Андрология и генитальная хирургия. 2016; 17: 119-122
Оценка изменений параметров спермограммы и показателя ДНК-фрагментации сперматозоидов при приеме биокомплекса Нейродоз у пациентов с преждевременной эякуляцией
https://doi.org/10.17650/2070-9781-2016-17-2-119-122Аннотация
Введение. Встречаемость преждевременной эякуляции (ПЭ) среди мужчин репродуктивного возраста 24–45 лет составляет 23 % случаев. Основной медикаментозной линией лечения ПЭ являются антидепрессанты из группы селективных ингибиторов обратного захвата серотонина. Однако данный ряд препаратов обладает гаметотоксическим действием.
Цель работы – оценить эффективность биокомплекса Нейродоз, его влияние на параметры спермограммы и целостность структуры ДНК сперматозоидов у пациентов с ПЭ.
Материалы и методы. Было обследовано 16 пациентов с ПЭ и нормозооспермией в возрасте 26–35 лет. Исследование эякулята и оценку процента фрагментации ДНК сперматозоидов методом Halosperm (Halotech®) выполняли до и после терапии. Продолжительность лечения – 2 мес. Оценку эффективности терапии проводили по длительности полового акта, а также по визуальной аналоговой шкале и анкете диагностики ПЭ.
Результаты. Через 8 нед терапии биокомплексом Нейродоз было отмечено уменьшение объема эякулята с 3,6 ± 1,1 до 3,2 ± 1,1 мл (p = 0,312) и увеличение концентрации сперматозоидов с (34,2 ± 9,8) × 106 до (35,6 ± 9,7) × 106 (p = 0,688). Подвижность сперматозоидов (категории а + b) повысилась с 36,6 ± 4,3 до 37,2 ± 4,5 % (p = 0,703), доля морфологически нормальных форм сперматозоидов – с 14,6 ± 1,4 до 14,8 ± 1,1 % (p = 0,656). Фрагментация ДНК сперматозоидов снизилась с 15,6 ± 2,7 до 15,4 ± 2,7 % (p = 0,635). Продолжительность интравагинальной латенции увеличилась с 101,8 ± 34,4 (45–150) до 217,3 ± 28,9 (190–280) с (p < 0,001). Балл по анкете диагностики ПЭ уменьшился с 13,9 ± 3,0 (9–20) до 4,4 ± 1,9 (0–7) (p < 0,001). По данным визуальной аналоговой шкалы симптоматика улучшилась с 7,3 ± 1,7 (5–10) балла до 2,6 ± 1,2 (0–4) балла (p < 0,001).
Заключение. Нейродоз – эффективное и безопасное средство для коррекции ПЭ. С учетом отсутствия отрицательного влияния биокомплекса на сперматогенез у пациентов с нормозооспермией возможно его назначение мужчинам, планирующим зачатие ребенка. Требуются дальнейшие исследования для оценки воздействия препарата на параметры эякулята у субфертильных пациентов.
Список литературы
1. http: www.issm.info/education/clinicalguidelines.
2. Porst H., Montorsi F., Rosen R. C. et al. The Premature ejaculation prevalence and attitudes (PEPA) survey: prevalence, comorbidities, and professional help-seeking. Eur Urol 2007;51(3):816–24.
3. McMahon C.G., Althof S. E., Waldinger M. D. et al. An evidence-based definition of lifelong premature ejaculation: report of the International Society for Sexual Medicine (ISSM) ad hoc committee for the definition of premature ejaculation. J Sex Med 2008;5(7):1590–606.
4. Lotti F., Corona G., Rastrelli G. et al. Clinical correlates of erectile dysfunction and premature ejaculation in men with couple infertility. J Sex Med 2012;9(10):2698–707.
5. http://uroweb.org/guideline//European association of urology. Guidelines 2015.
6. http://uroweb.org/guideline//European association of urology. Guidelines 2016.
7. Derogatis L. R., Burnett A. L. The epidemiology of sexual dysfunctions. J Sex Med 2008;5(2):289–300.
8. Spira A., Bajos N., Giami A., Michaels S. Cross-national comparisons of sexual behavior surveysmethodological difficulties and lessons for prevention. Am J Public Health 1998;88(5):730–1.
9. Whitaker-Azmitia P. M. The discovery of serotonin and its role in neuroscience. Neuropsychopharmacology 1999;21(2): 2S–8S.
10. Peroutka S. J., Snyder S. H. Multiple serotonin receptors: differential binding of [3H] 5-hydroxytryptamine, [3H] lysergic acid diethylamide and [3H] spiroperidol. Mol Pharmacol 1979;16(3):687–99.
