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    Hypergonadotropic Hypogonadism: Management of Infertility
    (Bentham Science Publ Ltd, 2021) Kalkanli, Arif; Akdere, Hakan; Cevik, Gokhan; Salabas, Emre; Cilesiz, Nusret Can; Kadioglu, Ates
    Background: Medical treatments are used either alone or in combination with assisted reproductive techniques for the treatment of infertile patients with hypergonadotropic hypogonadism. A wide range of treatment options such as gonadotropins, aromatase inhibitors (AIs), selective estrogen receptor modulators (SERMs) and their combination are available as options. Objective: The aim of this review was to evaluate treatment options for infertile men with hypergonadotropic hypogonadism. Methods: A literature search of MEDLINE (1980-2019) was conducted using the terms 'hypogonadism', 'male infertility', 'gonadotropins', 'SERMs' and 'AIs'. Pathologies leading to hypergonadotropic hypogonadism and treatment modalities such as gonadotropins, SERMs, AIs and surgical treatment were discussed. Results: FSH increases spontaneous pregnancy rates but the level of evidence was proven to be low for live birth rates. AIs are valid treatment options for patients with low T/E2 ratio as they significantly increase sperm concentrations. SERMs are recommended for infertile males with a sperm concentration between 10-20 million. Varicocele was reported to increase testosterone levels of hypogonadic infertile males. Conclusion: Medical treatment modalities such as gonadotropins, SERMs, AIs and a combination of these therapies has been showed to have some effect in improvement of fertility but is not mainstream of the treatment.
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    A Population-Based Study of Peyronie's Disease in Turkey: Prevalence and Related Comorbidities
    (Elsevier Sci Ltd, 2020) Kadioglu, Ates; Dincer, Murat; Salabas, Emre; Culha, Mehmet Gokhan; Akdere, Hakan; Cilesiz, Nusret Can
    Introduction: Peyronie's disease (PD) prevalence varies between 0.39% and 20% and studies on PD prevalence are limited. Aim: This study aims to determine the prevalence of PD in males aged >30 years in Turkey and to evaluate etiological factors associated with it. Methods: The study was conducted in 12 regions of Turkey according to the Eurostat Nomenclature of Territorial Units for Statistics 1 classification and included 1,208 patients. Survey questionnaires including questions about demographic features and basic health status as well as about diagnosis and etiology of PD were put forth to the volunteers who agreed to participate in the study. Diagnosis of probable PD was established by evaluating the questionnaires. Patients with a diagnosis of congenital penile curvature were excluded from the group with PD. Chi-square test, Fisher's exact test, and Mann-Whitney U test were used. Main Outcome Measure: The primary outcome analyzed in this article was the prevalence rate of PD in Turkey and the associated comorbidities. Results: The prevalence of PD was determined as 5.3%. The rates of participants with PD were found to be the highest in the 50-59 years group (27%) and in the North-East Region (20%). Compared with participants without PD, participants with PD were older (median: 52 interquartile range [41-64] vs 45 [37-55]; P < .001) and the rates of smokers (73% vs 60.9%; P = .036) and those having diabetes mellitus (17.5% vs 9.2%; P = .045), hypertension (14.3% vs 6.9%; P = .041), and heart failure were higher (7.9% vs 2.5%; P = .027). Male with PD symptoms preferred their partners on top during sexual intercourse (15.2% vs 34.1%; P < .001). This is the first study to evaluate premature ejaculation prevalence and related comorbidities with face-to-face interviews. Conclusion: The prevalence of PD was 5.3% in Turkey. Besides advanced age, smoking, position of sexual intercourse, and presence of comorbidities especially diabetes mellitus, hypertension, and heart failure were the factors associated with PD prevalence. Kadioglu A, Dincer M, Salabas E, et al. A Population-Based Study of Peyronie's Disease in Turkey: Prevalence and Related Comorbidities. Sex Med 2020;8:679-685. Copyright (c) 2020, International Society for Sexual Medicine. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).