Luca Boeri

181 Low birth weight is associated with a higher rate of health-significant comorbidities and worse seminal parameters – results of a cross-sectional study in primary infertile patients

To assess the rate and predictors of clinically meaningful improvements (CMI) in patients with lower urinary tract symptoms (LUTS) treated with either silodosin (SIL) alone or with a combination of SIL+ serenoa repens (Ser) hexanic lipidosterolic extract for ≥12 months. Data from 186 patients were collected. Patients completed the International Prostatic Symptoms Score (IPSS) at baseline and at follow-up assessment. Descriptive statistics and logistic regression models tested rates and predictors of CMI. Two CMI were assessed: 1) >3 points improvement in total IPSS from baseline to end (CMI#1); 2) >25% IPSS improvement from baseline to end (CMI#2). Overall, 93 (50%) patients were treated with SIL and SIL+ Ser, respectively. At a mean 13.5-mos follow-up [range: 12–20], mean IPSS scores were significantly lower in patients treated with SIL + Ser compared to those after SIL (p = 0.002). SIL + Ser patients more frequently achieved CMI#1 (69.9% vs. 30.1%, p = 0.001) and CMI#2 (68.8% vs. 31.2%, p < 0.001) compared SIL men. At multivariable analyses, younger age, IPSS severity and SIL + Ser (all p < 0.03) were independent predictors of CMI#1 and CMI#2. In conclusion, SIL + Ser therapy was more effective than SIL alone in improving IPSS scores in men with LUTS. SIL + Ser treatment led to CMIs in up to seven out of ten men.

MP68-03 PREVALENCE OF AND IMPACT OF HEALTH-SIGNIFICANT COMORBIDITIES IN CAUCASIAN-EUROPEAN MEN PRESENTING FOR PRIMARY COUPLE’S INFERTILITY – RESULTS OF A CROSS-SECTIONAL SURVEY

ABSTRACT Background: A rapid onset of action for phosphodiesterase type 5 inhibitors (PDE5is) emerged to be of clinical importance in men treated for erectile dysfunction (ED). Data from randomized clinical trials (RCTs) showed a rapid onset of action for vardenafil 10 mg orodispersible tablet (ODT). However, the effectiveness of vardenafil ODT has never been tested in a real-life setting. We assessed the efficacy and time to onset of action of vardenafil ODT in men seeking medical help for ED in the everyday real-life clinical practice. Research design and methods: Patients completed a baseline and follow-up International Index of Erectile Function (IIEF), along with a 8-item self-administered questionnaire about onset of action and overall treatment outcomes. Descriptive statistics tested efficacy rates, patient timing of drug intake and time to post-dosing onset of action. Results: Overall, 118(59.9%) patients used vardenafil ODT. Satisfactory erections for vaginal penetration were reported in 39(34.5%) and 26(21.8%), patients in =15 and =30, minutes post-dosing, respectively. Minimal Clinically Important Differences (MCIDs) criteria and Yang’s criteria for responders were obtained in 80(67.8%) and 72(60.8%) patients. Conclusions: This study showed that one in three patients had satisfactory erection for vaginal penetration in less than 15 min post-dosing in the real-life setting.

Prevalence and predictors of concomitant low sexual desire/interest and new-onset erectile dysfunction – a picture from the everyday clinical practice

BACKGROUND:Prevalence of and severity of lower urinary tract symptoms (LUTS) according to male sexual orientation have been scantly analysed. We aimed to assess the prevalence and severity of LUTS in a cohort of Caucasian-European men who have sex with men seeking medical help for uroandrologic reasons other than LUTS.METHODS:Data from 949 consecutive individuals in an outpatient setting were analysed. Severity of LUTS was measured with the International Prostate Symptom Score (IPSS). Men with storage symptoms scored 1–3 and ⩾4 (of 15), and voiding symptoms scored 1–4 and ⩾5 (of 20) were considered as having mild and moderate-to-severe symptoms, respectively. For individual symptoms, patients with scores ⩾1 were deemed symptomatic (according to Apostolidis et al.15). Descriptive statistics and logistic regression models tested the association between LUTS and sexual orientation.RESULTS:Complete data were available for 213 (22.4%) men who have sex with men (MSM) and 736 (77.6%) heterosexuals (mean age (s.d.): 41.0 (12.2) vs 39.9 (12.1) years). Compared with heterosexuals, MSM reported higher rates of total IPSS scores suggestive of moderate (21.6% vs 20%) and severe LUTS (3.8% vs 2.4%) (P=0.004). Similarly, MSM showed higher rates of mild (48.8% vs 45.2%) and moderate-to-severe (39.4% vs 30.4%) storage symptoms (all P<0.001), and of mild (45.1% vs 34.8%) and moderate-to-severe (20.2% vs 19.2%) voiding symptoms (all P<0.01). MSM status was an independent predictor of mild voiding symptoms (odds ratio (OR): 1.40; P=0.004), moderate-to-severe storage symptoms (OR: 1.40; P=0.04) and severe total IPSS (OR: 1.49; P=0.03), after adjusting for other variables.CONCLUSIONS:These findings suggest a higher prevalence and severity of LUTS in MSM compared with heterosexual men seeking medical help for uroandrologic reasons other than LUTS.