11. Ahlenius S., Svensson L., Hjorth S. et al. Effects of a new type of 5-HT receptor agonist on male rat sexual behavior. Pharmacol Biochem Behav 1981;15(5):785–92.
12. Виноградов И. В., Коршунов М. Н., Коршунова Е. С. Задержанная эякуляция – редкий диагноз. Экспериментальная и клиническая урология 2014;(1):55–9. [Vinogradov I. V., Korshunov M. N., Korshunova E. S. Delayed ejaculation is a rare diagnosis. Eksperimental’naya i klinicheskaya urologiya = Experimental and Clinical Urology 2014; (1):55–9. (In Russ.)].
13. Jiménez-Trejo F., Tapia-Rodríguez M., Queiroz D. B. Serotonin concentration, synthesis, cell origin, and targets in the rat caput epididymis during sexual maturation and variations associated with adult mating status: morphological and biochemical studies. J Androl 2007;28(1):136–49.
14. Jiménez-Trejo F., Tapia-Rodríguez M., Cerbón M. Evidence of 5-HT components in human sperm: implications for protein tyrosine phosphorylation and the physiology of motility. Reproduction 2012;144(6):677–85.
15. Syed V., Gomez E., Hecht N. Messenger ribonucleic acids encoding a serotonin receptor and a novel gene are induced in Sertoli cells by a secreted factor(s) from male rat meiotic germ cells. Endocrinology 1999;140(12):5754–60.
16. Maier U., Koinig F. Andrological findings in young patients under long-term antidepressive therapy with clomipramine. Neuropsychopharmacology 1994;116(3):357–9.
17. Tanrikut C., Feldman A. S., Altemus M. Adverse effect of paroxetine on sperm. Fertil Steril 2010;94(3):1021–6.
18. Korshunov M., Vinogradov I., Gabliya M. et al. The influence of the selective serotonin re-uptake inhibitors on spermatogenesis in fertile men with depression. https//uroweb.org/urosource/abstract/3dc6b537.
19. Коршунов М. Н., Коршунова Е. С., Штыря Ю. А., Виноградов И. В. Влияние селективных ингибиторов обратного захвата серотонина на сперматогенез. Экспериментальная и клиническая урология 2015;(4):67–9. [Korshunov M. N., Korshunova E. S., Shtyrya Yu. A., Vinogradov I. V. Effect of selective serotonin re-uptake inhibitors on spermatogenesis. Eksperimental’naya i klinicheskaya urologiya = Experimental and Clinical Urology 2015; (4):67–9. (In Russ.)].
Andrology and Genital Surgery. 2016; 17: 119-122
Estimation of changes in spermogram and index of sperm DNA fragmentation in patients with premature ejaculation receiving Neurodoz biocomplex
https://doi.org/10.17650/2070-9781-2016-17-2-119-122Abstract
Background. An incidence of premature ejaculation (PE) in men of reproductive age of 24–45 years is 23 %. The treatment of PE is based on antidepressants from the group of selective serotonin re-uptake inhibitors. However, drugs of this group have gametotoxic action.
Objective. Evaluate the effectiveness of Neurodoz biocomplex, its effect on the parameters of spermogram and sperm DNA integrity in patients with PE.
Materials and methods. The study involved 16 patients with PE and normozoospermia aged from 26 to 35 years. Ejaculate and sperm DNA fragmentation were assessed by Halosperm (Halotech®) method before and after the therapy. Duration of treatment was 2 months. Evaluation of efficacy was based on the duration of sexual intercourse, as well as on the visual analogue scale and the questionnaire data of patients with premature ejaculation.
Results. In 8 weeks there was a decrease in ejaculate volume from to 3.6 ± 1.1 down to 3.2 ± 1.1 mL (p = 0.312) and an increase in the concentration of sperm (34.2 ± 9.8) × 106 up to (35.6 ± 9.7) × 106 (p = 0.688). Sperm motility (category a + b) increased from 36.6 ± 4.3 to 37.2 ± 4.5 % (p = 0.703), the percentage of morphologically normal forms increased from 14.6 ± 1.4 up to 14.8 ± 1.1 (p = 0.656). DNA fragmentation of sperm has decreased from 15.6 ± 2.7 down to 15.4 ± 2.7 % (p = 0.635). Duration of intravaginal latency increased from 101.8 ± 34.4 (45–150) up to 217.3 ± 28.9 (190–280) sec (p < 0.001). An overall score according to the premature ejaculation questionnaire decreased from 13.9 ± 3.0 (9–20) down to 4.4 ± 1.9 (0–7) (p < 0.001). Visual analogue scale symptoms improved from 7.3 ± 1.7 (5–10) to 2.6 ± 1.2 (0–4) (p < 0.001).
