60 years of age. The overall mortality rate was 11.3%. The mean aortic diameter of the patients was 5.42 cm. All patients had type A dissection. In other words, type B was not seen.

Conclusion: Given the high prevalence and high mortality rate of thoracic aortic aneurysm, early screening can be beneficial and can increase the survival rate of patients. Laboratory and pathologic findings, along with clinical findings, can be very beneficial in early diagnosis.

Keywords: Aneurysm aorta; thoracic aortic aneurysm; aneurysm dissection; risk factor

Efficacy of DVIU and intralesional injection of mitomycin C in the treatment of bulbar urethral stricture

Jalil Hosseini, Farzad Allameh, Saman Najafi, Hojat Salimi, Zahra Sadeghzadeh, Mohammad Ali Hosseini

Men's Health Journal, Vol. 3 No. 1 (2019), 13 April 2019 , Page e9

Background and aim: To find if intra-operative local injection of Mitomycin-C after internal Urethrotomy in patients with urethral stricture can improve the outcome of surgery.

Materials and Methods: Seventy patients were allocated in two groups randomly and data were analyzed. The case group (n=35) was treated by internal Urethrotomy with intra-operative local injection of Mitomycin-C. The control group (n=35) was underwent standard internal Urethrotomy. The patients were followed after removing catheter and for 6 months after surgery by USS PROM questionnaire and uroflowmetry.

Results: A significant difference was observed in terms of urodynamic indices like Q-max (p-value=0.006) and urine flow pattern (p-value=0.025) after internal Urethrotomy in the local injection of Mitomycin-C group and control group, six months after surgery. In the case group, in the six months after operation, only 2.9% of patients had Q-max less than 15 and no one had obstructive pattern, while in the control group, 25.7% of patients had Q- max less than 15 and 17.1% had obstructive pattern. However, the patient's satisfaction history did not show any significant difference in post-internal Urethrotomy voiding status in the local injection of Mitomycin-C group and control group, either immediately after removal of the urethral catheter (p-value=1) and six months after surgery (p-value=0.198). Also, no significant difference was observed in terms of urodynamic indices like Q-max (p-value=0.771) and urine flow pattern (p-value=1) after internal Urethrotomy in the local injection of Mitomycin-C group and control group, immediately after removal of the urethral catheter.

Conclusions: Intra-operative local injection of Mitomycin-C after internal Urethrotomy can be regarded as a safe and efficient technique which has several advantages including lower cost. Lower recurrence rate of urethral stricture is the main effect of local Mitomycin-C application that is more prominent after six months follow up.

The prevalence of depression and its related factors among taxi drivers in Tehran city during 2017-2018

Monireh Faghir Gangi, Shahrzad Nematollahi

Men's Health Journal, Vol. 3 No. 1 (2019), 13 April 2019 , Page e10

Background: Depression is amongst the most significant causes responsible for loss of life, worldwide. It also increases the likelihood of accidents which may lead to unpleasant outcomes.

Aim: This paper was aimed to measure the prevalence and related factors of depression amongst taxi drivers in Tehran city, from 2017 to 2018.

Methods: This cross-sectional study was conducted on 350 taxi drivers. Cluster sampling was applied. Standard questionnaires, including Beck-21 items questionnaire, to measure depression, and job satisfaction questionnaire (JDI), were applied. Statistical analyses were performed using SPSS version 24 using Odds Ratios (OR) by logistic regression models. Significant level was considered 5% at all analyses.

Results: The prevalence of depression was 43.3% and mean (SD) of job satisfaction score was 188.1 (54), with a median and interquartile range (70±193) for the highest and lowest level of job satisfaction were 350 and 60, respectively. The odds of having depression were 2.2 times higher in drivers with low job satisfaction (OR=2.2; 95%CI:1.3,3.8), 6.2 times higher in drivers who reported bad/very bad economic status (OR=6.2; 95%CI:2.1,18.3), and 1.8 times higher in cigarette smokers ‎(OR=1.8; 95%CI:1.0,3.4). The odds also increased by 2.6 times in drivers who reported average self-rated health (OR=2.6; 95%CI: 1.5, 4.5), and by 10.1 times in drivers who reported bad self-rated health ‎ (OR=6.2; 95%CI: 1.5, 65.0). Furthermore, having a history of depression amongst first degree family members, increased the odds by 2.6 times‎ (OR=2.6; 95%CI: 1.5, 4.5).  ‎  ‎

Conclusion: We found that 43% of taxi drivers in Tehran city suffer from varying degrees of depression. It seemed that cigarette smoking, family history of depression, job dissatisfaction, and poorer economic status were important contributors of depression in our investigation.

Letter to the editor

Review Article

The role of men in recurrent miscarriage; a Narrative Review

Amir Reza Abedi, Amir Rahavian, Samira Shariatpanahi, Fereshte Aliakbari

Men's Health Journal, Vol. 3 No. 1 (2019), 13 April 2019 , Page e7

Background and Method: Recurrent Pregnancy Loss (RPL) is defined as the occurrence of two or more consecutive miscarriages within the first 20 weeks of pregnancy. The key challenge remains to be what it is that has to be done with couples experiencing RPL. Infections, endocrine disturbances, a suboptimal uterine environment, advanced maternal age, and genetic influences are some of the factors which may increase the chances of RPL occurrence. Despite all medical and research efforts, approximately 40 percent of RPL cases are categorized as unexplained. This is while amongst all the various factors which may lead to such condition, fathers’ genetic influences have often been ignored in the past. In fact, parental chromosomal anomalies, gene mutations such as the microdeletion of chromosome Y, and/or some polymorphism of HLA-G have shown to contribute and lead to miscarriage.

Result: Furthermore, high levels of Reactive Oxygen Species (ROS) can cause DNA damage in spermatozoa. Meantime, sperm DNA damage has been closely linked with indicators such as fertilization, embryo quality, implantation, spontaneous abortion, congenital malformations, and childhood diseases. Sperm Chromatin Structure Assay (SCSA) is a test to measure DNA fragmentation. Moreover, the other SCSA parameter that needs to be considered is high DNA stainability (HDS). It is worth mentioning that HDS is associated with frequency of aneuploidy in spermatozoa. In addition, high HDS can be associated with an increased risk of early abortion in IVF and ICSI cycles.

Conclusion: Additionally, increasing paternal age and varicocele can increase the risk of miscarriage. Advanced Paternal Age (APA) can also increase the relative risk of offspring neurocognitive defects. In saying that, the microsurgical varicocelectomy effectively increases the odds of natural pregnancy, the rate of high-quality embryos, and the success rate of in vitro fertilization.