Validation of the American Society for Reproductive Medicine guidelines/recommendations in white European men presenting for couple's infertility

INTRODUCTION AND OBJECTIVES: The raise of the developmental origins of adult disease has positioned low birth weight (LBW) as a significant health issue. We assessed prevalence of, and clinical and seminal impact of different categories of weight at birth in a cohort of white-European men presenting for primary couple’s infertility. METHODS: Complete data from 757 consecutive infertile men were analyzed. Patient with birth weight 2500, 2500 e 4200, and 4200 gr were considered as having LBW, normal birth weight (NBW) and high birth weight (HBW), respectively. Comorbidities were scored with the Charlson Comorbidity Index (CCI; categorized 0 vs 1 vs 2). Body mass index (BMI) was considered for each patient using NIH cut offs [normal weight (18.5e24.9), overweight (25.0e29.9), and class 1 obesity ( 30.0)]. Testicular volume (TV) was assessed with a Prader orchidometer. Semen analysis values were assessed based on 2010 WHO reference criteria. Descriptive statistics detailed the association between semen parameters and clinical characteristics and the defined birth weight categories. RESULTS: Of all, LBW, NBW and HBW were found in 52 (6.9%), 605 (79.9%) and 100 (13.2%) men, respectively. Normal BMI value and BMI suggestive for NIH class 1 obesity was more frequently reported in LBW and HBW (p<0.001), respectively. Of all, LBW reported a higher prevalence of comorbidities (p<0.001). Likewise, hypercholesterolemia (p1⁄40.04) and hypertriglyceridemia (p1⁄40.01) were more frequently reported in both LBW and HBW. LBW had a lower mean TV (p1⁄40.02). At semen analysis, LBW men showed a higher rate of both asthenozoospermia (p1⁄40.02) and teratozoospermia (p1⁄40.02). Overall, ejaculated volume (p1⁄40.006), sperm motility (p1⁄40.02) and normal morphology (p1⁄40.04) were significantly reduced in the LBW group. Likewise, LBW patients presented higher FSH levels (p1⁄40.04) but lower circulating testosterone levels (p1⁄40.03) as compared with the other groups. At MVA, LBW achieved independent predictor status for a higher CCI value (OR 3.7; p<0.001), lower sperm motility (OR 2.7; p<0.04), and lower normal sperm morphology (OR 2.3; p<0.04). CONCLUSIONS: Current findings in infertile patients showed that LBW was associated with a significant higher rate of adult diseases. Clinical, endocrine and semen parameters were significantly worse in the LBW group. These data confirmed the importance of the theory of LBW as a significant predictor of impaired health issue.

PD22-08 CLINICALLY MEANINGFUL IMPROVEMENTS IN LUTS/BPH SEVERITY IN MEN TREATED WITH SILODOSIN PLUS SERENOA REPENS OR SILODOSIN ALONE

We sought to determine if the severity of male factor infertilty, as assessed by sperm quality, was associated with the rate of birth defects. METHODS: Fathers with semen analysis data in the Baylor College of Medicine Semen Database (BCMSD) were linked with offspring in the Texas Birth Defects Registry (TBDFR) using data between 1999-2009. To determine the association between birth defects and semen parameters, we identified the subset of men with complete semen parameters. Hierarchical linear modeling was used to determine odds ratios between birth defect rates and semen parameters before and after adjustment for paternal, maternal, and birth covariates. Semen parameters were stratified based on subfertile cutoffs defined by the WHO 5th edition. RESULTS: Initial linkage between the BCMSD and TBDFR yielded 6,087 men with linked data. No association between semen parameters and birth defects were observed. As a sensitivity analysis, a subset of 1,382 men were identified who had been evaluated for infertility. After the above correction, 109 infants with and 2,115 infants without birth defects were identified. No statistically significant association was observed between birth defect rates and semen parameters, before or after adjustment for covariates (Table 1). CONCLUSIONS: Birth defect rates do not appear to be associated with semen quality. The current study suggests that the severity of male factor infertility does not impact the rate of congenital anomalies. This information is important when counseling couples concerned about the relationship between impaired semen quality and ultimate birth defects. Future examination of the impact of method of conception will help clarify the relationship between poor semen parameters and congenital abnormalities.