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All three treatments were equally effective in restoring testosterone levels. Single-agent CC is simple, cheap and may be used as treatment for hypogonadism when maintenance of fertility is desired. This approach seems to be as effective as either hCG alone or a combination of hCG and CC.

Prostate cancer is the third most common diagnosed malignancy. It is a heterogeneous disease with incidence rates that vary substantially across the world, from 6.3 to 83.4 per 100,000 people. Age-standardized incidence rates are the highest in Northern Europe and lowest in South Central Asia. Men of African origin are more prone to the disease compared with other ethnicities. Mortality rates differ significantly from incidence rates, with the highest figures in the Caribbean, Sub-Saharan Africa and Micronesia/Polynesia. This chapter provides an overview of the global trends in epidemiology of prostate cancer. Incidence and mortality rates in the Americas, Africa, Europe, Asia, and Oceania are presented.

A high percentage of men are satisfied after penile implant surgery. Only the presence of a major complication is linked to a lower likelihood of achieving high satisfaction. Habous M, Tal R, Tealab A, et al. Predictors of Satisfaction in Men After Penile Implant Surgery. J Sex Med 2018;15:1180-1186.

BackgroundThe inflatable penile prosthesis (IPP) is typically the preferred implant for Peyronie’s disease (PD) and malleable penile prostheses (MPPs) have been discouraged.AimsTo evaluate the effectiveness and patient satisfaction of the MPP vs IPP in patients with PD.MethodsMen with PD and erectile dysfunction who elected for penile implant surgery constituted the study population. Preoperatively, demographic and comorbidity parameters were recorded. Curvature was measured with a goniometer at maximum rigidity after intracavernosal injection of a vasoactive agent. Postoperatively, overall satisfaction was measured at 3, 6, 12, and 24 months on 5-point Likert scale from 1 (dissatisfied) to 5 (very satisfied).Results166 men with a mean age of 59 ± 10 years were analyzed. The mean preoperative curvature in the entire cohort was 65° (range = 30–130°). 94% of patients with MPP had total resolution of their curvature at the end of the operation, whereas 8 patients (6%) had residual curvature (25–40°). In the IPP group 25 of 30 (83.3%) had a straight penis at the end of surgery, whereas 5 of 30 (16.7%) had residual curvature, with the mean magnitude being 33° in the MPP group and 30° in the IPP group. 86% of all patients had diabetes. There were no differences between the 2 implant groups in age, hemoglobin A1c, body mass index, or smoking status. The mean patient satisfaction was 4.42 ± 0.70 (range = 2–5) and there was no difference between the 2 groups. The mean follow-up period was 23.4 months (range = 6–29 months).ConclusionWe found that the MPP is as effective as the IPP in curvature correction in patients with PD, with similar patient satisfaction for the 2 groups.Habous M, Farag M, Tealab A, et al. Malleable Penile Implant Is an Effective Therapeutic Option in Men With Peyronie’s Disease and Erectile Dysfunction. Sex Med 2018;6:24–29.

Background: To assess multiparametric magnetic resonance imaging (mpMRI) characteristics in prostate cancer (PCa) before and after irreversible electroporation (IRE) and to investigate their correlation with the presence of post-operative recurrence of PCa. Methods: MpMRI was performed in 30 men with PCa prior to treatment, after 10 days and at 6 months. An additional scan at 1 year was available for 18 men. Two radiologists assessed retrospectively the following parameters by planimetry: tumour volume, necrotic volume (early posttreatment scan) and residual fibrosis. Residual tumour/recurrence were defined as a suspicious area within the treatment field scored  4 on a 1to-5 scale. Oncological outcome was also assessed. Results: The median follow-up of the entire study was 16 months. Six men were undertreated and showed mpMRI recurrence after 6 months. At 1-year, three additional men had recurrence. Overall, four of these 9 men (44%) were retreated. The other five men did not receive any further treatment. Median time to re-treatment was 15 months. Median pretreatment lesion volume was 0.65cc, 0.66cc and 0.43cc on the different mpMRI sequences (T2, DWI and DCE). Median necrotic volume was 10.77cc. Median overall residual fibrosis volume were 0.84cc and 0.95cc at 6-month and 1-year mpMRI. Pre-treatment, necrotic and residual fibrosis volumes were significantly different (p <0.

Although primary germ cell tumors may be of retroperitoneal origin, the likelihood of metastasis from a testicular primary origin should always be carefully considered in order to avoid misdiagnosis and to apply the best treatment schedule for the patients. Therefore, a testicular ultrasonography is mandatory in patients presenting CT findings of retroperitoneal adenopathy, even if patients are completely asymptomatic and their physical examination appears normal.