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but further afield.

Men with unexplained infertility (UI) should undergo an initial hormonal evaluation including serum FSH and total testosterone (TT). Unfortunately, there is no consensus regarding which TT cut point should be used to define hypogonadism in such men. To determine the best definition for hypogonadism, three different, literature-based TT cut points were used to assess associations between TT and semen parameters. The hypothesis was that the lowest TT cut point would associate with poorest sperm parameters.

We performed an IRB-approved retrospective chart review of 247 consecutive males presenting for evaluation of male factor infertility. After exclusions, basic statistics and correlation analysis of semen analysis parameters, TT, age, and body mass index (BMI) were evaluated on 128 men (age 34+/-33.5) categorized by three different TT cut points 65 males were hypogonadal according to a TT cutoff of < 264; 16 with a cutoff of 264-300; 44 with a cutoff of 301-400; and 42 with a TT over 400 ng/dL. momordin-Ic SUMO inhibitor Basic statistics, one-way ANOVA and Levene comparative analysis were performed. Besides a negative correlation between TT and BMI, there was no significant association between the three TT literature-based cut points and the other studied parameters. These findings were further supported by multiple comparison analyses.

For men with UI, regardless of how hypogonadism was defined, no relationship between semen parameters and TT was found.

Conventional, TT-based definitions of male hypogonadism in the setting of UI need to be clarified. Clinically relevant, accurate and reproducible multivariable biomarkers need to be investigated to further advance best practices for treating men with UI.

Conventional, TT-based definitions of male hypogonadism in the setting of UI need to be clarified. Clinically relevant, accurate and reproducible multivariable biomarkers need to be investigated to further advance best practices for treating men with UI.

Data on the prevalence of lower urinary tract symptoms (LUTS) and urinary incontinence (UI) in Canada are dated. This study aims to describe the current prevalence of LUTS and UI, to assess the state of knowledge of these conditions, the treatment for them and the treatment experience of symptomatic persons.

A nationally representative adult (= 18 years) sample was surveyed using a questionnaire based on the EPIC study. The margin of error associated with this probability-based sample was +/-3.1%, 19 times out of 20.

Of the 1000 people contacted, (52% female, 48% male), 78.4% were either aware or vaguely aware of the term ‘incontinence’. A total of 43.7% of respondents felt that UI was a serious problem that could easily ruin quality of life. When asked, 93.7% of respondents felt that people with UI should seek medical advice, but only 41.4% (27.4% men, 54.3% women) knew what help was available. Of 23.7% of the sample with UI, 145 (61.2%) experienced leakage a few times a month or more frequently and 23.7% had UI for > 11 years. A total of 48.8% of people with UI had initiated a discussion with their healthcare provider about their urinary symptoms, 52.4% within the last year.

The current distribution of UI in Canada is similar to that found in 2004. There remains a lack of awareness of the available treatments despite an acknowledgement that UI is an important medical condition. Few people had actively engaged with treatments. Men remain less aware and less likely to seek help than women.

The current distribution of UI in Canada is similar to that found in 2004. There remains a lack of awareness of the available treatments despite an acknowledgement that UI is an important medical condition. Few people had actively engaged with treatments. Men remain less aware and less likely to seek help than women.

We sought to investigate whether starting clean intermittent catheterization (CIC) for multiple sclerosis (MS) patients with lower urinary tract symptoms (LUTS) and elevated post-void residual (PVR) would improve urinary quality of life (QoL) and decrease risk of urinary tract infection (UTI).

We retrospectively reviewed an institutional data base for MS patients with PVR > 100 mL and obstructive LUTS. Patients were categorized by subsequent choice of treatment CIC versus medical treatment. Outcomes compared over 1-year follow up included incidence of UTI, urinary QoL, emergency room visits, and adherence to therapy.

Between 2014 and 2017, 37 patients met inclusion criteria. Nineteen patients started daily CIC, while 18 patients had pharmacologic therapy. At 1-year follow up, the CIC group had less improvement in urinary symptoms (26% improvement from baseline versus 72%, p = 0.02) and 7 times greater odds of having minimum one UTI within 1 year (OR 6.8, p = 0.01). The CIC group was also more likely to start an additional treatment for LUTS, and to visit the ED (all p < 0.05).

In this group of MS patients with LUTS and elevated PVR, initiation of CIC was associated with increased incidence of UTI and less improvement in urinary symptoms over the subsequent year compared to pharmacologic treatment.

In this group of MS patients with LUTS and elevated PVR, initiation of CIC was associated with increased incidence of UTI and less improvement in urinary symptoms over the subsequent year compared to pharmacologic treatment.

Renal mass biopsy (RMB) may not be indicated when the results are unlikely to impact management, such as in young and/or healthy patients and in elderly and/or frail patients. We analyzed the utility of RMB in three patient cohorts stratified by age-adjusted Charlson comorbidity index score (ACCI).

We identified patients with cT1a renal tumors in the National Cancer Database from 2004-2014. We combined age and Charlson-Deyo scores to identify young and/or healthy patients (‘healthy-ACCI’), elderly and/or frail patients (‘frail-ACCI’), and a reference cohort. We performed multivariable logistic regression to identify predictors of RMB and treatment. We evaluated the impact of RMB on management by analyzing the proportion of high-grade disease on final pathology as a surrogate for risk stratification.

We identified 36,720 healthy-ACCI, 2,516 frail-ACCI, and 18,989 reference-ACCI patients. Healthy-ACCI patients were less likely to undergo RMB (7.5% versus 10.8%; p < 0.001) while frail-ACCI patients underwent RMB at similar rates (11.