Conclusion. Neurodoz is an effective and safe agent for PE correction. Giving an absence of negative impact of biocomplex on spermatogenesis in patients with normozoospermia, it is possible to administer it to men who are trying to conceive. Further study is necessary in order to assess an impact of the drug on semen parameters in subfertile patients
References
1. http: www.issm.info/education/clinicalguidelines.
2. Porst H., Montorsi F., Rosen R. C. et al. The Premature ejaculation prevalence and attitudes (PEPA) survey: prevalence, comorbidities, and professional help-seeking. Eur Urol 2007;51(3):816–24.
3. McMahon C.G., Althof S. E., Waldinger M. D. et al. An evidence-based definition of lifelong premature ejaculation: report of the International Society for Sexual Medicine (ISSM) ad hoc committee for the definition of premature ejaculation. J Sex Med 2008;5(7):1590–606.
4. Lotti F., Corona G., Rastrelli G. et al. Clinical correlates of erectile dysfunction and premature ejaculation in men with couple infertility. J Sex Med 2012;9(10):2698–707.
5. http://uroweb.org/guideline//European association of urology. Guidelines 2015.
6. http://uroweb.org/guideline//European association of urology. Guidelines 2016.
7. Derogatis L. R., Burnett A. L. The epidemiology of sexual dysfunctions. J Sex Med 2008;5(2):289–300.
8. Spira A., Bajos N., Giami A., Michaels S. Cross-national comparisons of sexual behavior surveysmethodological difficulties and lessons for prevention. Am J Public Health 1998;88(5):730–1.
9. Whitaker-Azmitia P. M. The discovery of serotonin and its role in neuroscience. Neuropsychopharmacology 1999;21(2): 2S–8S.
10. Peroutka S. J., Snyder S. H. Multiple serotonin receptors: differential binding of [3H] 5-hydroxytryptamine, [3H] lysergic acid diethylamide and [3H] spiroperidol. Mol Pharmacol 1979;16(3):687–99.
11. Ahlenius S., Svensson L., Hjorth S. et al. Effects of a new type of 5-HT receptor agonist on male rat sexual behavior. Pharmacol Biochem Behav 1981;15(5):785–92.
12. Vinogradov I. V., Korshunov M. N., Korshunova E. S. Zaderzhannaya eyakulyatsiya – redkii diagnoz. Eksperimental'naya i klinicheskaya urologiya 2014;(1):55–9. [Vinogradov I. V., Korshunov M. N., Korshunova E. S. Delayed ejaculation is a rare diagnosis. Eksperimental’naya i klinicheskaya urologiya = Experimental and Clinical Urology 2014; (1):55–9. (In Russ.)].
13. Jiménez-Trejo F., Tapia-Rodríguez M., Queiroz D. B. Serotonin concentration, synthesis, cell origin, and targets in the rat caput epididymis during sexual maturation and variations associated with adult mating status: morphological and biochemical studies. J Androl 2007;28(1):136–49.
14. Jiménez-Trejo F., Tapia-Rodríguez M., Cerbón M. Evidence of 5-HT components in human sperm: implications for protein tyrosine phosphorylation and the physiology of motility. Reproduction 2012;144(6):677–85.
15. Syed V., Gomez E., Hecht N. Messenger ribonucleic acids encoding a serotonin receptor and a novel gene are induced in Sertoli cells by a secreted factor(s) from male rat meiotic germ cells. Endocrinology 1999;140(12):5754–60.
16. Maier U., Koinig F. Andrological findings in young patients under long-term antidepressive therapy with clomipramine. Neuropsychopharmacology 1994;116(3):357–9.
17. Tanrikut C., Feldman A. S., Altemus M. Adverse effect of paroxetine on sperm. Fertil Steril 2010;94(3):1021–6.
18. Korshunov M., Vinogradov I., Gabliya M. et al. The influence of the selective serotonin re-uptake inhibitors on spermatogenesis in fertile men with depression. https//uroweb.org/urosource/abstract/3dc6b537.
19. Korshunov M. N., Korshunova E. S., Shtyrya Yu. A., Vinogradov I. V. Vliyanie selektivnykh ingibitorov obratnogo zakhvata serotonina na spermatogenez. Eksperimental'naya i klinicheskaya urologiya 2015;(4):67–9. [Korshunov M. N., Korshunova E. S., Shtyrya Yu. A., Vinogradov I. V. Effect of selective serotonin re-uptake inhibitors on spermatogenesis. Eksperimental’naya i klinicheskaya urologiya = Experimental and Clinical Urology 2015; (4):67–9. (In Russ.)].
