PDF(Pubmed)
Abstract：
OBJECTIVE: This retrospective study aimed to evaluate the effectiveness of low-dose prednisone as a rescue therapy for patients with deteriorating semen parameters following vasovasostomy.
METHODS: Electronic medical records were queried at the University of Miami with documented CPT code 55400 (Bilateral Vasovasostomy) between January 2016 and April 2023. Records were then reviewed to identify patients who demonstrated ≥50% decrease in semen parameters, specifically sperm concentration, motility and total motile sperm count. Patients who were treated with 6 weeks of low-dose prednisone were identified, and baseline semen parameters and subsequent changes after prednisone therapy were assessed. A Mann-Whitney U Test was used to compare semen parameter changes before and after prednisone. Adverse effects associated with prednisone were monitored.
RESULTS: A total of 8 patients were identified with deteriorating semen parameters who were treated with 6 weeks of low-dose prednisone. Following prednisone therapy, all patients demonstrated improvements in total motile sperm count (TMSC), with a median improvement of 6 million. The median relative improvement in TMSC was 433%. Sperm concentration and motility also improved compared to post-operative baseline. No adverse effects were reported during the treatment period.
CONCLUSIONS: Low-dose prednisone therapy appears to be a safe and effective intervention for managing deteriorating semen parameters following VV. The observed improvements in TMSC suggest the potential of prednisone to rescue patients with delayed failure after VV. Further research with larger sample sizes is warranted to confirm the safety and efficacy of low-dose prednisone as a rescue therapy in this specific patient population. Optimizing VV outcomes is crucial in male infertility, and further exploration of steroid therapy and innovative biotechnologies is warranted.
METHODS: Electronic medical records were queried at the University of Miami with documented CPT code 55400 (Bilateral Vasovasostomy) between January 2016 and April 2023. Records were then reviewed to identify patients who demonstrated ≥50% decrease in semen parameters, specifically sperm concentration, motility and total motile sperm count. Patients who were treated with 6 weeks of low-dose prednisone were identified, and baseline semen parameters and subsequent changes after prednisone therapy were assessed. A Mann-Whitney U Test was used to compare semen parameter changes before and after prednisone. Adverse effects associated with prednisone were monitored.
RESULTS: A total of 8 patients were identified with deteriorating semen parameters who were treated with 6 weeks of low-dose prednisone. Following prednisone therapy, all patients demonstrated improvements in total motile sperm count (TMSC), with a median improvement of 6 million. The median relative improvement in TMSC was 433%. Sperm concentration and motility also improved compared to post-operative baseline. No adverse effects were reported during the treatment period.
CONCLUSIONS: Low-dose prednisone therapy appears to be a safe and effective intervention for managing deteriorating semen parameters following VV. The observed improvements in TMSC suggest the potential of prednisone to rescue patients with delayed failure after VV. Further research with larger sample sizes is warranted to confirm the safety and efficacy of low-dose prednisone as a rescue therapy in this specific patient population. Optimizing VV outcomes is crucial in male infertility, and further exploration of steroid therapy and innovative biotechnologies is warranted.
摘要：
目的：这项回顾性研究旨在评估低剂量泼尼松作为抢救治疗血管血管造口术后精液参数恶化患者的有效性。
方法：在2016年1月至2023年4月期间，在迈阿密大学查询电子病历，记录CPT代码为55400（双侧血管血管造口术）。然后对记录进行审查，以确定精液参数下降≥50％的患者，特别是精子浓度，运动性和活动精子总数。确定接受6周低剂量泼尼松治疗的患者，和基线精液参数以及泼尼松治疗后的后续变化进行评估.使用Mann-WhitneyU检验比较泼尼松前后精液参数的变化。监测与泼尼松相关的不良反应。
结果：共有8例精液参数恶化的患者接受了6周的低剂量泼尼松治疗。泼尼松治疗后，所有患者均表现出活动精子总数（TMSC）的改善，中位数改善600万。TMSC的中位数相对改善为433%。与术后基线相比，精子浓度和运动性也有所改善。在治疗期间未报告不良反应。
结论：低剂量泼尼松治疗似乎是治疗VV后精液参数恶化的安全有效的干预措施。观察到的TMSC改善表明泼尼松有可能挽救VV后延迟衰竭的患者。有必要进行更大样本量的进一步研究，以确认低剂量泼尼松作为该特定患者人群的抢救治疗的安全性和有效性。优化VV结果对男性不育至关重要，并进一步探索类固醇治疗和创新的生物技术是必要的。
方法：在2016年1月至2023年4月期间，在迈阿密大学查询电子病历，记录CPT代码为55400（双侧血管血管造口术）。然后对记录进行审查，以确定精液参数下降≥50％的患者，特别是精子浓度，运动性和活动精子总数。确定接受6周低剂量泼尼松治疗的患者，和基线精液参数以及泼尼松治疗后的后续变化进行评估.使用Mann-WhitneyU检验比较泼尼松前后精液参数的变化。监测与泼尼松相关的不良反应。
结果：共有8例精液参数恶化的患者接受了6周的低剂量泼尼松治疗。泼尼松治疗后，所有患者均表现出活动精子总数（TMSC）的改善，中位数改善600万。TMSC的中位数相对改善为433%。与术后基线相比，精子浓度和运动性也有所改善。在治疗期间未报告不良反应。
结论：低剂量泼尼松治疗似乎是治疗VV后精液参数恶化的安全有效的干预措施。观察到的TMSC改善表明泼尼松有可能挽救VV后延迟衰竭的患者。有必要进行更大样本量的进一步研究，以确认低剂量泼尼松作为该特定患者人群的抢救治疗的安全性和有效性。优化VV结果对男性不育至关重要，并进一步探索类固醇治疗和创新的生物技术是必要的。
